Critical Review of Alcohol, Alcoholism and the Withdrawal Symptoms I. Mechanisms of Addiction and Withdrawal Syndrome

Abstract

Alcoholic beverages are socially accepted around the world, consumed mostly to socialize, celebrate, and relax. The pleasant effects of alcohol are attributed to (i) an increase in GABAergic (inhibitory signals), OPergic and 5HTergic (euphoric effects) neuronal activities and (ii) a decrease in DAergic ('want' signal or craving), Gluergic (excitatory signals), NEergic (stress signals) neuronal, and the HPA axis (stress hormones) activities. If alcohol drinking continues, the receptors are sensitized, resulting in development of tolerance when alcohol drinking must be increased to achieve desired effects. In genetically/Environmentally predisposed subjects, chronic alcohol drinking results in the development of addiction, characterized by a condition when alcohol caseation results in rapid onset of withdrawal symptoms including, but not limited to, alcohol craving and moderate to severe discomfort. Because pharmacotherapy alone or in combination with behavioral approaches is only modestly effective in treating alcoholism symptoms, there is an urgent need to development effective and safe therapies. At present, a lack of clear understanding of the mechanisms underlying addiction hinders possible development of new treatment strategies. Therefore, the aim of this article is to discuss the mechanisms underlying (i) the euphoric, relaxing and adverse effects of alcohol drinking and (ii) addiction and the withdrawal symptoms.