Cognitive effects alcohol

In a double-blind, placebo-controlled study of sex differences in the effects of lorazepam in trained social drinkers, lorazepam substituted for alcohol equally in both sexes and increased associated scores for light-headedness (14). The women had much greater performance impairment in a digital symbol substitution test after lorazepam than the men. These results suggest that the stimulus and cognitive effects of benzodiazepine receptor agonists are modulated by different brain mechanisms. 

In a randomized, double blind, six-way, crossover study of the cognitive effects of fexofenadine 180 mg, both alone and in combination with alcohol, fexofenadine had no disruptive effects on objective measures related to driving a car and aspects of psychomotor and cognitive function, even when combined with a dose of alcohol equivalent to 0.3 g/kg (62). 

Moderate social drinking does not appear to affect the serum levels of carbamazepine, ethosuximide or phenytoin. Some small changes are seen in the serum levels of phenobarbital and sodium valproate, but no changes in the control of epilepsy seem to occur. No pharmacokinetic interaction was detected between tiagabine and alcohol, and tiagabine did not alter the cognitive effect of alcohol. The adverse effects of both alcohol and antiepileptics, such as enhanced sedation, may be additive. 

A double-blind study in 12 healthy subjects given two Mandrax tablets (methaqualone 250 mg with diphenhydramine 25 mg) showed that the resulting sedation and reduction in cognitive skills were enhanced by alcohol 0.5 g/kg. Residual amounts of a single-dose ofMandrax continued to interact for as long as 72 hours. Methaqualone blood levels are also raised by regular moderate amounts of alcohol. Enhanced effects were also seen in another study. ... 

A randomised, crossover study in 8 men with psychotic disorders found that quetiapine 250 mg three times daily did not afTect the mean breath-alcohol concentration after they took 0.8 g/kg of alcohol in orange juice. Some statistically significant changes in the performance of psychomotor tests were seen, but these were considered to have little clinical relevance. However, the US manufacturers of quetiapine say that, in clinical studies, the motor and cognitive effects of alcohol were potentiated by quetiapine. Therefore the US manufacturers of quetiapine advise avoiding alcohol, and the UK manufacturers advise caution with the concurrent use of alcohol. Note that drowsiness is the most common adverse effect of quetiapine, occurring in over 10% of patients. Quetiapine may occasionally induce postural hypotension, which could be exacerbated by alcohol administration. 

Deficiencies of various nutrients, primarily vitamins, impair cognition. The link is strongest for vitamin Bj2, thiamine, and niacin. Yet even for these, the role of mild subclinical or multiple deficiencies in the genesis of mental dysfunction is unclear. Most information in this field is based on animal studies often poorly applicable to the human condition or on clinical pathology complicated by advanced age, alcoholism, and intercurrent disease. There is a need for well controlled, double-blind, prospective trials to elucidate the cognitive effects of malnutrition. 

Carter LP, Reissig CJ, Johnson MW, KKnedinst MA, Griffiths RR, Mintzer MZ. Acute cognitive effects of high doses of dextromethorphan relative to triazolam in humans. Drug Alcohol Depend March 1,2013 128(3) 206-13. 

Kranzler HR, Del Boca F, Korner P, et ah Adverse effects limit the usefulness of flu-voxamine for the treatment of alcoholism.] Subst Abuse Treat 10 283-287, 1993 Kranzler HR, Burleson JA, Del Boca FK, et ah Buspirone treatment of anxious alcoholics a placebo-controlled trial. Arch Gen Psychiatry 31 720—731, 1994 Kranzler HR, Burleson JA, Korner P, et ah Placebo-controlled trial of fluoxetine as an adjunct to relapse prevention in alcoholics. Am] Psychiatry 152 391-397, 1995 Kranzler HR, Burleson JA, Brown J, et al Fluoxetine treatment seems to reduce the beneficial effects of cognitive-behavioral therapy in type B alcoholics. Alcohol Clin Exp Res 20 1534-1341, 1996... 

Benzodiazepines are used commonly in SAD however, there are limited data supporting their use. Clonazepam has been effective for social anxiety, fear, and phobic avoidance, and it reduced social and work disability during acute treatment.58 Long-term treatment is not desirable for many SAD patients owing to the risk of withdrawal and difficulty with discontinuation, cognitive side effects, and lack of effect on depressive symptoms. Benzodiazepines may be useful for acute relief of physiologic symptoms of anxiety when used concomitantly with antidepressants or psychotherapy. Benzodiazepines are contraindicated in SAD patients with alcohol or substance abuse or history of such. 

Summarise the cognitive and behavioural effects of alcohol intoxication. 

Curran HV and Hildebrandt M (1999). Dissociative effects of alcohol on recollective experience. Consciousness and Cognition, 8, 497-509. 

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