People who develop an addiction or dependency on alcohol may have a difficult time quitting and abstaining from drinking long-term. Physical withdrawal effects and psychological dependence symptoms such as intense cravings for alcohol can make alcohol abstinence a challenge. However, a number of medications are available to treat these symptoms and reduce the risk of relapse.
Benzodiazepines
Benzodiazepines are anti-anxiety agents. According to the National Guidelines Clearinghouse, benzodiazepines should be used to treat withdrawal symptoms in alcohol detoxification for a maximum of seven days. Benzodiazepines that may be prescribed include diazepam, lorazepam, Phenobarbital, chlordiazepoxide and oxazepam. Chlordiazepoxide is recommended for patients managed in the community.
Topiramate
Topiramate is an anticonvulsant (anti-seizure) medication that works on the neurotransmitter dopamine in the brain and affects pleasurable sensations those with alcohol dependence get from drinking. Studies have shown that topiramate can decrease heavy drinking, improve liver enzymes, cholesterol levels, body mass index, blood pressure and obsessive thinking about alcohol, according to the Addiction Recovery Guide.
Although topiramate may be an effective treatment, the National Guidelines Clearinghouse urges that anti-seizure medication should not be used as the sole medication during alcohol detoxification in primary care.
Baclofen
Baclofen is a muscle relaxant that may reduce alcohol cravings. It works by acting on gamma-Aminobutyric acid (GABA) in the brain, an amino acid that acts as a neurotransmitter. It's partially responsible for regulating excitability of the neurons in our central nervous system.
Acamprosate
Acamprosate is approved by the Food and Drug Administration for treatment of alcohol dependence and withdrawal. It acts on GABA in the brain to help reduce relapse and improve negative thoughts and cravings that sometimes occur during abstinence. It may not be appropriate for those who are currently drinking when they start the drug, or for those who are using or abusing other substances. Acamprosate is recommended for use in conjunction with behavior therapy.
Naltrexone
Naltrexone is FDA approved for the treatment of alcohol dependence. By blocking the pleasure centers of the brain that are usually stimulated when you drink alcohol, it lessens alcohol's positive effects and reduces the urge to drink. Although adherence to treatment using the oral form of naltrexone has been a problem, a long-acting, once-a-month naltrexone injection has shown promise in reducing heavy drinking over six months, according to the Addiction Recovery Guide. Naltrexone may be particularly effective when combined with behavioral therapy.
Disulfiram
Disulfiram is a drug that has been used since the 1950s to treat chronic alcoholism. It causes severe nausea, flushing, a headache, dizziness, lowered blood pressure and vomiting in people who drink alcohol. Although some studies have shown that disulfiram reduces alcohol cravings and risk of relapse, a review published in the November 2005 issue of American Family Physician said that disulfiram does not increase abstinence rates or decrease cravings when compared with a placebo, and recommended the drug not be prescribed for routine use in primary care.
Serotonergic Agents
The November 2005 review in American Family Physician says fluoxetine (a selective serotonin reuptake inhibitor, or SSRI) may be appropriate in patients who also have comorbid depressive disorders.
Another serotonergic agonist called ondansetron that's sometimes used to treat nausea and vomiting associated with chemotherapy may also be effective in treating alcoholism. Though not yet FDA approved for the purpose of treating alcohol dependence and withdrawal, it has been shown to stop cravings, decrease alcohol consumption and promote abstinence in early-onset alcoholics.
