Modified: August 01, 2023
ethanol
This page is from my personal notes, and has not been specifically reviewed for public consumption. It might be incomplete, wrong, outdated, or stupid. Caveat lector.Probably the simplest and smallest molecule used as a psychoactive drug: It is neurotoxic, carcinogenic, and addictive, but of course still widely used as a "legacy drug". (see alcohol substitutes)
Being such a lightweight molecule, taken in relatively enormous doses (a typical alcoholic 'drink' might contain 15g of pure ethanol, approximately 1000x more than a typical dose of THC) it does a lot of stuff in the body. We can't easily characterize its psychoactive effects in terms of a single neurotransmitter, because it gets everywhere and affects pretty much every system.
It seems to act on most receptors generally as an "allosteric modulator", binding to a different site on the receptor than the usual (orthosteric) site of the endogenous ligand (e.g., it binds to GABA_A receptors at a different site than GABA itself would bind), but in a way that either up- or down-regulates the activity of the receptor with respect to its usual ligand.This seems unsurprising since it's such a small molecule; as a tiny "key" it's unlikely to activate any specific elaborate "lock", but it will accidentally have small effects on everything it touches For example, ethanol is a positive modulator of GABA_A receptor receptors, which may account for its general anxiolytic effect, but also a negative modulator of various glutamate receptors, which may account for its dyscoordinating "drunkenness" effect.
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