[Alcohol-induced hallucinosis. Clinical aspects, pathophysiology and therapy]

In recent years, little research has been focused on alcohol hallucinosis. The psychopathology of alcohol hallucinosis (vivid acoustic hallucinations, paranoid symptoms and fear) resembles paranoid schizophrenia, but other organic mental disorders have to be excluded too. Prognosis is usually good, but in 10-20% of cases alcohol hallucinosis tends to become chronic. Possible pathophysiological mechanisms involved in the development of the syndrome are changes in dopaminergic transmission or other neurotransmitter systems and neuronal membranes, elevated levels of betacarbolines and an impaired auditory system. For treatment, highly potent neuroleptics (haloperidol) are the drugs of first choice. In the case of alcohol abstinence the prognosis is good, but otherwise the risk of a recurrence is high.