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A diagnosis of alcohol use disorder is associated with a higher risk of dementia, but a dose-response relationship between alcohol intake consumption and cognitive impairment remains unclear. Alcohol is associated with a range of effects on the central nervous system at different doses and acts on a number of receptors. Acute disorders include Wernicke's encephalopathy (WE), traumatic brain injury, blackouts, seizures, stroke and hepatic encephalopathy. The most common manifestations of chronic alcohol consumption are Korsakoff's syndrome (KS) and alcohol-related dementia (ARD). There is limited evidence for benefit from memantine in the treatment of ARD, but stronger evidence for the use of high-dose parenteral thiamine in the progression of neuropsychiatric symptoms for WE. Accumulating evidence exists for pharmacological treatment in the prevention of hepatic encephalopathy. Rehabilitation of people with ARD may take several years, and requires an approach that addresses physical and psychosocial factors.

Original publication

DOI

10.1111/add.15023

Type

Journal article

Journal

Addiction (Abingdon, England)

Publication Date

08/2020

Volume

115

Pages

1580 - 1589

Addresses

Institute of Psychiatry, Psychology and Neuroscience, Department of Old Age Psychiatry, London, UK.

Keywords

Brain, Humans, Wernicke Encephalopathy, Korsakoff Syndrome, Alcoholism, Dose-Response Relationship, Drug