Nitric oxide mediates cardiovascular symptoms in alcohol withdrawal

We studied whether nitric oxide is involved in cardiovascular symptoms in alcohol withdrawal. Cardiovascular effects of isosorbide dinitrate (ISDN; 20 mg sublingually), a nitric oxide donor were compared in 21 alcohol-dependent subjects during alcohol withdrawal (n = 11) on days 1, 2, 3, and 10 to those during remission (n = 10; duration = 60.7 ± 10.5 days). Cardiovascular parameters were measured non-invasively. The levels of systolic and diastolic blood pressure, total peripheral resistance were significantly higher in patients with withdrawal than in remission. Same cardiovascular parameters showed different response to ISDN during withdrawal when compared to remission. The differences were largest during the initial phase (1–2 days) of withdrawal. Nitric oxide may mediate at least some cardiovascular symptoms in withdrawal.