The kindling hypothesis: further evidence from a U.S. national study of alcoholic men.

A sample of 6818 alcoholic men participating in a short in-patient detoxification episode was studied to examine the kindling effect of repeated prior alcohol withdrawals on occurrence of seizures or severe withdrawal problems observed during the hospitalization. Subjects studied were hospitalized in one of 172 U.S. Department of Veterans Affairs medical centers. Patients with seizures and withdrawal problems had more prior detoxifications and other alcohol-specific hospitalizations. They were also more likely to be later readmitted for an alcoholism diagnosis. Patients with withdrawal problems during the detoxification episode studied were more likely to have such problems again as well as seizures during the readmission; those with seizures during the index detoxification were more likely to have repeated seizures during the readmission. These results confirm the kindling effect in a large, multi-site patient sample and suggest that alcohol detoxification programs may need to consider anticonvulsant therapy in patients with many prior detoxifications or withdrawals.