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Review Papers | Psychiatry | India | Volume 12 Issue 1, January 2023

Agmatine and Acetyl L Carnitine - A Novel Adjunctive Therapy for Management of Alcohol Withdrawal Syndrome

Dr. Ab Samad | Dr. Prashant Jalak | Dr Anupam Borade | Dr. Ravindra N Chavhan | Dr. Adwait Jadhav

Abstract: The majority of the rise in global alcohol consumption over the past few decades has been seen in developing nations. According to the ICMR Bulletin, there are 62 million alcoholics in India, which is equal to the size of France's population, and up to 50% of alcohol use disorder (AUD) patients experience alcohol withdrawal symptoms (AWS). The clinical appearance ranges from moderate to severe, and a small percentage of individuals have severe alcohol withdrawal symptoms, including delirium tremens that lead to the length of stay more than double for severe in AWS. Epileptic seizures and/or delirium tremens (DT), which can occur in up to 15% of AUD patients, are symptoms of severe AWS. When a chronic user abruptly discontinues drinking, the alcohol-mediated CNS inhibition is reduced, allowing glutamate-mediated CNS excitation unopposed, resulting in net CNS excitation. Benzodiazepines (BZDs) are currently the "gold standard" in the treatment of AWS. Available pharmacotherapy for alcohol withdrawal syndrome has various disadvantages including the fact that it only works on GABA. Agmatine is a polyamine that has been considered a potential central nervous system neurotransmitter or neuromodulator, it has a multi-model action on the other hand Acetyl l carnitine (ALCAR) is one of the most common carnitine metabolites discovered in humans and mammalian plasma and tissues, it enhancing brain energy metabolism, modulating neurotransmitters, and increasing neural plasticity. The synergistic effects of Agmatine and acetyl l carnitine can be used to manage delirium and other core symptoms of alcohol withdrawal. Hence, the aim of this review is to increase awareness of AWS and adjunctive use of Agmatine and acetyl l carnitine in the management of alcohol withdrawal syndrome and complications arising during alcohol withdrawal such as delirium, Fatigue, seizures, anxiety, cognitive impairment, melancholia (depression), agitation, and anhedonia.

Keywords: Alcohol withdrawal symptoms, Delirium, Agmatine, acetyl l carnitine

Edition: Volume 12 Issue 1, January 2023,

Pages: 658 - 668