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Glutamate: [10].

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Alcohol reduces glutamate levels in the nucleus accumbens and suppresses glutamate-mediated signal transmission in the central nucleus of the amygdala. Acamprosate used in the treatment of alcohol dependence has demonstrated that its mechanism of action is through its inhibition of the NMDA receptor. Serotonin: [10]. There is evidence of a link between serotonin deficiency, impulsivity and drinking behaviour which may explain the role of SSRIs in suppressing alcohol reinforced behaviour in some alcohol-dependent patients.

On the other hand, SSRIs are associated with new-onset alcohol dependence in some patients. The differential effects highlight the presence of different subtypes in alcohol dependence. Opioid Systems: [10]. Opioid systems involving endogenous opioids endorphins, enkephalins and dynorphins influence drinking behaviour via interaction with the mesolimbic system.

Naltrexone is an opiate-receptor antagonist and has been shown to limit cravings by reducing the positive reinforcement effect of alcohol consumption. Moreover, naltrexone has been shown to reduce alcohol priming i. Acetaldehyde: [10]. The primary breakdown product of ethanol is acetaldehyde, which is produced through a series of oxidative metabolic reactions.

Acetaldehyde is a highly reactive compound that reacts with several catecholamines i. These alkaloid compounds have been suggested to be responsible for the physiological effects of alcohol as well as the manifestation of the behavioural aspects of alcohol-related disorders. Disulfiram is is a drug that inhibits the enzyme aldehyde dehydrogenase and is used in the treatment of alcohol dependence. The accumulation of acetaldehyde is known to cause unpleasant side effects such as vomiting, headaches, and anxiety after the consumption of alcohol.

Disulfiram administration helps patients learn non-drinking behaviours and the ability to exercise self-control. In fact, most individuals cease alcohol use after the administration of disulfiram due to the strong expectancy of negative consequences.

Thiamine deficiency Thiamine deficiency leads to low levels of active thiamine thiamine pyrophosphate in the brain which impairs several biochemical pathways in the brain:. The following are key neurofunctional abnormalities with key areas of the brain involved. Other causes include gastric bypass surgery, gastric and colon cancer, hyperemesis gravidarum, long-term parenteral feeding, and poor nutrition.

Genetic susceptibility linked to thiamine transporter genes may be involved in the development of WKS in vulnerable patients. Thiamine deficiency in alcohol dependence occurs because of poor absorption of thiamine from the GI tract, impaired thiamine storage and reduced thiamine phosphorylation in the brain, reducing the amount of active thiamine in the brain.

Impacts of Drugs on Neurotransmission

Treatment of acute WE [15] , [16] —. An abnormal mental state in which memory and learning are affected out of all proportion to other cognitive functions in an otherwise alert and responsive patient. The most obvious neuroradiological sign of acute WE, regardless of etiology, is bilateral hyperintensity on late-echo MRI, generally occurring in gray matter tissue of the mammillary bodies, anterior and medial nuclei of the thalamus, periventricular gray matter, inferior and superior colliculi.

From the case rID: Psychiatric disorders are commonly associated with alcoholism, and the compounded dysfunction of their comorbidity is a critical element in the diagnosis and treatment of these patients.

In this study, it was shown that alcohol dependency comes with a 4-times increase in the risk of developing a major depressive disorder. Conversely, there are also high rates of alcohol-related disorders in psychiatric patients, particularly in those with bipolar disorder and depression when compared to the general population [19] , [20]. The study found that alcohol use disorders were associated with all types of dementia even after controlling for other confounding factors.

Impacts of Drugs on Neurotransmission | National Institute on Drug Abuse (NIDA)

Excessive alcohol consumption is associated with structural changes in certain brain areas and functional changes to neurotransmitter pathways that cause impairments to cognition and behaviour. The effects, however, differ from person to person. Exciting developments are happening in the world of addiction that will allow clinicians and researchers to develop targeted therapies that may be able to prevent addiction and alcohol-related brain damage in dependent individuals.

World Health Organisation.


  1. The effect of alcohol on neurotransmitters in the brain.
  2. ISBN 13: 9781468459098.
  3. Neurotransmitter;
  4. Neuroreceptor Mechanisms in Brain;

The alcohol fact sheet. Global Status Report on Alcohol and Health.


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    Zahr, N. Clinical and pathological features of alcohol-related brain damage. Nature Reviews Neurology, 7 5 , Yoshimoto K et al. Yim H et al. Alcohol: Clinical and Experimental Research. Cowen M and Lawrence A. The role of opioid-dopamine interactions in the induction and maintenance of ethanol consumption. Yim H and Gonzales R. Ethanol-induced increases in dopamine extracellular concentration in rat nucleus accumbens are accounted for by increased release and not uptake inhibition. Adermark L et al. Addiction Biology. Suppression of alcohol dependence using baclofen: a 2-year observational study of patients.

    Frontiers in psychiatry, 3. Gilpin, N. Neurobiology of alcohol dependence: focus on motivational mechanisms.

    GABAergic transmission regulates epileptic mechanisms, cognition, behavior and arousal level. Clinical presentations include epileptic encephalopathies, intellectual disability, behavioral disturbances and episodes of lethargy. Glycine defects produce severe epileptic encephalopathy due to defecst in the cleavage system and hyperekplexia due to mutations in glycine receptors or transporters.

    Other disorders include defects in the metabolism of pyridoxine and its derivative, pyridoxal phosphate, a cofactor necessary for the synthesis of several neurotransmitters. Some neurotransmitter disorders are treatable and require the study of cerebrospinal fluid metabolites for diagnosis. Primary neurotransmitter disorders include inborn errors of metabolism of dopamine, serotonin, GABA, glycine, pyridoxine and pyridoxal phosphate.

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    As examples mitochondrial disorders are very likely to show neurotransmitter defects due to energy mediated synaptic mechanisms; neurodegenerative disorders have reduced levels of neurotransmitters due to neuronal loss. Many other disorders and mechanisms can be included in this category of secondary neurotransmitter defects. Connecting the growing brain network of specialised clinicians and researchers. People and labs around the world with the aim to understand the developing brain through synaptic communication. The challenge of our project is to build bridges between different disciplines that are normally practiced one far apart from the other.

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