Binge drinking in alcoholics who have undergone repeated detoxification is associated with an inability to interpret facial expressions properly; this is believed to be due to kindling of the amygdala with resultant distortion of neurotransmission.
It is possible in some cases that alcohol abuse via a kindling mechanism can cause the development of a chronic substance-induced psychotic disorder (e.g., schizophrenia).
[1] Binge drinking regimes are associated with causing an imbalance between inhibitory and excitatory amino acids and changes in monoamine release in the central nervous system, which increases neurotoxicity; this may result in cognitive impairments, psychological problems, and may cause irreversible brain damage in both adolescent and adult long-term binge drinkers.
[3][4] Similar to binge drinkers, individuals suffering from alcohol dependence develop changes to neurotransmitter systems, which occur as a result of kindling and sensitization during withdrawal.
This progressively lowers the threshold needed to cause alcohol-related brain damage and cognitive impairments, leading to altered neurological function.
The changes in activity of excitatory and inhibitory neurotransmitter systems is similar to that which occurs in individuals suffering from limbic or temporal lobe epilepsy.
Tolerance to drugs is commonly believed to be due to receptor down-regulation; however, there is very limited evidence to support this, and this hypothesis comes from animal studies using very high doses.
[7] Based on animal studies, regular binge drinking in the long-term is thought to be more likely to result in brain damage than chronic (daily) alcoholism.
Evidence from animal studies suggests that some people may be more genetically sensitive to the neurotoxic and brain damage associated with binge drinking regimes.
[3][4] Repeated acute withdrawal from alcohol which occurs in heavy binge drinkers has been shown in several studies to be associated with cognitive deficits as a result of neural kindling; neural kindling due to repeated withdrawals is believed to be the mechanism of cognitive damage in both binge drinkers and alcoholics.
The finding of kindling in alcoholism is consistent with the mechanism of brain damage due to binge drinking and subsequent withdrawal.