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Alcohol MD

Drug Therapy

Although no "perfect" medication exists as an instant cure for alcoholism, researchers have strived to produce medicines that reduce cravings for alcohol and block reinforcing effects of alcohol in the brain with few side effects. Some medications used today affect certain chemicals in the brain to combat the desired effect of alcohol. Generally, taking any kind of prescription medicine with alcohol consumption is fraught with risk and is warned against with most medications

FDA Approved Treatment Methods

Naltrexone (ReVia) is an opiate antagonist, which blocks the desired effects of drugs like heroin while having no effect themselves. Although alcoholics ingest alcohol and not heroin, this medication blocks some of alcohol's rewarding effects like the "high" felt. Naltrexone users experience more of alcohol's sluggish, sedative effects and less of the euphoric, stimulant effects. Naltrexone may also block environmental cues in the brain to which alcoholics may have become conditioned, such as automatically drinking after work or in social situations.

Studies have shown that people who take prescriptions as directed have a lower relapse to heavy drinking and lower percentages of drinking days than people who did not take Naltrexone or who did not follow recommended doses regularly.

However, Naltrexone is expensive (almost $5 a day) and is not recommended for people with acute hepatitis or liver failure.

Disulfiram (Antabuse) produces very unpleasant effects, such as severe headache, flushing, vomiting and chest pain in reaction to alcohol. Antabuse is used to manage alcoholism and discourage alcohol consumption. The effects are so strong against alcohol that even alcohol found in toiletries and cough syrups can cause very strong reactions.

Disulfiram should not be the sole treatment for alcoholism and should be administered under a physician's supervision. Disulfiram has many adverse side effects for people with diabetes, heart, blood, or liver disease, and pregnant women.

Studies have shown that disulfiram will benefit only certain types of people who are high-functioning with alcohol problems related to high stress, where temporary usage will benefit their reactions to those situations.

Non-FDA Approved Treatment Methods

Prozac (Fluoxetine) is one of many Selective Serotonin Reuptake Inhibitors that blocks the neurons ability to re-absorb the serotonin that it releases. As alcohol causes a reduction in the release of serotonin, Prozac causes the little that is released to remain active longer thereby reducing some of alcohol's effects. Studies have shown a reduced intake of 15-20% in patients without a background of depression. However, there hasn't been a clear indication that SSRI's are effective in alcohol dependent individuals as opposed to mild or moderate drinkers.

Acamprosate (Campral) interacts with different chemicals in the brain, affecting two neurotransmitter systems involved in maintaining alcohol dependence. Acamprosate does not interact with alcohol or other medications prescribed for alcoholism, depression, anxiety, insomnia, or psychoses and is safe for people with liver problems.