Alcohol Withdrawal: Symptoms, Timeline, and Treatment

Ultimately, if you find alcohol is interfering with your health or your personal, financial, or professional life, then it’s time to consider quitting. For people who experience hallucinations as part of alcohol withdrawal, these may begin in the 12- to 24-hour time frame. Delirium tremens occurs in 2% of people with alcohol use disorder and less than 1% of the general population.

If you are dependent on alcohol, it’s important to participate in a medically-supervised detox program, which can help alleviate the risks of the situation. Previous seizure activity while in alcohol withdrawal indicates that, if the person relapses, they will then experience more severe withdrawal symptoms when they quit drinking again. Symptoms usually begin within 6–12 hours of the last drink and can last for a few days. Individuals experiencing severe symptoms may require immediate treatment at the hospital treatment to minimize the risk of potential complications. Excessive alcohol consumption may cause seizures, particularly alcohol withdrawal after heavy drinking.

Can Alcohol Trigger a Seizure?

People with alcohol withdrawal seizures may also experience tremors, hallucinations, muscle spasms, and a rapid heart rate. In some cases, medical help may be required to get through alcohol withdrawal. Antianxiety medications such as benzodiazepines are considered the gold standard. Symptoms outside of the anticipated withdrawal period or resumption of alcohol use also warrants referral to an addiction specialist or inpatient treatment program. This same study found that more than 81 percent of those who have alcoholic seizures were experiencing depression.

• The short-term effects of alcohol result from its actions on ligand-gated and voltage-gated ion channels (2–4).
• Prolonged alcohol consumption leads to the development of tolerance and physical dependence, which may result from compensatory functional changes in the same ion channels.
• Chronic ethanol exposure to GABA creates constant inhibition or depressant effects on the brain.
• Symptoms usually begin within 6–12 hours of the last drink and can last for a few days.

Ethanol is a central nervous system depressant that produces euphoria and behavioral excitation at low blood concentrations and acute intoxication (drowsiness, ataxia, slurred speech, stupor, and coma) at higher concentrations. The short-term effects of alcohol result from its actions on ligand-gated and voltage-gated ion channels (2–4). Prolonged alcohol consumption leads to the development of tolerance and physical dependence, which may result from compensatory functional changes in the same ion channels. Abrupt cessation of prolonged alcohol consumption unmasks these changes, leading to the alcohol withdrawal syndrome, which includes blackouts, tremors, muscular rigidity, delirium tremens, and seizures (5,6). Alcohol withdrawal seizures typically occur 6 to 48 hours after discontinuation of alcohol consumption and are usually generalized tonic–clonic seizures, although partial seizures also occur (7,8).

Minor withdrawal symptoms: 6–12 hours

If your doctor thinks you might be going through alcohol withdrawal, they’ll ask you questions about your drinking history and how recently you stopped. Oral chlordiazepoxide and oxazepam are very commonly used for the prevention of withdrawal symptoms. Other drugs often used to manage symptoms include neuroleptics, anticonvulsants like carbamazepine, and valproic acid. Withdrawal seizures can typically be managed with benzodiazepines but may require adjunct therapy with phenytoin, barbiturates, and may even require intubation and sedation with propofol, ketamine, or in the most severe cases, dexmedetomidine.

Some people may also need supplements such as folate, multivitamin, thiamine, and dextrose. These triggers may come from a fleeting thought, an emotion, or a physical sensation, such as a headache or nervousness. To find a treatment program, browse the top-rated addiction treatment facilities in each state by visiting our homepage, or by viewing the SAMHSA Treatment Services Locator.

Alcohol withdrawal syndrome : Nursing2023

Withdrawal seizures are believed to reflect unmasking of these changes and may also involve specific withdrawal-induced cellular events, such as rapid increases in α4 subunit–containing GABAA receptors that confer reduced inhibitory function. Optimizing approaches to the prevention of alcohol withdrawal seizures requires an understanding of the distinct neurobiologic mechanisms that underlie these seizures. Neuronal plasticity mechanisms may play a role in the susceptibility to alcohol withdrawal seizures in humans and rodents.

Binge drinking refers to a scenario where you drink a lot in a short period of time, and the seizures related to binge drinking can stem from withdrawal. Even if you’re not a chronic drinker, in some cases, you may also experience withdrawal seizures after binge drinking. People with alcohol use disorder (AUD) may experience uncomfortable and potentially severe alcohol withdrawal symptoms when attempting to quit. A supervised, medical detox can help people avoid unnecessary discomfort or life-threatening withdrawal complications. Evidence from clinical and basic research studies also suggests that androgens can have antiseizure effects.

History and Physical

Alcohol works as a depressant on the central nervous system and alters the function of gamma-aminobutyric acid (GABA) receptors. Inhibitory neurotransmitters prevent certain chemical messages from passing on. This may be due to alcohol’s effect on the brain, sleep, and anti-seizure medications. By Sarah Bence

Sarah Bence, OTR/L, is an occupational therapist and freelance writer.

Prior to the seizure, you may also experience an “aura,” consisting of an unusual visual change, smell, taste, or sound caused by abnormal brain activity. https://ecosoberhouse.com/article/alcohol-withdrawal-seizure-causes-symptoms-treatment/s can occur within a few hours or up to 72 hours after stopping drinking. The Centers for Disease Control and Prevention (CDC) outlines epilepsy as a neurological disorder in which recurring seizures occur.

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For many, choosing to take that first step to seeking treatment can be scary, but you’re not alone. This is a major concern, as approximately 37 percent of individuals with untreated delirium tremens die. Compared to those who are monitored in the hospital, only one to four percent actually die from symptoms of delirium tremens. According to a research study, 46 percent of those who had an alcohol-related seizure did not have another condition that could lead to a seizure. Alcohol withdrawal appeared to be the only cause of seizures in nearly half the subjects.

GABA (gamma-aminobutyric acid) is the major inhibitory neurotransmitter in the central nervous center. GABA has particular binding sites available for ethanol, thus increasing the inhibition of the central nervous system when present. Chronic ethanol exposure to GABA creates constant inhibition or depressant effects on the brain. Ethanol also binds to glutamate, which is one of the excitatory amino acids in the central nervous system. When it binds to glutamate, it inhibits the excitation of the central nervous system, thus worsening the depression of the brain.

Alcohol withdrawal seizures may occur after cessation of ethanol consumption, and a classic study clearly implicates the causal link between ethanol cessation and seizures in humans (Isbell et al., 1955). Alcohol withdrawal seizures may occur at any time after the cessation of ethanol intake, but the occurrence peaks in the 12–24-hour range (Victor and Brausch, 1967). Alcohol withdrawal seizures are usually characterized by one or two generalized tonic-clonic events, with a clear sensorium after a brief postictal state, although status epilepticus is reported (Alldredge and Lowenstein, 1993).

• Research also notes that an intravenous administration of benzodiazepines can help decrease the risk of delirium tremens.
• Delirium tremens is the most severe form of alcohol withdrawal, and its hallmark is that of an altered sensorium with significant autonomic dysfunction and vital sign abnormalities.
• Ethylene glycol (antifreeze) ingestion can lead to an altered sensorium, seizures, and severe renal dysfunction with acidemia that may require the initiation of hemodialysis.
• There’s a man who, while incarcerated in a Tennessee special needs prison, had a sexual relationship with his Corizon mental health counselor, which, “as an inmate and mental health patient,” he was “unable to give consent for,” according to his lawsuit.