What are the best anti-addiction medications, especially for alcoholism? I'm really struggling.

The treatment of alcoholism by use of medication is called "pharmacotherpay", and the drugs fall into a few different categories:

1. Anti-craving Medications
- naltrexone (Revia), an opioid antagonist, reduces urge to drink by blocking the pleasure-seeking chemicals in your brain
- naltrexone (Vivitrol), injected once/month and may reduce urge to drink by blocking neurotransmitters in brain associated with alcohol dependence
- acamprosate (Campral), a glutamate antagonist, is an "anti-craving medication" that may help you combat alcohol cravings and remain abstinent from alcohol. The American Academy of Family Physicians (AAFP) said, "acamprostate...may almost double the abstinence rate among recovering alcoholics."

2. Aversive Pharmacotherapy
- disulfiram (Antabuse) is an "alcohol-sensitizing" drug that acts as a deterrent, causing severe physical reactions when drinking alcohol. It works by blocking the metabolism of acetaldehyde and causes an unpleasant flushing reaction if taken with alcohol.

3. Pharmacotherapy for Comorbid Conditions
"Depression and anxiety can precipitate heavy drinking but can also be a result of alcohol abuse. Fluoxetine (Prozac), a selective serotonin reuptake inhibitor, has been found to be effective in decreasing depressive symptoms and the level of alcohol consumption".

Another medication found in the medical literature:
- topiramate, was found to "not only decrease heavy drinking but also diminish the physical and psychosocial harm caused by alcohol dependence." Study published in Internal Medicine and can be viewed at: "Pivotal Breakthrough Made In Alcohol Addiction Treatment (Science Daily), June 2008.
- Topiramate is an anticonvulsant drug. Study published in the Lancet, 2003 demonstrated that subjects who received 300 mg/day of topiramate were much more likely to abstain from both alcohol and tobacco than patients receiving only brief therapy. In this study, topiramate had no effect on mood.

- Most important aspect of treatment: "medication adherence"
Another study found that the most important aspect of treatment, whether it be medication or behavior therapy, was "medication adherence" (basically, taking the drug as instructed on a consistent basis was more important than the type of medication). The study compared naltrexone and acamprosate. You can read the article here.

These drugs are for use in combination with medical and behavioral therapy, after through medical and psychological examination, as well as treatment for withdrawal symptoms. Your level and type of dependence on alcohol, and any withdrawal symptoms or physical effects from alcohol use, will determine the medication(s) that your medical doctor recommends.

It is great that you are doing your own research before your visit with your doctor! Let us know if you have any further questions, and we would love to hear about your visit and what was recommended; your information could help even more women who are struggling with alcohol dependence.

For more info. on clinical trials, treatment and information:
-National Institute of Alcohol Abuse and Alcoholism (NIAAA), part of the National Institutes of Health (NIH)
-journal of Alcoholism: Clinical and Experimental Research is a medical journal that your treating doctor should be reading (or another equivalent medical journal; I would ask which ones s/he reviews to keep up-to-date). You can ask him/her for articles that pertain to you; I would ask for literature and you can also read these journals at a local or University library.
- Mayo Clinic's "Treatment and Drugs" for Alcoholism
- Alcoholism
- Lastly, here is a Quick Guide to Finding Effective Alcohol and Drug Addiction Treatment

(all of the orange bold words are links to external medically-credible health resources online).

I am sorry to hear that you are suffering. It is never easy dealing with addiction.

There is always AA (Alcoholics Anonymous). Thats a great place to get some support from others that are also suffering from alcoholism. You can find more information on their website at www.aa.org.

The FDA actually came out with a new drug that helps fight off alcoholism and you may want to consult your physician to try and see if it is something you could try. Here is the link to the new drug http://www.foxnews.com/story/0,2933,191857,00.html. It is called vivirtol.

I would consult your physician before trying the new drug but it may help. Do you have a good support system? Family, friends that will help assist with your sobriety?