Elevated homocysteine levels in alcohol withdrawal

Ethanol exerts its behavioural effects largely by interacting with receptor s for brain neurotransmitters. However, the molecular mechanisms involving these interactions and the pathogenesis of alcohol-withdrawal symptomatolog y are still not well understood. Until recently, no data were available abo ut homocysteine (Hcy) levels in acute alcohol intoxication of chronic alcoh olics and in patients undergoing withdrawal from alcohol. Hey, blood-alcoho l concentrations, vitamins B-6, B-12, and folate concentrations were assess ed in 29 chronic alcoholics, who underwent withdrawal from alcohol. We obse rved increased Hcv levels in most patients. Hey levels steadily decreased d uring the observation period. We postulate that hyperhomocysteinaemia and e xcitatory amino acid neurotransmitters, by their agonism at the N-methyl-D- aspartate receptor, may partly mediate alcohol-associated withdrawal sympto matology. The importance of assessing serum Hey levels in order to detect m ethylation deficiency in patients with chronic alcoholism and for possible therapeutic strategies is discussed.