Types of alcohol withdrawal syndrome and dexamethasone suppression test.

Several data show a biological heterogeneity of the alcohol withdrawal syndrome. The determination of basic cortisol level and the Dexamethasone Suppression Test (DST) were performed in 10 healthy men and 54 male alcoholics in the stage of acute withdrawal divided into four groups, according to their clinical symptoms. In 46% of the patients the DST was positive (vs. nil in controls). The positive DST was significantly higher in subjects where depressive symptoms especially of endogenous character prevailed. The cortisol level was significantly increased in subjects characterized predominantly by anxiety-irritation. The possible explanations of these findings are discussed. The clinical picture of the withdrawal syndrome may be determined by disturbed functions of the hypothalamo-pituitary-adrenal system (HPAS). Correction of such disorders seems to be sufficient when treating acute withdrawal syndromes of different types.