Chronic alcohol consumption can cause psychotic disorders, most commonly with hallucinatory features. In the older psychiatric literature, this schizophrenia-like syndrome was called alcohol hallucinosis. Patients suffer from predominantly auditory but also visual hallucinations and delusions of persecution. The psychosis usually has a rapid onset. In contrast to alcohol delirium, the sensorium is clear and withdrawal symptoms are weak or absent. Alcohol psychosis is considered to be rather rare [20]
[21], although there are no exact estimates of prevalence. The prognosis is usually good, but 10-20% of patients with alcohol psychosis develop a chronic schizophrenia-like syndrome [8]. In these cases, differential diagnosis between alcohol hallucinosis and schizophrenia can be difficult [12]. The pathophysiology of alcohol psychosis is not clear [14]
[16]. There is no evidence that alcohol psychosis and schizophrenia have a common genetic basis [7]. An impaired dopaminergic neurotransmission and hyperdopaminergic state may play a role [3]
[6] but this has not been shown in alcohol hallucinosis [17]. Recent PET findings indicate a hypofunction of the thalamus in patients with alcohol psychosis, which may resolve upon clinical improvement [11]
[17]
[18].
No studies have been performed on the pharmacotherapy of alcohol psychosis and there is no established therapy. A few case series have been published [1]
[5]
[10]
[13]
[15]. We performed a retrospective chart analysis to study the effects of neuroleptic treatment in patients with alcohol hallucinosis.
References
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2 Arbeitsgemeinschaft für Methodik und Dokumentation in der Psychiatrie/AMDP .Das AMDP-System: Manual zur Dokumentation psychiatrischer Befunde. 5th revised edn. Göttingen, Bern, Berlin, Heidelberg, New York, Hogrefe 2005
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Borg S, Kvande H, Valverius P.
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4
Caton CLM, Drake RE, Hasin D, Dominguez B, Shrout PE, Samet S, Schanzer B.
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9 Guy W, Ban TA. The AMDP-SYSTEM. Manual for the Assessment and Documentation of Psychopathology. Berlin, Heidelberg, New York, Springer 1982
10
Hermann D, Heinz A, Croissant B, Mann K.
Provoked recurrence of alcohol hallucinosis - remission with additive amisulpride medication. A case report.
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13
Soyka M, Botschev C, Völcker A.
Neuroleptic treatment in alcohol hallucinosis: no evidence for increased seizure risk.
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66-67
16
Soyka M Dresel S, Horak M, Rüther T, Tatsch K.
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