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"Alcohol Withdrawal"

Soumitra Sen, Philip Grgurich, Amanda Tulolo, Andrew Smith-Freedman, Yuxiu Lei, Anthony Gray, James Dargin
BACKGROUND: There are limited data on the efficacy of symptom-triggered therapy for alcohol withdrawal syndrome (AWS) in the intensive care unit (ICU). OBJECTIVE: To evaluate the safety and efficacy of a symptom-triggered benzodiazepine protocol utilizing Riker Sedation Agitation Scale (SAS) scoring for the treatment of AWS in the ICU. METHODS: We performed a before-and-after study in a medical ICU. A protocol incorporating SAS scoring and symptom-triggered benzodiazepine dosing was implemented in place of a protocol that utilized the Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar) scale and fixed benzodiazepine dosing...
October 12, 2016: Annals of Pharmacotherapy
Srinivasa P Kommajosyula, Marcus E Randall, Srinivasan Tupal, Carl L Faingold
Patients with epilepsy are at risk of sudden unexpected death in epilepsy (SUDEP). The most common series of events in witnessed cases of SUDEP is a generalized convulsive seizure followed by terminal apnea. Risk factors for SUDEP include prolonged postictal depression (PID), as well as alcohol abuse. The present study examined these issues in a genetic epilepsy model that exhibits generalized convulsive audiogenic seizures (AGSz) but rarely exhibits seizure-induced death, the genetically epilepsy-prone rats (GEPR-9s)...
October 7, 2016: Epilepsy & Behavior: E&B
Luli R Akinfiresoye, Clive Miranda, David M Lovinger, Prosper N'Gouemo
BACKGROUND: Cyclic AMP-dependent protein kinase A (PKA) signaling is a key target for the action of alcohol and may therefore play a role in the pathophysiology of alcohol withdrawal seizures (AWSs). Here, we investigated the role of PKA activity with respect to increased seizure susceptibility in rats that were subjected to alcohol withdrawal. METHODS: Adult male Sprague Dawley rats received 3 daily doses of ethanol (EtOH) (or vehicle) for 4 consecutive days. Rats were then tested for susceptibility to acoustically evoked AWSs 3, 24, and 48 hours after the last alcohol dose...
September 26, 2016: Alcoholism, Clinical and Experimental Research
Kathryn M Harper, Darin J Knapp, Meredith A Park, George R Breese
RATIONALE: Behavioral and neuroimmune vulnerability to withdrawal from chronic alcohol varies with age. The relation of anxiety-like behavior to amygdalar CCL2 responses following stress after withdrawal from chronic intermittent alcohol (CIA) was investigated in adolescent and adult rats. METHODS: Adolescent and adult Wistar rats were exposed to CIA (three 5-day blocks of dietary alcohol separated by 2 days of withdrawal) at concentrations that created similar blood alcohol levels across age...
September 24, 2016: Psychopharmacology
Manoel Jorge Nobre
Exposure to stress and prolonged exposure to alcohol leads to neuronal damages in several brain regions, being the medial prefrontal cortex (mPFC) one of the most affected. These changes presumably reduce the ability of the organism to cope with these stimuli and may underlie a series of maladaptive behaviours among which include drug addiction and withdrawal. Drug-addicted individuals show a pattern of behavior similar to patients with lesions of the mPFC. This impairment in the decision-making could be one of the mechanisms responsible for the transition from the casual to compulsive drug use...
September 9, 2016: International Journal of Developmental Neuroscience
Abdul S Mohammed, Prajwal Boddu, Dina F Yazdani
Central pontine myelinolysis (CPM), a potentially fatal and debilitating neurological condition, was first described in 1959 in a study on alcoholic and malnourished patients. It is a condition most frequently related to rapid correction of hyponatremia. Chronic alcoholism associated CPM tends to be benign with a favorable prognosis compared to CPM secondary to rapid correction of hyponatremia. We describe a normonatremic, alcoholic patient who presented with CPM after a rapid rise in his sodium levels. Our case illustrates the fact that CPM can manifest even in patients who are normonatremic at baseline...
2016: Case Reports in Medicine
Michel Maitre, Christian Klein, Ayikoe G Mensah-Nyagan
Gamma-hydroxybutyrate (GHB or Xyrem(R)) is frequently used in humans for several clinical indications, including anesthesia, narcolepsy/cataplexy, and alcohol-withdrawal symptoms. Pharmacological effects induced in the brain by therapeutic doses of Xyrem(R) are generally GABAergic-dependent. These effects allow sedation, stress/anxiety reduction, deep sleep induction, decrease of neuroinflammation, and neuroprotection. Furthermore, Xyrem(R) promotes the expression of pivotal genes reducing toxic proteinopathies, as demonstrated in laboratory animal models...
2016: Alzheimer's Research & Therapy
S Jesse, G Bråthen, M Ferrara, M Keindl, E Ben-Menachem, R Tanasescu, E Brodtkorb, M Hillbom, M A Leone, A C Ludolph
The alcohol withdrawal syndrome is a well-known condition occurring after intentional or unintentional abrupt cessation of heavy/constant drinking in patients suffering from alcohol use disorders (AUDs). AUDs are common in neurological departments with patients admitted for coma, epileptic seizures, dementia, polyneuropathy, and gait disturbances. Nonetheless, diagnosis and treatment are often delayed until dramatic symptoms occur. The purpose of this review is to increase the awareness of the early clinical manifestations of AWS and the appropriate identification and management of this important condition in a neurological setting...
September 1, 2016: Acta Neurologica Scandinavica
Philippe Nubukpo, Murielle Girard, Jean-Marie Sengelen, Sophie Bonnefond, Aurélien Varnoux, Benoît Marin, Dominique Malauzat
BACKGROUND: The objective of this study was to describe the profile and alcoholic status of a population with alcohol use disorders (AUD) requesting help from a psychiatric hospital to stop drinking, as well as their clinical outcome and care consumption over the 2 years following the request. METHODS: The visits were conducted at baseline (M0) and at 6, 12, 18 and 24 months (M6, M12, M18, M24). Demographic, clinical and psychometric data [Beck Depression Inventory (BDI), AUDIT questionnaire, Global Assessment of Functioning (GAF) scale], and information regarding the use of psychiatric care and therapeutics were collected...
2016: Annals of General Psychiatry
Doungkamol Alongkronrusmee, Terrance Chiang, Richard M van Rijn
BACKGROUND: As a legal drug, alcohol is commonly abused and it is estimated that 17 million adults in the United States suffer from alcohol use disorder. Heavy alcoholics can experience withdrawal symptoms including anxiety and mechanical allodynia that can facilitate relapse. The molecular mechanisms underlying this phenomenon are not well understood, which stifles development of new therapeutics. Here we investigate whether delta opioid receptors (DORs) play an active role in alcohol withdrawal-induced mechanical allodynia (AWiMA) and if DOR agonists may provide analgesic relief from AWiMA...
October 1, 2016: Drug and Alcohol Dependence
G Gerresheim, J Brederlau, U Schwemmer
No abstract text is available yet for this article.
August 23, 2016: Der Anaesthesist
Elena Gianni, Paolo Forte, Valentina Galli, Giulia Razzolini, Gabriele Bardazzi, Vito Annese
AIMS: Fibroscan(®) is a non-invasive method to evaluate liver stiffness (LS), however, its accuracy in alcohol-related liver diseases (ALD) especially with respect to active or stopped alcohol drinking is largely unknown. We prospectively evaluated the LS changes in patients with ALD following alcohol withdrawal. METHODS: Sixty-four patients were evaluated by FibroScan(®) and lab tests at baseline and after 4 weeks of abstinence. RESULTS: At baseline, 21 patients (33%) had an abnormal LS (> 7 kPa) and 32 patients (50%) had abnormal liver function tests...
August 19, 2016: Alcohol and Alcoholism: International Journal of the Medical Council on Alcoholism
Mickael Vourc'h, Fanny Feuillet, Pierre-Joachim Mahe, Véronique Sebille, Karim Asehnoune
BACKGROUND: Alcohol is the leading psychoactive substance consumed in France, with about 15 million regular consumers. The National institute on Alcohol Abuse and Alcoholism (NIAAA) considers alcohol abuse to be more than 14 units of alcohol a week for men and 7 units for women. The specific complication of alcoholism is the alcohol withdrawal syndrome. Its incidence reaches up to 30 % and its main complications are delirium tremens, restlessness, extended hospital stay, higher morbidity, and psychiatric and cognitive impairment...
August 19, 2016: Trials
Bin Qiu, Susan E Luczak, Tamara L Wall, Aaron M Kirchhoff, Yuxue Xu, Mimy Y Eng, Robert B Stewart, Weinian Shou, Stephen L Boehm, Julia A Chester, Weidong Yong, Tiebing Liang
FKBP5 encodes FK506-binding protein 5, a glucocorticoid receptor (GR)-binding protein implicated in various psychiatric disorders and alcohol withdrawal severity. The purpose of this study is to characterize alcohol preference and related phenotypes in Fkbp5 knockout (KO) mice and to examine the role of FKBP5 in human alcohol consumption. The following experiments were performed to characterize Fkpb5 KO mice. (1) Fkbp5 KO and wild-type (WT) EtOH consumption was tested using a two-bottle choice paradigm; (2) The EtOH elimination rate was measured after intraperitoneal (IP) injection of 2...
2016: International Journal of Molecular Sciences
Victoria Eads, Gregory Maruzzella
The physiologic risk is great for patients undergoing alcohol withdrawal without appropriate medication apd monitoring support. An interprofessional team adapted several alcohol withdrawal protocols for this project using evidence-based practice principles.
May 2016: Medsurg Nursing: Official Journal of the Academy of Medical-Surgical Nurses
Abdul Maruf Asif Aziz, Shaun Brothers, Gregory Sartor, Lovisa Holm, Markus Heilig, Claes Wahlestedt, Annika Thorsell
RATIONALE: Alcoholism is a complex disorder in which diverse pathophysiological processes contribute to initiation and progression, resulting in a high degree of heterogeneity among patients. Few pharmacotherapies are presently available, and patient responses to these are variable. The nociceptin/orphanin FQ (NOP) receptor has been suggested to play a role both in alcohol reward and in negatively reinforced alcohol seeking. Previous studies have shown that NOP-receptor activation reduces alcohol intake in genetically selected alcohol-preferring as well as alcohol-dependent rats...
October 2016: Psychopharmacology
Annemarie Heberlein, Bernd Lenz, Birgitt Opfermann, Michael Gröschl, Eva Janke, Katrin Stange, Adrian Groh, Johannes Kornhuber, Helge Frieling, Stefan Bleich, Thomas Hillemacher
Preclinical and clinical studies show associations between testosterone and brain-derived neurotrophic growth factor (BDNF) serum levels. BDNF and testosterone have been independently reported to influence alcohol consumption. Therefore, we aimed to investigate a possible interplay of testosterone and BDNF contributing to alcohol dependence. Regarding possible interplay of testosterone and BDNF and the activity of the hypothalamic pituitary axis (HPA), we included cortisol serum levels in our research. We investigated testosterone and BDNF serum levels in a sample of 99 male alcohol-dependent patients during alcohol withdrawal (day 1, 7, and 14) and compared them to a healthy male control group (n = 17)...
August 2016: Alcohol
Gian D Greenberg, Tamara J Phillips, John C Crabbe
Nest building has been used to assess thermoregulatory behavior and positive motivational states in mice. There are known genetic influences on ethanol withdrawal severity as well as individual/thermoregulatory nest building. Withdrawal Seizure-Prone (WSP-1, WSP-2) and Withdrawal Seizure-Resistant (WSR-1, WSR-2) mice were selectively bred for high vs low handling-induced convulsion (HIC) severity, respectively, during withdrawal from chronic ethanol vapor inhalation. They also differ in HIC severity during withdrawal from an acute, 4g/kg ethanol injection...
October 15, 2016: Physiology & Behavior
Patrycja Kleczkowska, Irena Smaga, Małgorzata Filip, Magdalena Bujalska-Zadrozny
Cannabinoids are still classified as illegal psychoactive drugs despite their broad and increasingly acknowledged therapeutic potential. These substances are most famous for their wide recreational use, particularly among young adults to either alter the state of consciousness, intensify pleasure induced by other psychoactive substances or as an alternative to the previously abused drugs. It is important to emphasize that cannabinoids are often taken together with a variety of medications intended for the treatment of alcohol use disorder (AUD) or alcohol withdrawal syndrome (AWS)...
November 2016: Neurotoxicity Research
Volker Nüstedt
Most of the patients addicted to alcohol are socially well integrated. The offer of a low threshold ambulant withdrawal therapy opens an opportunity to build a sustainable therapeutic relationship. The so started empathic addiction therapy will be well accepted and will lead to a satisfying outcome. Using Clomethiazole or Oxazepam in a daily reduced dose and with daily personal contacts, the ambulant withdrawal in patients without seizures or delir in medical history is a secure and successful therapeutic option...
July 2016: Deutsche Medizinische Wochenschrift
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