Alcohol Dependence - withdrawal is typically characterized by which feature?

• A. Hypersympathetic state around 18 hours after last drink; morning "eye opener" to calm nerves
• B. Depressed mood lasting weeks after withdrawal
• C. Euphoria during withdrawal
• D. Seizures as the first symptom

Answer: (A)

Alcohol withdrawal is driven by rebound central nervous system hyperactivity once alcohol, a depressant, is stopped. The most characteristic early change is autonomic overactivity—the hypersympathetic state—that emerges within hours after the last drink. This includes tremors, tachycardia, sweating, hypertension, anxiety, and insomnia. The phrase “morning eye-opener” captures how some individuals drink soon after waking to relieve these withdrawal symptoms, reinforcing dependence.

Other options don’t fit this typical early pattern: depressed mood lasting weeks reflects a longer-lasting post-acute withdrawal state, not the immediate autonomic symptoms; euphoria during withdrawal is not characteristic; seizures can occur in withdrawal but are not the first or most common presenting feature.