Medications for Alcoholism and Alcohol Abuse

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:

• Stomach cramps
• Headache
• Muscle or joint pain
• ]]>Anxiety]]> , nervousness, and ]]>insomnia]]>
• Fatigue
• Nausea and vomiting
• Adverse reactions at the injection site (Vivitrol)

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

• Campral]]>

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.