Pathological Intoxication

[TooMuchCall]

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I'm a psych resident, recently treated a patient with what my attending described as pathological intoxication. DSMII/III. Opinions on this have been divided, but his presentation seemed consistent with the dx.

"Classically, pathological intoxication is said to occur when, after consuming a relatively small amount of alcohol, drinkers undergo a marked change in behavior, often becoming agitated or violent, afterwards having at best a spotty memory for the event."

Is it real? Not sure. I had never heard of it prior to his mentioning it to me. Still not sure if there is such an entity.

 

[BobA]

I swear, I only had two sips of beer but the officer didn't believe that's why I was driving erratically. It must have been a pathological intoxication.

 

[TooMuchCall]

Yeah, I get what you're saying. It does seem to be a bit of a legal defense more than a legitimate psychiatric entity.

 

[Regnvejr]

LOL. Some people may be extra sensitive, but they would figure out pretty early. Sounds silly. Intoxication with low BAL, at least in my experience, typically is a late effect from intoxication with high BAL

 

[kugel]

there used to be a lot of talk about two kinds of alcoholics.
I forget if it's Types I & II or Types A & B

One type develops slowly as both tolerance and using alcohol as a coping mechanism build over time. This was considered the more common type.

The other tends to clearly remember the very first intoxication as WONDERFUL and included feeling free and powerful. These people are considered more likely to become problem drinkers very fast and are more likely to have 1st degree male relatives with the same kind of pattern. There was even talk of slightly different biochemistry that leads to a dramatic intoxicating effect more quickly. Although it sounds like they would drink less per session (b/c it takes less to produce intoxication), in fact they drink more and very quickly in order to reach the high they're seeking.

Or was this all part of some alcoholic hallucinosis of mine during residency?