Alcohol Withdrawal and Limbic Kindling: A Hypothesis of Relapse

B. Adinoff, H. K. O'Neill, J. C. Ballenger

Research output: Contribution to journalArticlepeer-review

27 Scopus citations


In this concept paper, the authors review the arguments and evidence for the hypothesized link between the alcohol withdrawal syndrome and the anxiety and craving that occurs during abstinence in alcohol‐dependent patients. This hypothetical construct suggests that the repeated experience of alcohol withdrawal and its associated limbic‐neuronal discharge induces a permanent state of limbic hyperexcitability. This phenomenon has been referred to as “kindling.” Subsequent episodes of limbic discharge may then be precipitated during abstinence by alcohol‐related cues or may even occur spontaneously. Subjectively experienced as anxiety or craving, such a neuronal discharge could provoke relapse to drinking in vulnerable subjects. The clinical, neurochemical, and electrophysiologic rationale for this hypothesis will be presented, along with implications for treatment and suggested future studies. 1995 American Academy of Addiction Psychiatry

Original languageEnglish (US)
Pages (from-to)5-17
Number of pages13
JournalThe American Journal on Addictions
Issue number1
StatePublished - 1995

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Clinical Psychology
  • Psychiatry and Mental health


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