Presently available evidence for the action of ethanol on the peripheral noradrenergic system is reviewed. Acute ethanol treatment produces an initial elevation in catecholamine levels in blood, and in the excretion of catecholamines, which may be followed by a decrease in catecholamine release. Correspondingly, a hyposensitivity of peripheral beta receptors has been noted. Other tissues such as vascular smooth muscles show a biphasic response to ethanol: a hypersensitivity to norepinephrine at low concentrations of ethanol, and hyposensitivity to norepinephrine at high ethanol concentrations. In the adrenal medulla the activity of various enzymes involved in catecholamine synthesis is increased by ethanol treatment. Chronic treatment with ethanol does not alter endogenous norepinephrine levels in heart, but does increase its turnover. Chronic treatment also lowers the number of beta-adrenergic receptors in the heart, and decreases the response to peripherally administered isoproterenol, which suggests a hyposensitivity of peripheral beta receptors. Tolerance may develop to the chronic effects of ethanol in the heart and the vas deferens, but in the adrenals the activity of enzymes for catecholamine synthesis remains elevated with chronic treatment. During withdrawal, there is generalized hyperexcitability of the sympathetic nervous system. Norepinephrine and amine turnover in the heart is increased, as is the activity of adrenal medullary enzymes involved in catecholamine synthesis.
