Ethanol psychotropics

CNS effects Because of the rapid onset of action, eszopiclone should only be ingested immediately prior to going to bed or after the patient has gone to bed and has experienced difficulty falling asleep. Eszopiclone may produce additive CNS-depressant effects when coadministered with other psychotropic medications, anticonvulsants, antihistamines, ethanol, and other drugs that produce CNS depression. Eszopiclone should not be taken with alcohol. Dose adjustment may be necessary when eszopiclone is administered with other CNS-depressant agents because of the potentially additive effects. 

A key effect of addictive psychotropic drugs is to increase the extracellular concentration of dopamine in the nucleus accumbens. Ethanol does this in part by direct excitation of the mesolimbic dopamine neurons projecting to the accumbens (Koyama et al. 2007). However, studies in alcohol-preferring rats, animals which tend to develop alcohol dependence, have indicated an additional component a reduction of presynaptic D2 autoreceptor function (Engleman et al. 2003 Thielen et al. 2004). 

Morselli PL. Further observations on the interaction between ethanol and psychotropic drugs. Aizneimittelforschung 1971 2 20. 

Psychotropic effects. Ethanol is unusual in that it is freely soluble in both water and lipids. Thus, it has access to all regions of the highly vascularized brain. Although the molecular basis of ethanol action in the brain is not clear, it is evident that ethanol influences a number of neurotransmitter receptors and ion channels. Suggest a biochemical explanation for the diverse effects of ethanol. 

Most, if not all, of the tissues and organs in the body are adversely affected by chronic ingestion of excessive amounts of alcohol, including the liver, pancreas, heart, reproductive organs, central nervous system, and the fetus. Some of the effects of alcohol ingestion, such as the psychotropic effects on the brain or inhibition of vitamin transport, are direct effects caused by ethanol itself. However, many of the acute and chronic pathophysiologic effects of alcohol relate to the pathways of ethanol metabolism (see Chapter 25). 

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