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Post-acute withdrawal syndrome (PAWS) is a hypothesized set of persistent impairments that occur after withdrawal from alcohol, [1] [2] opiates, benzodiazepines, barbiturates, and other substances. [ 3 ] [ 4 ] [ 5 ] Infants born to mothers who used substances of dependence during pregnancy may also experience a PAWS.
Alcohol withdrawal syndrome (AWS) is a set of symptoms that can occur following a reduction in or cessation of alcohol use after a period of excessive use. [1] Symptoms typically include anxiety , shakiness , sweating, vomiting, fast heart rate , and a mild fever. [ 1 ]
Benzodiazepines such as chlordiazepoxide (Librium), diazepam (Valium), lorazepam (Ativan) or oxazepam (Serax) are the most commonly used drugs used to reduce alcohol withdrawal symptoms. There are several treatment patterns in which it is used: [medical citation needed] The first option takes into consideration the varying degrees of tolerance.
Benzodiazepine withdrawal syndrome (BZD withdrawal) is the cluster of signs and symptoms that may emerge when a person who has been taking benzodiazepines as prescribed develops a physical dependence on them and then reduces the dose or stops taking them without a safe taper schedule.
This was demonstrated by the ability to avoid the withdrawal syndrome by the administration of AMPA antagonists. It is believed that different glutamate subreceptors, e.g., NMDA and AMPA, are responsible for different stages/time points of the withdrawal syndrome. NMDA receptors are upregulated in the brain as a result of benzodiazepine tolerance.
Management with a combination of abstinence from alcohol and the use of neuroleptics has been shown to be effective. [11] It is also possible to treat withdrawal before major symptoms start to happen in the body. Diazepam and chlordiazepoxide have proven to be effective in treating alcohol withdrawal symptoms such as alcoholic hallucinosis ...
(However, the cohort studies were homogenous and the case–control studies were heterogeneous, thus reducing the strength of the case–control results). There have also been several reports that suggest that benzodiazepines have the potential to cause a syndrome similar to fetal alcohol syndrome, but this has been disputed by a number of ...
Failure to manage the alcohol withdrawal syndrome appropriately can lead to permanent brain damage or death. [ 11 ] Acamprosate , a drug used to promote abstinence from alcohol, an NMDA antagonist drug, reduces excessive glutamate activity in the central nervous system and thereby may reduce excitotoxicity and withdrawal related brain damage.