The British Journal of Psychiatry 175: 114-119 (1999)
© 1999 The Royal College of Psychiatrists

Alcohol and the brain. Pharmacological insights for psychiatrists

D Nutt
Division of Psychiatry, School of Medical Sciences, University Walk, Bristol. david.j.nutt@bristol.ac.uk

BACKGROUND: Alcohol misuse, as well as being a major form of psychiatric morbidity, is also commonly associated with other psychiatric disorders. A greater understanding of the brain mechanisms underlying the adverse effects of alcohol is now possible, thanks to significant research advances made over the past decade. AIMS: To elucidate for psychiatrists the growing knowledge of the importance of specific neurotransmitter interactions in the effects of alcohol. METHOD: A survey of the literature, extracting current knowledge of interest to psychiatrists. RESULTS: There is good evidence that the acute effects of alcohol are mediated through interactions with amino acid neurotransmitters plus parallel changes in amines such as noradrenaline, dopamine and serotonin. Neuroadaptive responses at amino acid receptors probably underlie significant components of the withdrawal syndrome and probably also contribute to neuronal death found in chronic alcoholism. CONCLUSIONS: An understanding of the pharmacology of alcohol use may lead to greater ability to treat psychiatric consequences of alcoholism, and may also prevent some of the secondary psychiatric comorbidity and later brain damage.

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