Medications for Alcoholism and Alcohol Abuse
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The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included, so ask your doctor if you need to take any special precautions. Use each of these medications as recommended by your doctor, or according to the instructions provided. If you have further questions about usage or side effects, contact your doctor.
Certain medications can help alleviate symptoms of alcohol withdrawal and help prevent relapse. Your doctor may prescribe medication to reduce cravings for alcohol. Medications used to treat alcoholism will vary on a case-to-case basis.
Prescription Medications
- Naltrexone (ReVia)
- Disulfiram (Antabuse)
- Campral
Selective Serotonin Reuptake Inhibitors (SSRIs)
- Fluoxetine (Prozac)
- Sertraline (Zoloft)
- Paroxetine (Paxil)
- Citalopram (Celexa)
- Fluvoxamine (Luvox)
- Buspirone (BuSpar)
- Diazepam (Valium)
- Chlordiazepoxide (Librium)
- Alprazolam (Xanax)
- Lorazepam (Ativan)
- Midazolam (Versed)
- Oxazepam (Serax)
- Topiramate (Topamax)
Prescription Medications
Alcohol Abuse Adjunct Therapy
- Naltrexone (ReVia, Vivitrol)
Naltrexone is used to help you to stay away from alcohol, but it is not a cure for addiction. It may work by blocking the high that makes you crave alcohol. It will not, however, prevent you from experiencing the effects of alcohol. Naltrexone is available as a pill (ReVia) and an injection in the muscle (Vivitrol).
Possible side effects include:
Alcohol Abuse Deterrent
- Disulfiram (Antabuse)
Disulfiram (Antabuse) helps you overcome your drinking problem by making you very sick if you drink alcohol. However, it does not "cure" alcoholism. While you take this medicine, and for 14 days before you begin taking it, you should not drink even the smallest amount of alcohol. You should not use any foods, products, or medicines that contain alcohol, nor should you come into contact with any chemicals that contain alcohol while using this medicine.
If you use alcohol while taking this medicine, you may experience some of the following symptoms:
- Nausea and vomiting
- Chest pain
- Dizziness or fainting
- Sweating and flushing
- Difficulty breathing
- Confusion
- Weakness
- Rapid heart beat
- Drowsiness
Symptoms will last from 30 minutes to several hours.
Acamprosate
Acamprosate (Campral) reduces your craving for alcohol by inhibiting a chemical in your brain called gamma aminobutyric acid (GABA). Several studies have indicated that it may help you remain abstinent.
Possible side effects include:
- Diarrhea
- Headache
Selective Serotonin Reuptake Inhibitors (SSRIs)
- Paroxetine (Paxil)
- Sertraline (Zoloft)
- Fluoxetine (Prozac)
- Citalopram (Celexa)
- Fluvoxamine (Luvox)
Selective serotonin reuptake inhibitors (SSRIs) affect the concentration of the neurotransmitter serotonin, which plays a role in anxiety and depression . SSRIs may be used to reduce cravings for alcohol. They are also helpful if you have a coexisting psychiatric problem, such as an anxiety disorder or depression. Improvement is usually seen in 4-6 weeks after beginning treatment.
Possible side effects include:
- Nausea
- Diarrhea
- Insomnia
- Sexual dysfunction (ranging from decreased arousal to erectile dysfunction and/or delayed time to orgasm)
- Risk of severe mood and behavior changes, including suicidal thoughts in some patients (Young adults may be at a higher risk for this side effect.)
Azapirones
- Buspirone (BuSpar)
This anti-anxiety drug may be used in the treatment of alcoholism and withdrawal symptoms, as well as a coexisting anxiety disorder. It takes from 2-4 weeks for improvement to be evident. For this reason, this drug is not useful for treating acute anxiety and insomnia. The primary advantages of buspirone are that it is less sedating than benzodiazepines, and it does not result in physical dependence or tolerance.
Buspirone should be taken with food to increase absorption. Do not take with MAO inhibitors. Avoid alcohol in excessive amounts when taking this medication due to possible adverse reactions.
Possible side effects include:
- Excitability
- Headache
- Nausea
- Dizziness
Benzodiazepines
- Diazepam (Valium)
- Chlordiazepoxide (Librium)
- Alprazolam (Xanax)
- Lorazepam (Ativan)
- Midazolam (Versed)
- Oxazepam (Serax)
Benzodiazepines are anti-anxiety drugs that may be used to relieve withdrawal symptoms of alcoholism and reduce the risk of seizures . These drugs produce a sedative effect and are fast-acting. Benzodiazepines are usually not used for long periods of time because they can lead to dependence and may cause withdrawal symptoms when discontinued.
Possible side effects include:
- Drowsiness
- Dizziness
Other Treatments
- Topiramate (Topamax)
Topiramate (Topamax) is an anticonvulsant drug. A 2007 study found that this medication may reduce alcohol dependence.
Possible side effects include:
- Numbness and tingling
- Headache
- Taste alteration
- Fatigue
- Loss of appetite
- Dizziness
Special Considerations
Contact your doctor if your medication does not seem to be working after the allotted period of time or if you have any side effects that are troublesome or persistent.
Special Considerations
If you are taking medications, follow these general guidelines:
- Take your medication as directed. Do not change the amount or the schedule.
- Do not stop taking them without talking to your doctor.
- Do not share them.
- Know what the results and side effects. Report them to your doctor.
- Some drugs can be dangerous when mixed. Talk to a doctor or pharmacist if you are taking more than one drug. This includes over-the-counter medication and herb or dietary supplements.
- Plan ahead for refills so you don’t run out.
References:
Antidepressant use in children, adolescents, and adults. US Food and Drug Administration website. Available at: http://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/UCM096273 . Published May 22, 2009. Accessed July 15, 2009.
Carson RC, Butcher JN, Mineka S. Abnormal Psychology and Modern Life . 11th ed. Boston, MA: Allyn and Bacon; 2000.
Kleber HD, Weiss RD, Anton RF Jr, et al. Practice Guideline for the Treatment of Patients with Substance Use Disorders. 2nd ed. American Psychiatric Association website. Available at: http://www.psych.org/psych_pract/treatg/pg/SUD2ePG_04-28-06.pdf . Accessed April 14, 2007.
Myrick H, Brady K. Current review of the comorbidity of affective, anxiety, and substance use disorders. Curr Opin Psychiatry. 2003;16:261-270.
National Institute on Alcohol Abuse and Alcoholism website. Available at: http://www.niaaa.nih.gov/ .
USP DI . 21st ed. Micromedex; 2001.
10/29/2007 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Johnson BA, Rosenthal N, Capece JA, et al. Topiramate for treating alcohol dependence: a randomized controlled trial. JAMA. 2007;298:1641-1651.
5/14/2010 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Vivitrol (naltrexone). US Food and Drug Administration website. Available at: http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm106211.htm. Accessed May 14, 2010.
Last reviewed November 2009 by Theodor B. Rais, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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