Alcohol- and drug-related neurotoxicity

The nervous system is vulnerable to a wide range of toxic insults. Historically, the toxic syndromes most often encountered have involved drugs of abuse, most notably alcohol. Cocaine has also been securely identified in recent years as neurotoxic. Equally distressing are neurotoxic disorders resulting from the administration of drugs for other conditions, and a growing literature is documenting these effects as well. This review discusses the cerebral basis of drug abuse and then considers recent data on the neurotoxicity of ethanol, methanol, and cocaine. Finally, selected examples of iatrogenic drug effects illustrate the variety of toxic syndromes that can occur with commonly employed treatment modalities.