From a medical point of view, a hangover or alcohol withdrawal syndrome is not painful Monday after roughly spent partying, but something much more serious. Alcohol withdrawal symptoms can be called pathological intoxication, which is found in the already established “full” alcoholic.
The content of the article
Alcohol withdrawal sindromalnah abstinence manifested a whole bunch of symptoms, including disorders of internal organs, nervous system and mental disorders. To fall into a state of withdrawal, it’s necessary being “blackout” drunk to dramatically cut all the contacts with alcohol, and sometimes just to reduce the dose. And the easiest, and at the same time a vicious way to deal with abstinence — alcohol intake, or speaking folk, “sober”, some “mixing” the severity of hangover agony.
Causes of alcohol withdrawal
Here I would like to not “chew” once again that excessive hangover leads to alcoholism, and Vice versa, and figure out what is a withdrawal syndrome at the cellular level. Warn that easy reading will not work. As you know, in the human brain, all mental processes are governed by the special substances — neurotransmitters that may have a stimulating and inhibiting effect. One of them is gamma-aminobutyric acid (GABA) — refers to the latter. There is an opinion (I am writing this because this recently this thesis has not yet elevated to the rank of axioms) that ethanol acts synergistically to GABA, “helping” her to sell their brake function, and therefore to reduce the excitability of the brain.
What happens after sudden withdrawal from alcohol? The nervous system is now a little that restrains, plus ethanol and even spur its stimulating effect of the excitation of the Central nervous system neurotransmitter glutamate.
Thus, sudden cessation of intake of alcohol leads to overstimulation of the brain, which is manifested typical withdrawal symptoms, which develops in a strict sequence. What? Read about it below.
The symptoms of alcohol withdrawal
Manifestations of alcohol withdrawal run in two directions: asthenic and affective.
Fatigue, fatigue, fear, the symptoms of alcohol abstinencecoitus (asthenia Greek. — weakness, powerlessness) disorders are manifested by irritability, rapid fatigue, reconcentrating attention, low performance, tachycardia, increased pressure, body temperature and perspiration, tremor of hands and tongue.
Affective (emotional) disorders presents with anxiety, various phobias, a desire to blame everyone and everything, suspicion, decline of mood, outbursts of aggressiveness, hysteroid manifestations.
The first withdrawal symptoms start to make itself felt in the presence of residues of alcohol in the blood. It all starts, usually with seizures, especially if newly abstinent is not the first time was in a drinking bout. However, it is not always necessary to link seizures with withdrawal symptoms. If alcohol was last used more than 2 days ago, you have to look for another possible cause of seizures (traumatic brain injury, etc.).
From other primary withdrawal symptoms include the disorder of nighttime sleep (shortened, full insomnia, nightmares). In more severe forms of withdrawal symptoms upon awakening or falling asleep may experience auditory and visual hallucinations. For example, the patient may seem that someone Testament by name.
Sometimes the initial symptoms are not so bright “performances” and appear just a little affective disorders. And in the end, the climax of the withdrawal syndrome — delirium tremens — occurs. Such a characteristic for mild forms of withdrawal.
For severe symptoms characteristic of epileptic seizure symptoms, exacerbation of chronic diseases and “crown” to all events — delirium tremens or delirium tremens. The condition for the emergence of the latter are prolonged periods of alcohol abuse, but, eventually, enough for her and small binges. The onset of delirium tremens happens in the first three days after alcohol withdrawal.
Signs of delirium tremens
- all the above-mentioned affective withdrawal symptoms, to which is added an unstable hyperactivity and excitement, worse in the evening and at night;
- strengthening of asthenic symptoms. Persistent fear, confusion, shakiness, muscle weakness;
- hallucinations. The weakening of the hallucinatory manifestations in the morning — “light window” and resume them in the evening. The patient can start chatting with illusory voices, with surprise, that apart from him they can not hear. Appear tactile hallucinations: phantom hair in my mouth, worms on the body surface. The common theme for visual hallucinations is Zoological: rats, cockroaches, snakes. Sometimes fictional characters: devils, monsters.
- delusional state (delusional beliefs physical destruction, persecution).
Mortality in delirium tremens (and it is 2 — 5%) largely due to the fact that often provoke hallucinations of the patient to make life-threatening (including to others) action: jump out the window, to escape, to hurt, to throw at people.
The more the patient’s tolerance withdrawal episodes, the worse the future prediction. The clinical picture with each time more exacerbated in the brain epileptic foci are formed, unbalances the work of the limbic structures of the brain.
Diagnosis of withdrawal syndrome
Symptoms of withdrawal expressive enough to make a diagnosis only on the basis of examination of the patient and collecting information about it. Sometimes, though, it is necessary to differentiate withdrawal symptoms from other pathological conditions: thyrotoxicosis, anticholinergic overdose (atropine, Tropicamide, trovent), the effect of cocaine and amphetamine, withdrawal of tranquilizers.
Treatment of alcohol withdrawal
Treatment alcoholyou abstinence Abstinence require immutable treatment, so as not to get even more serious disorders and not to aggravate already existing. Moderate withdrawal symptoms can be treated on an outpatient basis. Stationary conditions are required for “customers” with a heavy abstinence-colored delirium tremens, active convulsions and concomitant mental and somatic diseases.
The elements of the treatment of alcohol withdrawal — replenishment of fluids, normalization of electrolyte balance in blood plasma, the debug power mode.
The normal levels of electrolytes is solved by means of infusion therapy, which incidentally “sweeps” the toxins from the body. The composition of infusion solutions consistent with the goals of therapy: glucose and electrolytes (chloride, potassium and sodium).
For the prevention of seizures and delirium tremens use sedative therapy with benzodiazepines (Diazepam, Valium, Razepam, Tazepam, Lorazepam). Choose the drug is based on its “technical-tactical” (read: pharmacological) characteristics. If withdrawal due to duration of action and good tolerability above the rest listed the first two.
Alcoholism is always fraught with deficiency, so vitamin is also an important element of the relief of withdrawal. Therefore, higher doses of thiamine, pyridoxine, ascorbic, nicotinic and folic acids, and daily doses of all other vitamins prescribed mandatory.
To reduce excitation and prevent hallucinations can with care be administered neuroleptics (Haloperidol, Clozapine). Why the caution? Remember one of the withdrawal symptoms — seizures. And antipsychotics just increase seizure status of the patient.
If the patient nalichestvuya problems with the heart, to prevent heart attacks he prescribed beta-blockers (Inderal, Bisoprolol, Metoprolol).