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Alcohol and Alcoholism Advance Access originally published online on October 31, 2005
Alcohol and Alcoholism 2006 41(1):11-13; doi:10.1093/alcalc/agh228
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© The Author 2005. Published by Oxford University Press on behalf of the Medical Council on Alcohol. All rights reserved

COMMENTARY

RESPONSES TO CARDIOVASCULAR DRUGS DURING ALCOHOL WITHDRAWAL

SEPPO KÄHKÖNEN*

BioMag Laboratory, Helsinki University Central Hospital; Cognitive Brain Research Unit, University of Helsinki, Finland

* Correspondence: Tel.: +358 9 47175579; Fax: +358 9 47175781; E-mail: seppo.kahkonen{at}helsinki.fi

(Received 11 May 2005; first review notified 6 July 2005; in revised form 23 August 2005; accepted 7 October 2005)

Aim: To present findings on the kinetics and dynamics of cardiovascular drugs during alcohol withdrawal (AW), compared with that observed in remission. Method: Studies were reviewed and summarized. Results: A single-dose study in alcoholic patients with propranolol, a ß-adrenergic antagonist, showed that the negative inotropic effect was decreased and the bradycardiac effect increased during AW as compared with during early remission. The hypotensive effect of isosorbid dinitrate, commonly used as a vasodilatator, was weaker at the onset of AW, being associated with the decreased bioavailability of the drug. Verapamil, which is a L-type Ca2+ channel antagonist, produced a bradycardiac effect at the onset of AW, but no effect was observed in early remission. The effect was probably due to changes in L-type Ca2+ channels because no differences in verapamil concentrations between AW and early remission were observed. Conclusion: Taken together, AW modifies the dynamics and kinetics of cardiac drugs, which may have an impact on the treatment of alcoholic patients with cardiac diseases.


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