Article at a Glance:
Some medications can help people reduce or stop drinking, although no medication cures alcoholism.
FDA-approved medications to treatalcohol use disorderare Acamprosate, Disulfiram, and Naltrexone.
Anticonvulsants and Baclofen can be used to help someone stop drinking.
The effectiveness of medications varies between individuals.
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FDA Approved Medications to Stop Drinking
The FDA has approvedthree medicationsfor use in the treatment of alcohol use disorder (AUD):
- Acamprosate
- Disulfiram
- Naltrexone (oral and extended-release injectable)
In addition to the FDA-approved medications,other drugsare sometimes used off-label (without FDA approval) for treating AUD, such as:
- Anticonvulsants (including topiramate)
- Baclofen
Vivitrol (Naltrexone)
Vivitrol (naltrexone) is an opioid antagonist (blocker) medication, but it appears to reduce cravings in some individuals seeking treatment for AUD. This has generally been supported by the research literature, although it is still not possible to predict whom it will work well for.
The research evidencesuggests that naltrexone is more suited to helping people reduce their alcohol consumption than it is for helping them to stop drinking alcohol.
However,a recent studydemonstrated that Vivitrol merely accelerates a reduction in cravings by a few days. People treated with Vivitrol for alcoholism experienced a reduction in cravings that equaled out with those not treated with Vivitrol by about day 8 of treatment, thereafter the level of cravings were not different.
In this article, we review the major FDA-approved and off-label medications used to treat alcohol use disorder. Some may be useful adjuncts to treatment for some individuals.
For people who areaddicted to alcohol, stopping drinking can be a formidable obstacle. For many, all attempts at stopping are in vain, despite repeated earnest attempts. As they watch their alcohol use progressively destroy their lives, they become understandably desperate.
There are some medications that may help some people reduce or stop their obsessive drinking. However, it must be emphasized that, at best, these medications are an adjunct to getting proper treatment for alcohol addiction. There is no pill or no chemical that cures alcoholism.
Rather, lasting, long-term recovery from alcohol use requires carefully identifying and addressing thecauses of the addictionand the effects of the drinking and related behaviors on mind and body. That is the function ofalcohol treatment programsand the basis of their success.
However, for those who are seeking proper treatment for their alcohol addiction, there are some medication options that may be useful as a tool to support their recovery. The medications’ effectiveness varies between individuals because no two individuals are exactly alike.
Antabuse (Disulfiram)
Antabuse is a rather unusual medication in that it is designed to punish individuals who drink alcohol by making them very sick. It blocks one of the enzymes involved in alcohol metabolism so that toxic metabolites accumulate in the body and cause an unpleasant reaction: rapid heart rate, flushing, nausea, and vomiting.
As such, Antabuse uses a psychological deterrence to alcohol use by providing negative reinforcement; it does not have a direct pharmacological effect in preventing relapse.
However, disulfiram’s efficacy is heavily dependant upon supervised use of the drug; otherwise, people who are planning to relapse simply stop taking the medication. One large study showed that only 20% of people who take Antabuse are compliant without supervision. The psychological threat deterrent created by the drug is completely removed when the drug is stopped.
Campral (Acamprosate)
Campral is a novel medication to stop drinking. It acts on the same neurotransmitter systems that alcohol targets in the brain (glutamate, NMDA and GABA), apparently acting as an agonist and antagonist (blocker) and modulator of the receptors. Therefore, its effects appear to be from stabilizing the neurotransmitter system from the effects of alcohol.
Treatment with acamprosate for alcoholism is initiated once individuals have been detoxed from alcohol (not before five days after the last drink). Combining acamprosate and alcohol does not produce an aversion reaction.
Related Topic:Aversion therapy
Topamax (Topiramate)
Topamax is an anti-seizure medication that is sometimes used off-label (without FDA approval) to treat AUD. There issome evidence(although conflicting) that it may reduce alcohol consumption in some individuals.
Lioresal (Baclofen)
Baclofen is used off-label, mostly in Australia and some European countries, to treat AUD, despite a lack of clinical evidence backing its use. It is seldom used for AUD in the U.S.
A2018 reviewof all available research evidence showed that Baclofen makes little or no difference in the risk of relapse or how often people drink, and may even increase alcohol use.
