[Clinical and therapeutic aspects in the treatment of alcohol addiction]

Abstract

The alcohol-withdrawal syndrome is a well-known clinical situation, so does its treatment. However, new researches have shown that the risk of severe withdrawal manifestations increases proportionally with the number of previous detoxifications, according to a sensitisation stress model. As a consequence, special attention should be paid to patients with a clinical history of multiple alcohol detoxifications, even if they never previously had delirium tremens and/or comitiality. Even in the absence of characteristic neurologic lesions, long-lasting heavy drinking is associated with brain dysfunction, concerning mostly the frontal cortex. This is clinically associated to neuropsychological deficits, specifically disorders of working memory and the so-called "executive functions". These deficits have a dramatic importance, because they impair drastically the outcome of alcoholic patients after detoxification. In Belgium like in other countries, an increasing prevalence of hepatitis C is present in alcoholic patients. This is due probably to the increase of a former illegal drugs consumption in those patients. This association between alcoholism and hepatitis C is of major importance, because alcohol consumption increases the viral load and the risk of cirrhosis and hepatocarcinoma. Furthermore, alcohol reduces the response to interferon therapy.