How Free Do You Want to Be?
Recovery Transforms Lives

If you are a woman who has found the courage to start down the road of recovery, know that you are never alone. Others have walked before you and have experienced recovery's promises of radical change. This book, written by the director of the Hazelden Women's Recovery Center, explains how you, too, can live a life "beyond your wildest dreams." Its pages are filled with expert advice, caring support, and personal stories of women who have found their way out of the mess of addiction.

Here you'll read about
•     the basics of addiction, the principles of the Twelve Step program, and how to get started in recovery
•     how addiction and recovery are different for women
•     what "self-care" means—physically, socially, emotionally, and spiritually
•     recognizing and working with feelings in a mature way
•     how recovery affects relationships, including those with your children
•     how the promises of recovery can transform your life, inside and out

Glimpse the freedom that accompanies recovery. Learn how other women with similar struggles have built new, meaningful lives without alcohol or other mood-altering drugs. Most important, grab the lifeline of hope offered in this book, the knowledge that recovery is possible.

"New, scientifically-based approaches that recognize the biological basis of addiction have brought major advances in the treatment of addiction. Dr. Urschel is at the forefront of this treatment paradigm."
Dr. Larry Hanselka, Psychologist

The Proven Scientific Approach to Conquering Addiction and Defeating the Disease

Healing the Addicted Brain is a breakthrough work that focuses on treating drug and alcohol addiction as a biological disease—based on the Recovery Science program that has helped thousands of patients defeat their addictions over the past 10 years. It combines the best behavioral addiction treatments with the latest scientific research into brain functions, providing tools and strategies designed to overcome the biological factors that cause addictive behavior along with proven treatments and medications.

Using this scientific approach, you will learn to conquer the physical factors that keep people tied to drug and alcohol addiction. The proven fact is addiction is not a moral failing or an issue of not having enough willpower. It is a disease of the brain that can and must be treated like other chronic medical illnesses —such as diabetes, hypertension, or asthma—in order to defeat the disease.

This revolutionary program can triple the success rate of patients, from 20-30% to 90%

There Is Hope.

Throughout history, and across cultures, alcohol has affected the fabric of society through abuse and addiction, contributed to violence and accidents, and caused injuries and health issues. In Alcohol: Its History, Pharmacology, and Treatment, part of Hazelden's Library of Addictive Drugs Series, Cheryl Cherpitel, Dr.P.H. and Mark Rose, M.A. examine the nature and extent of alcohol use in the United States, current treatment models and demographics, and the biology of alcohol, addiction, and treatment.

In separating fact from fiction, Cherpitel and Rose give context for understanding the alcohol problem by tracing its history and different uses over time, then offer an in-depth look at

Thoroughly researched and highly readable, Alcohol offers a comprehensive understanding of medical, social, and political issues concerning this legal, yet potentially dangerous, drug.

"Rorabaugh has written a well thought out and intriguing social history of America's great alcoholic binge that occurred between 1790 and 1830, what he terms 'a key formative period' in our history....A pioneering work that illuminates a part of our heritage that can no longer be neglected in future studies of America's social fabric.

A bold and frequently illuminating attempt to investigate the relationship of a single social custom to the central features of our historical experience....A book which always asks interesting questions and provides many provocative answers.

Addiction destroys lives. In The Addicted Brain, a leading neuroscientist explains how and why this happens–and presents advances in treatment and prevention. Using breathtaking brain imagery and other research, Michael Kuhar, Ph.D., shows the powerful, long-term brain changes that drugs can cause, revealing why it can be so difficult for addicts to escape their grip.

In plain English, Kuhar describes why some people are far more susceptible to addiction than others. He illuminates striking neural similarities between drugs and other pleasures potentially capable of causing abuse or addiction–including alcohol, gambling, sex, caffeine, and even Internet overuse. Finally, he outlines the 12 characteristics most often associated with successful treatment.

Authoritative and easy to understand, The Addicted Brain offers today’s most up-to-date scientific explanation of addiction–and what addicts, their families, and society can do about it.

This second edition of the “Encyclopedia of Drugs, Alcohol, and Addictive Behavior” reflects changes in the attitudes about, use, and knowledge of drugs and alcohol since the first edition published in 1995. These changes include the decrease of crack cocaine use and resurgence of heroin use; changes in laws dealing with drug use (on both the state and national levels), and new discoveries leading to a better understanding of how drugs work and what makes them addictive. More than 700 articles, written for both the student and layperson, cover the social, medical and political issues related to drugs and alcohol, as well exploring and explaining types of addiction.

The “Gale Encyclopedia of Mental Disorders” is a comprehensive two-volume set providing detailed information on mental disorders and conditions, in an easy-to-use format. It includes entries for all 150 disorders classified in the “Diagnostic and Statistical Manual of Mental Disorders,” and also features entries for prescription, alternative and over-the-counter drugs, as well as the various therapies used to treat mental disorders.

First, you learn five safe-drinking guidelines, then, each week you learn clinically-proven behavioral, cognitive, motivational and lifestyle strategies and techniques to help you stay within those guidelines. The result? You enjoy controlled drinking and no problems. It's an easy, commonsense moderate drinking program that works!

Learn what triggers your alcohol craving and how to manage it, how to slow down and pace your drinking, how to pre-plan for drinking occasions, how to master the art of social drinking and how to make alcohol less important in your life so you drink less naturally. Drink/Link is registered with both the California Department of Alcohol and Drug Programs and the United States Department of Health and Human Services.

Author: Donna J. Cornett
Paperback: 184 pages
Company: People Friendly Books (2011-08-05)
ISBN: 0976372002
List Price: $18.95
Amazon Price: $13.95
Used Price: $13.95

J Hosp Med. 2012 Jan 23;
Lyon J, Khan R, Gessert C, Larson P, Renier C

Pharmacol Biochem Behav. 2012 Jan; 100(3): 522-9
Cippitelli A, Damadzic R, Singley E, Thorsell A, Ciccocioppo R, Eskay RL, Heilig M

A dysregulation of the corticotropin-releasing hormone (CRH) system has been implicated in the development of excessive alcohol consumption and dependence. The aim of the present study was to evaluate whether the CRH system is also recruited when non-dependent Wistar rats escalate to high alcohol intake in the intermittent (alternate days) model of drinking.We compared intermittent and continuous access to 20% (v/v) alcohol in a two-bottle free choice drinking paradigm. Following a total of twenty 24-hour exposures for every experimental group, we assessed signs of alcohol withdrawal, including anxiety-like behavior and sensitivity to stress. The selective CRH1 receptor (CRH1R) antagonist antalarmin (0, 10, 20 mg/kg, i.p.) was tested on alcohol consumption.Intermittent access to 20% alcohol led non-selected Wistar rats to escalate their voluntary intake to a high and stable level, whereas continuously exposed animals maintained a lower consumption. These groups did not differ in physical withdrawal signs. In addition, no differences were found when anxiogenic-like behavior was studied, neither under basal conditions or following restraint stress. Nevertheless, sensitivity to the treatment with the CRH1R antalarmin was observed since a reduction of 20% alcohol intake was found in both groups of animals regardless of the regimen of alcohol exposure. In addition, antalarmin was effective when injected to animals exposed to intermittent 10% (v/v) alcohol whereas it failed to suppress 10% continuous alcohol intake.Pharmacological blockade of CRH1R reduced alcohol drinking when sustained high levels of intake were achieved suggesting that the CRH system plays a key role when high doses of ethanol are consumed by non-dependent subjects. This supports the notion that CRH system not only maintains the dependent state but also engages the transition to dependence.

Cardiol J. 2012; 19(1): 81-5
Yazdan-Ashoori P, Nichols R, Baranchuk A

A 57 year-old woman with no history of cardiac disease presented to the emergency department with confusion and seizures secondary to alcohol withdrawal. Elevated troponin levels and an electrocardiogram demonstrating global T-wave inversions prompted coronary angiography, which revealed coronary vessels free of significant disease. An echocardiogram showed both hypokinesis of the left-ventricular mid-segments with apical involvement and a hyperkinetic base consistent with tako-tsubo cardiomyopathy (TCM). Several clinical conditions have been reported as triggers of TCM. We report a case of TCM in a post-menopausal woman that was precipitated by alcohol withdrawal. (Cardiol J 2012; 19, 1: 81-85).

J Neurosci. 2012 Jan 4; 32(1): 390-401
Shen Y, Lindemeyer AK, Gonzalez C, Shao XM, Spigelman I, Olsen RW, Liang J

Alcohol use disorders (AUDs) constitute the most common form of substance abuse. The development of AUDs involves repeated alcohol use leading to tolerance, alcohol withdrawal syndrome, and physical and psychological dependence, with loss of ability to control excessive drinking. Currently there is no effective therapeutic agent for AUDs without major side effects. Dihydromyricetin (DHM; 1 mg/kg, i.p. injection), a flavonoid component of herbal medicines, counteracted acute alcohol (EtOH) intoxication, and also withdrawal signs in rats including tolerance, increased anxiety, and seizure susceptibility; DHM greatly reduced EtOH consumption in an intermittent voluntary EtOH intake paradigm in rats. GABA(A) receptors (GABA(A)Rs) are major targets of acute and chronic EtOH actions on the brain. At the cellular levels, DHM (1 μM) antagonized both acute EtOH-induced potentiation of GABA(A)Rs and EtOH exposure/withdrawal-induced GABA(A)R plasticity, including alterations in responsiveness of extrasynaptic and postsynaptic GABA(A)Rs to acute EtOH and, most importantly, increases in GABA(A)R α4 subunit expression in hippocampus and cultured neurons. DHM anti-alcohol effects on both behavior and CNS neurons were antagonized by flumazenil (10 mg/kg in vivo; 10 μM in vitro), the benzodiazepine (BZ) antagonist. DHM competitively inhibited BZ-site [(3)H]flunitrazepam binding (IC(50), 4.36 μM), suggesting DHM interaction with EtOH involves the BZ sites on GABA(A)Rs. In summary, we determined DHM anti-alcoholic effects on animal models and determined a major molecular target and cellular mechanism of DHM for counteracting alcohol intoxication and dependence. We demonstrated pharmacological properties of DHM consistent with those expected to underlie successful medical treatment of AUDs; therefore DHM is a therapeutic candidate.

Alcohol Clin Exp Res. 2011 Dec 5;
Serrano A, Rivera P, Pavon FJ, Decara J, Suárez J, Rodriguez de Fonseca F, Parsons LH

Background:  Endogenous cannabinoids such as anandamide and 2-arachidonoylglycerol (2-AG) exert important regulatory influences on neuronal signaling, participate in short- and long-term forms of neuroplasticity, and modulate stress responses and affective behavior in part through the modulation of neurotransmission in the amygdala. Alcohol consumption alters brain endocannabinoid levels, and alcohol dependence is associated with dysregulated amygdalar function, stress responsivity, and affective control. Methods:  The consequence of long-term alcohol consumption on the expression of genes related to endocannabinoid signaling was investigated using quantitative RT-PCR analyses of amygdala tissue. Two groups of ethanol (EtOH)-exposed rats were generated by maintenance on an EtOH liquid diet (10%): the first group received continuous access to EtOH for 15 days, whereas the second group was given intermittent access to the EtOH diet (5 d/wk for 3 weeks). Control subjects were maintained on an isocaloric EtOH-free liquid diet. To provide an initial profile of acute withdrawal, amygdala tissue was harvested following either 6 or 24 hours of EtOH withdrawal. Results:  Acute EtOH withdrawal was associated with significant changes in mRNA expression for various components of the endogenous cannabinoid system in the amygdala. Specifically, reductions in mRNA expression for the primary clearance routes for anandamide and 2-AG (fatty acid amide hydrolase [FAAH] and monoacylglycerol lipase [MAGL], respectively) were evident, as were reductions in mRNA expression for CB(1) , CB(2) , and GPR55 receptors. Although similar alterations in FAAH mRNA were evident following either continuous or intermittent EtOH exposure, alterations in MAGL and cannabinoid receptor-related mRNA (e.g., CB(1) , CB(2) , GPR55) were more pronounced following intermittent exposure. In general, greater withdrawal-associated deficits in mRNA expression were evident following 24 versus 6 hours of withdrawal. No significant changes in mRNA expression for enzymes involved in 2-AG biosynthesis (e.g., diacylglicerol lipase-α/β) were found in any condition. Conclusions:  These findings suggest that EtOH dependence and withdrawal are associated with dysregulated endocannabinoid signaling in the amygdala. These alterations may contribute to withdrawal-related dysregulation of amygdalar neurotransmission.

Pflege Z. 2011 Nov; 64(11): 662-4
Kraus A

Pharmacol Biochem Behav. 2012 Jan; 100(3): 485-9
McCulley WD, Walls SA, Khurana RC, Rosenwasser AM, Devaud LL

Ethanol withdrawal is a dysphoric condition that arises from termination of ethanol intake by dependent individuals. Common withdrawal symptoms include anxiety, increased reactivity to stimuli and increased seizure susceptibility as well as the risk of increased seizure severity. We use an animal model of dependence and withdrawal to study withdrawal behaviors and potential underlying neurobiological mechanisms. For a number of years, we have quantified pentylenetetrazol seizure thresholds as an assessment of ethanol withdrawal at both one day and three days of withdrawal. Typically, we see a significant decrease in seizure threshold (increased sensitivity to seizure induction) that persists through three days of withdrawal for male rats. Increasing evidence indicates that voluntary exercise affords protection against various challenges to physical and psychological health, including ethanol-related challenges. Therefore, the current study investigated the effect of voluntary wheel running on seizure susceptibility following chronic ethanol administration and withdrawal. We found that voluntary wheel running attenuated the increased sensitivity to pentylenetetrazol-induced seizures observed with ethanol withdrawal, at both the one-day and three-day time points. This result was especially interesting as animals with access to the running wheels consumed more of the ethanol-containing diet. These findings showed that chronic voluntary wheel running reduces the severity of ethanol withdrawal in our animal model and suggest that exercise-based interventions may have some utility in the clinical management of heavy drinking and alcohol withdrawal.

Tidsskr Nor Laegeforen. 2011 Nov 1; 131(21): 2132-3
Helland A, Bramness JG

Baclofen is approved for muscle spasms and cerebral spasticity. Several studies have recently investigated the use of baclofen for alcohol withdrawal symptoms and as an abstinence-promoting agent in alcohol-dependent subjects. The evidence is too weak to recommend baclofen for alcohol withdrawal, and drugs with better documentation such as benzodiazepines and carbamazepine should be preferred for this indication. The evidence for the use of baclofen to prevent relapse to drinking in alcohol dependence is somewhat conflicting, but the drug could be considered as a therapeutic option in case of conservative measures and approved drugs such as disulfiram and acamprosate having insufficient effect. Despite enthusiastic appraisal in case reports, the use of baclofen in high doses to suppress alcohol craving cannot be recommended due to insufficient evidence. Trials that may resolve this issue are underway.

Anesthesiol Clin. 2011 Dec; 29(4): 721-7
Skrobik Y

Little is known of nonpharmacologic and pharmacologic delirium prevention and treatment in the critical care setting. Trials emphasizing early mobilization suggest that this nonpharmacologic approach is associated with an improvement in delirium incidence. Titration and reduction of opiate analgesics and sedatives may improve subsyndromal delirium rates. All critical care caregivers should rigorously screen for alcohol abuse, apply alcohol withdrawal scales in alcoholic patients, and titrate sedative drugs accordingly. No nonpharmacologic approach or drug has been shown to be beneficial once delirium is established. Considering the importance and the consequences of delirium in the critical care setting, studies to further address prevention and rigorous trials addressing pharmacologic intervention are urgently needed.

Drug Alcohol Depend. 2011 Oct 20;
van Rijn RM, Brissett DI, Whistler JL

BACKGROUND: Naltrexone is one of the few drugs approved by the Federal Drug Administration for the treatment of alcoholism. However, naltrexone is only effective in a subpopulation of treatment-seeking alcohol abusers, and suffers from compliance issues. The non-selective nature of this opioid antagonist likely contributes to its side effects and poor therapeutic efficacy. Drugs selectively targeting delta opioid receptor subtypes offer a potential way to treat alcohol abuse disorders. We have recently shown that delta subtype-selective agonists TAN-67 and SNC80 can have opposing effects on alcohol consumption, while having similar effects on alcohol withdrawal-induced anxiety. METHODS: We studied the ability of TAN-67 and SNC80 to induce place preference in naïve and ethanol exposed C57BL/6 mice and determined the effect of these agonists on the expression of ethanol place preference. RESULTS: We show that TAN-67 and SNC80 have opposing actions on ethanol place preference. However, neither of the drugs induces place preference by themselves at doses that are therapeutically effective in mice. Interestingly, SNC80, like naltrexone reduces ethanol place preference, however we have previously shown that SNC80 increases ethanol consumption at the tested dose. Similar to naltrexone, TAN-67 reduces alcohol consumption, but we show here that it may be due to an increase in ethanol place preference. Importantly, we found that chronic ethanol exposure does not increase the rewarding properties of the DOR subtype selective agonists. CONCLUSIONS: Our results provide a better understanding of how DOR subtype selective drugs could potentially be used for treatment of alcohol abuse disorders.

An Bras Dermatol. 2011 Dec; 86(6): 1189-1192
Filgueiras FD, Stolarczuk DD, Gripp AC, Succi IC

A 42-year-old male patient, alcoholic, presented showing signs of tumors in the neck and around the shoulders, scaly, erythematous-violaceous lesions and some bullous lesions in sun-exposed areas of upper and lower limbs. Based on clinical features, laboratory tests and imaging studies we have established the diagnosis of pellagra associated with benign symmetrical lipomatosis, both justified by chronic alcoholism. Treated with intravenous B-complex and oriented about the importance of alcohol withdrawal, the patient showed complete remission of skin lesions, but with no change in the lipomatosis.

Eur Addict Res. 2012 Jan 24; 18(3): 97-102
Karagülle D, Heberlein A, Wilhelm J, Frieling H, Kornhuber J, Bleich S, Hillemacher T

Aims: Alcohol withdrawal seizures (AWS) are among the most important possible complications during the detoxification treatment of alcohol-dependent patients. Pharmacological therapy is often used during detoxification, but can cause dangerous side effects [Eur Addict Res 2010;16:179-184]. In separate studies several biological markers have been described as being associated with AWS risk. We investigated the role of homocysteine (HCT), carbohydrate-deficient transferrin (CDT) and prolactin (PRL) as biological markers for the risk of developing AWS. Methods: The present study included 189 alcohol-dependent patients of whom 51 had a history of AWS. We investigated the HCT, CDT and PRL levels of all patients and calculated sensitivity and specificity. Bayes' theorem was used to calculate positive (PPV) and negative (NPV) predictive values. Results: The highest combined sensitivity and specificity for %CDT was reached at a plasma cutoff value of 3.75%. The combination of HCT at a cutoff value of 23.9 μmol/l and %CDT at a cutoff value of 3.75% showed the best predictive values (sensitivity 47.1%, specificity 88.4%, PPV 0.504, NPV 0.870). Conclusion: A combined assessment of HCT and CDT levels can be a useful method to identify patients at a higher risk of AWS, which may lead to a more individualized therapy.

Alcohol Alcohol. 2012 Jan 2;
Förg A, Hein J, Volkmar K, Winter M, Richter C, Heinz A, Müller CA

AIMS: The objective of this study was to collect preliminary data on the efficacy and safety of pregabalin in attenuating the severity of alcohol withdrawal symptoms during detoxification treatment in alcohol dependence. METHODS: Forty-two alcohol-dependent patients with an alcohol withdrawal syndrome (AWS) were included in the prospective randomized double-blind placebo-controlled trial during inpatient alcohol detoxification. For 6 days, participants either received pregabalin or placebo according to a fixed dose schedule starting with 300 mg/day. Depending on the score of the AWS Scale (AWSS), diazepam was additionally administered as a rescue medication. The primary endpoint was the total amount of diazepam required from Day 2 to 6 of detoxification treatment in each of the two groups. Secondary outcome variables were the difference in AWSS and Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar) scores between Day 2 and 6, tolerability and safety data, drop-out rates as well as changes in the neuropsychological scales. RESULTS: Pregabalin and placebo were equally safe and well tolerated. However, no statistically significant difference was found comparing the total amount of additional diazepam medication required in the two study groups. Pregabalin and placebo also showed similar efficacy according to alterations of scores of the AWSS, CIWA-Ar and neuropsychological scales. The frequency of adverse events and drop-outs did not differ between the both treatment groups. CONCLUSIONS: The study demonstrates the relative safety of pregabalin in the treatment of AWS. However, the results do not provide evidence in favor of pregabalin compared with placebo concerning its efficacy in the treatment of AWS.

Eur Addict Res. 2012; 18(1): 12-5
Dammann G, Walter M, Gremaud-Heitz D, Wolfersdorf M, Hartmann S, Wurst FM

The issue of leptin as a putative state marker of alcohol use and its role in craving has been raised in the last few years. Recently, a strong GABA-ergic modulation of leptin was postulated. The aim of the pilot study was to examine leptin levels in correlation with the strongly GABA-mimetic active substance clomethiazole. The main hypothesis was that higher doses of the strong GABA-mimetic clomethiazole are positively correlated with higher leptin levels.Twenty-eight alcohol-dependent patients (3 females, median age 36 years) undergoing alcohol withdrawal were included. In 18 patients with and 10 without clomethiazole, serum leptin was analyzed at day 1 and day 7 of alcohol withdrawal. Both groups did not differ by age, BMI, or alcohol use characteristics.In the clomethiazole group, significant correlations were found between leptin levels at day 1 and clomethiazole dose (p = 0.004), clomethiazole and leptin at day 1/BMI (p = 0.009) and leptin at day 1 and clomethiazole/body surface (p = 0.006). Furthermore, patients with higher clomethiazole doses demonstrated significant higher leptin levels at day 1 (p = 0.044) and day 7 (p = 0.046).Our pilot data show a strong association between leptin levels and clomethiazole doses, thus supporting further research.

J Neural Transm. 2011 Nov 11;
Wang KS, Liu X, Zhang Q, Wu LY, Zeng M

Several genome-wide association (GWA) studies of alcohol dependence (AD) and alcohol-related phenotypes have been conducted; however, little is known about genetic variants influencing alcohol withdrawal symptoms (AWS). We conducted the first GWA study of AWS using 461 cases of AD with AWS and 408 controls in Caucasian population in the Collaborative Study on the Genetics of Alcoholism (COGA) sample. Logistic regression analysis of AWS as a binary trait, adjusted for age and sex, was performed using PLINK. We identified 51 SNPs associated with AWS with p 

Sleep Med. 2011 Dec; 12 Suppl 2: S50-3
Manni R, Ratti PL, Terzaghi M

Most secondary forms of REM sleep behavior disorder are associated with neurodegenerative diseases belonging to the α-synucleinopathies or with narcolepsy. However, RBD may also occur in subacute- or acute-onset conditions involving the central nervous system, irrespective of subjects' age and sex, and with or without relapse at follow-up. These conditions include structural brain lesions (vascular, demyelinating, tumoral, iatrogenic, etc.), CNS diseases (encephalitis, Guillain-Barré syndrome, etc.), forms induced by drug consumption or alcohol withdrawal, and possibly post-traumatic stress disorder. This review focuses on these forms of RBD, which are referred to as 'acute' as they occur as incidental phenomena within the context of other subacute- or acute-onset disorders. In these cases, RBD does not appear as a 'classical' clinical feature of the underlying condition, but rather as an intercurrent, somewhat unexpected phenomenon that deserves consideration in routine clinical practice, in order to avoid misdiagnoses and mistreatments.

Alcohol Alcohol. 2012 Jan 25;
Geoffroy PA, Rolland B, Cottencin O

AIMS: Catatonia is a neuropsychiatric syndrome characterized by alterations in motor behavior, vigilance, thought and mood. Catatonia syndrome occurs in many neuropsychiatric and medical conditions, but it is very rarely mentioned as occurring during alcohol withdrawal. We think that this co-occurrence could be underestimated in clinics because alcohol withdrawal symptoms may distract from its identification. METHODS: We report the case of a patient presenting with catatonia during the benzodiazepine reduction period of alcohol detoxification. RESULTS: A 65-year-old woman presented with a 15-year history of alcohol dependence and developed catatonic episodes several times during alcohol withdrawal treatment. Misdiagnosis delayed specific treatment. Symptoms of episodes dramatically improved 48 h after treatment with diazepam and revealed an anxiety disorder. CONCLUSION: This report confirms that catatonia is a non-specific response to psychological, physical and psychosocial stress factors. Recent alcohol withdrawal may sensitize the patient to benzodiazepine withdrawal catatonia, and this phenomenon is probably underestimated. Catatonia Rating Scales can be useful when diagnosis is complicated as in alcohol and benzodiazepine withdrawal. In that situation, misdiagnosis is common and may delay specific treatment.

Drug Alcohol Depend. 2011 Nov 3;
Jochum T, Schulz S, Schein M, Schröder R, Voss A, Bär KJ

BACKGROUND: Alcohol withdrawal syndrome is associated with an increased incidence of cardiac arrhythmias and sudden cardiac death. Heart rate turbulence (HRT) parameters were applied during withdrawal to estimate cardiac regulation during treatment with clomethiazole. METHODS: Twenty-two patients suffering from alcohol withdrawal syndrome were included in the study. Heart rate regulation was obtained by means of Holter ECG analyzing time intervals before medication, and 2 and 6h after medication. Slope and onset of HRT were calculated in addition to heart rate variability (HRV) parameters. Furthermore, we calculated the slope and the onset of ectopic beat-like events. RESULTS: Heart rate variability parameters indicated a minor reduction of vagal modulation during withdrawal syndrome. Especially, the fractal scaling exponent BBI alpha1 (4-16) indicated the autonomic shift. In contrast to HRV parameters, no significant changes were observed in the HRT parameters. Significant correlations were observed between severity of withdrawal, as assessed by the AWS scale, and the fractal scaling exponent BBI alpha2 (16-64), and the onset and the slope of HRT of ectopic beat-like activity. CONCLUSION: Increased sympathetic modulation during withdrawal and clomethiazole treatment is not associated with changes of heart rate turbulence parameters predictive of cardiac death after myocardial infarction.

Inflammopharmacology. 2012 Feb; 20(1): 39-48
Sternberg Z, Cesario A, Rittenhouse-Olson K, Sobel RA, Pankewycz O, Zhu B, Whitcomb T, Sternberg DS, Munschauer FE

This pilot study aimed to determine the efficacy of acamprosate (N-acetyl homotaurine) in reducing the pathological features of experimental autoimmune encephalomyelitis (EAE) which is an animal model for multiple sclerosis (MS).The amino acid taurine has multiple biological activities including immunomodulation and neuromodulation. The synthetic acetylated taurine derivative, acamprosate, which crosses the blood-brain barrier more readily compared to taurine, is currently being used for the prevention of alcohol withdrawal symptoms associated with enhanced glutamatergic receptor function and GABA receptor hypofunction.EAE was induced in C57BL/6 female mice with myelin oligodendrocyte glyocoprotein, amino acid 35-55. Mice were treated with 20, 100 and 500 mg/kg acamprosate for 21 days.Neurological scores at disease peak were reduced by 21, 64 and 9% in the 20, 100 and 500 mg/kg groups, respectively. Neurological improvement in the 100 mg/kg group correlated with a reduction in numbers of inflammatory lesions and the extent of CNS demyelination. Blood TNF-α levels were significantly reduced in the 500 mg/kg group.Acamprosate and other taurine analogs have a potential for future MS therapy.

Psychoneuroendocrinology. 2011 Dec 13;
Koopmann A, von der Goltz C, Grosshans M, Dinter C, Vitale M, Wiedemann K, Kiefer F

OBJECTIVE: Recent preclinical and clinical studies suggested ghrelin to have an orexigenic role in regulating appetite and energy balance. Preclinical studies also provided support for an important role of ghrelin in the neurobiology of addiction-related reward pathways, affecting the self-administration of alcohol and drugs as well as conditioned place preference. In contrast, clinical data have until now failed to support an association between ghrelin and alcohol craving, possibly due to the fact that these studies have analyzed the pharmacologically inactive, preprohormone ghrelin instead of ghrelin in its active, acetylated form. MATERIALS AND METHODS: Our study sample was a group of 61 alcohol-dependent male inpatients. We assessed their plasma concentrations of both active and total ghrelin, using blood samples taken twice during the study: once at the onset of withdrawal, 12-24h after admission, and then again after 14 days of controlled abstinence. During this time, we also assessed the patients' alcohol cravings (applying the obsessive compulsive drinking scale, or OCDS), symptoms of depression (Beck Depression Inventory; BDI) and anxiety (State Trait Anxiety Inventory; STAI). The severity of alcohol dependence was assessed using the alcohol dependence scale (ADS). RESULTS: We found a significant positive correlation between the plasma concentration of active ghrelin and alcohol craving in both blood samples. Plasma concentrations of active ghrelin increased significantly during early abstinence. In a linear regression model, the plasma concentration of active ghrelin on day one, the scores of the ADS, and the BDI explained 36% of the variance in OCDS sum score (p