A sleeping giant: Suvorexant for the treatment of alcohol use disorder?

@article{Campbell2020ASG,
  title={A sleeping giant: Suvorexant for the treatment of alcohol use disorder?},
  author={Erin J. Campbell and Nathan J. Marchant and Andrew J. Lawrence},
  journal={Brain Research},
  year={2020},
  volume={1731}
}

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References

SHOWING 1-10 OF 82 REFERENCES

Nalmefene for the treatment of alcohol use disorders: recent data and clinical potential

  • M. Soyka
  • Medicine
    Expert opinion on pharmacotherapy
  • 2016
TLDR
Nalmefene is the first medication to be approved specifically in this indication and seems to be most suitable for patients with alcohol misuse or a rather low physical dependence on alcohol who do not require immediate detoxification or inpatient treatment.

Acamprosate in alcohol dependence: how does it work?

TLDR
It is suggested that acamprosate may reduce craving that is associated with conditioned withdrawal and be a novel kind of agent that suppresses "craving" in weaned alcohol dependent patients.

Role of Lateral Hypothalamic Orexin (Hypocretin) Neurons in Alcohol Use and Abuse: Recent Advances

TLDR
Recent studies have identified anatomic loci of action and interactions between OX and other neuropeptides that drive alcohol seeking, and future studies are required to fully elucidate these behaviors, in which optogenetic and chemogenetic approaches may prove useful.

Gabapentin treatment for alcohol dependence: a randomized clinical trial.

TLDR
Gabapentin was effective in treating alcohol dependence and relapse-related symptoms of insomnia, dysphoria, and craving, with a favorable safety profile and increased implementation of pharmacological treatment of alcohol dependence in primary care may be a major benefit of gabapentin as a treatment option for alcohol dependence.

Alcohol Detoxification and Relapse Prevention Using Valproic Acid Versus Gabapentin in Alcohol-dependent Patients

TLDR
The results of this randomized trial suggest that the anticonvulsants were not significantly better than placebo in treating mild withdrawal symptoms, did not influence relapse to alcohol and did not treat the symptoms of depression and sleep disturbance that occur in the postwithdrawal period.

Pharmacotherapy of alcoholism – an update on approved and off-label medications

TLDR
This paper discusses approved AUD medications, including the opioid antagonists naltrexone and nalmefene, the putative glutamate receptor antagonist acamprosate and the aldehyde dehydrogenase inhibitor disulfiram, and off-label medications of interest, including topiramate, gabapentin, ondansetron, varenicline, baclofen, sodium oxybate and antidepressants.

Gabapentin combined with naltrexone for the treatment of alcohol dependence.

TLDR
The addition of gabapentin to naltrexone improved drinking outcomes over nALTrexone alone during the first 6 weeks after cessation of drinking, and this effect did not endure after gabAPentin was discontinued.

Naltrexone in the treatment of alcohol dependence.

TLDR
The findings do not support the use of naltrexone for the treatment of men with chronic, severe alcohol dependence.

The hypocretin/orexin system as a target for excessive motivation in alcohol use disorders

TLDR
The role of ORX in alcohol-associated behaviors and whether and how this system could be targeted to treat alcohol use disorders while avoiding impacts on other ORX-relevant functions are focused on.
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