The Pharmacology of Alcohol

To review the pharmacology of alcohol, and agents to reduce alcohol consumption including acamprosate and naltrexone. 

A reasonable conclusion, about the acute effects of alcohol on male sexual response is that, similar to aggression, the disinhibition theory falls far short of explaining the information that is available. Rather, social and psychological factors seem to be important determinants of sexual response in men at low BACs and often work to increase libido. However, the pharmacology of alcohol begins to dominate at BACs greater than 0.05%, which cause a decrease in arousal and sexual competence. 

The two main settings in which medications are used for alcohol treatment are to control the symptoms of alcohol withdrawal (i.e., detoxification) and to reduce or prevent alcohol consumption (i.e., rehabilitation). In the sections that follow, we will first discuss pharmacological approaches to detoxification... 

As reviewed earlier in the section on the pharmacology of ethanol, several neurotransmitter systems appear to influence the reinforcing or discriminative stimulus effects of ethanol. Although these systems appear to function interactively in their influences on drinking behavior, the medications that have been employed to treat alcohol dependence affect neurotransmitter systems relatively selectively. Consequently, these systems will be discussed individually here. 

In summary, research on the use of antidepressants to treat cannabis dependence, particularly among individuals with comorbid major depressive disorder, although limited, offers a promising avenue for the development of pharmacological aids to assist in the treatment of cannabis withdrawal. There are clear parallels between this literature and the existing research on the use of antidepressants in the treatment of alcohol dependence comorbid with major depressive disorder (see Chapter 1, Medications to Treat Co-occurring Psychiatric Symptoms or Disorders in Alcoholic Patients). 

GHB treatment in mice, tolerance develops to both the hypolocomotion and cataleptic effects of the drug (Itzhak and Ali 2002). There is also preclinical evidence of cross-tolerance and cross-dependence of GHB with alcohol (Colombo et al. 1995 Fadda et al. 1989). As described in the earlier section on clinical pharmacology, GHB and its analogues have been used in humans in the treatment of alcohol withdrawal. Nicholson and Balster (2001) reviewed the evidence for cross-tolerance and cross-dependence of GHB with alcohol. 

Secobarbital exhibits the same pharmacologic properties as other members of the barbiturate class. Most nonmedical use is with short-acting barbiturates, such as secobarbital. Although there may be considerable tolerance to the sedative and intoxicating effects of the drug, the lethal dose is not much greater in addicted than in normal persons. Tolerance does not develop to the respiratory effect. The combination of alcohol and barbiturates may lead to fatalities because of their combined respiratory depressive effects. Similar outcomes may occur with the benzodiazepines. Severe withdrawal symptoms in epileptic patients may include grand mal seizures and delirium. 

Pharmacologic Agents Used in the Treatment of Alcohol Withdrawal... 

Anton RF. Pharmacologic approaches to the management of alcoholism. J Clin Psychiatry 2001 62(Supplement 20) 11-17. 

Harris, D.S., Everhart, E.T., Mendelson, J., and Jones, R.T., The pharmacology of cocaethylene in humans following cocaine and ethanol administration, Drug Alcohol Depend., 72(2), 169-182, 2003. 

The time spent reviewing the pharmacology of marijuana, nicotine and alcohol was just right. ... 

Peters DH, Faulds D. Tiapride. A review of its pharmacology and therapeutic potential in the management of alcohol dependence syndrome. Drugs 1994 47(6) 1010-32. 

Alcohol is chiefly important in medicine because of the consequences of its misuse/abuse. Alcohol misuse is a social problem with pharmacological aspects, which latter are discussed here. The history of alcohol is part of the history of civilisation ever since Noah made his epoch-making discovery. ... 

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