Differences in the Course of Alcohol Withdrawal in Women and Men

Abstract

A retrospective study compared the course of alcohol withdrawal, including delirium tremens, in women and men hospitalized in the Nowowiejski Hospital in Warsaw from 1973 to 1987. Medical records pertaining to 1179 patients were analyzed; 13.8% of these patients were women and 86.2% were men. The study showed that women began intensive alcohol drinking later than men (p < 0.0001), but the period between the onset of alcohol abuse and the first occurrence of alcohol withdrawal was shorter in women than in men (p < 0.0001). In the period of heavy drinking before hospitalization, women consumed significantly less alcohol then men (p < 0.0001); moreover, women drank nonbeverage alcohol less frequently than men (p < 0.05). Women were hospitalized substantially longer than men (p < 0.0001), whereas the duration of alcohol withdrawal symptoms at the time of hospitalization was comparable in both groups. Withdrawal seizures were significantly more frequent among men than among women (p < 0.001). Significant differences in the patients' somatic conditions were not noted between the groups, with the exception of anemia and decreased potassium concentration, which were more frequently observed in women (both p < 0.0001), and of increased concentration of ALT and hypoproteinemia, which were more frequent in men (respectively, p < 0.05 and p < 0.01). Co-existing personality disorders, depressive disorders, and anxiety disorders--as well as abuse of benzodiazepines and barbiturates--were more frequently observed in women (p < 0.0001). The period between the first hospitalization due to alcohol withdrawal and the time of death was significantly shorter in men than in women (p < 0.05). The results point to differences in the conditions and the course of alcohol dependence and alcohol withdrawal between women and men.

A sex difference in oxidative stress and behavioral suppression induced by ethanol withdrawal in rats

“…In agreement, an animal study reported that female mice showed more severe cell death in the forebrain compared to male mice [8]. On the other hand, more men than women displayed withdrawal syndromes such as seizure, tremor, anxiety, and insomnia [7, 9]. The greater vulnerability of male than female subjects has been shown in an animal study where EW-induced anxiety was more severe in male rats than female rats [10].…”

“…Sex differences in EW have been shown in human and animals studies which yielded somewhat controversial results. The period between the onset of alcohol abuse and the first occurrence of EW syndromes was shorter in women than men [7], indicating that women are more vulnerable to EW. In agreement, an animal study reported that female mice showed more severe cell death in the forebrain compared to male mice [8].…”

Sex differences in neuroadaptation to alcohol and withdrawal neurotoxicity

“…However, it is not clear if sex differences may exist with regard to the manifestation of severe alcohol withdrawal or the “kindling-like” phenomenon observed with repeated alcohol withdrawals. While animal studies suggest a greater susceptibility to withdrawal seizure and greater duration of withdrawal in male rodents as compared to female rats or mice [6,150], studies of human samples suggest that either few sex differences exist [61,84] or that males display alcohol withdrawal of a greater severity than females [139,155]. Further, a link between withdrawal seizure and overt neurodegeneration has not been established.…”