In tolerant animals, the lethal dose is only minimally higher than an intoxicating dose. Persons may die of respiratory depression secondary to alcohol overdose, even in the presence of tolerance. The physical dependence accompanying tolerance is profound, and withdrawal produces adverse effects that may lead to death. Withdrawal Syndromes A continuum of symptoms and signs accompanies alcohol withdrawal, usually beginning 12 to 48 h after cessation of intake. The mild withdrawal syndrome includes tremor, weakness, sweating, hyperreflexia, and GI symptoms.
Alcoholic hallucinosis follows abrupt abstinence from prolonged excessive use of alcohol.
The syndrome resembles schizophrenia, but thought is usually not disordered, and the history is not typical of schizophrenia. Symptoms do not resemble the delirious state of an acute organic brain syndrome as much as does delirium tremens or other pathologic reactions associated with withdrawal. Consciousness remains clear, and the signs of autonomic lability seen in delirium tremens are usually absent. When hallucinosis occurs, it generally precedes delirium tremens. Hallucinosis is usually transient.