New pharmacological approaches for the treatment of alcoholism

  title={New pharmacological approaches for the treatment of alcoholism},
  author={Michael Soyka and Susan A Roesner},
  journal={Expert Opinion on Pharmacotherapy},
  pages={2341 - 2353}
  • M. SoykaS. Roesner
  • Published 17 November 2006
  • Medicine, Psychology
  • Expert Opinion on Pharmacotherapy
Pharmacological relapse prevention in alcoholism is a rather new clinical field with few drugs being available. Acamprosate, acting predominantly via glutamatergic pathways, and the opioid receptor antagonist naltrexone, were both shown to be efficient in improving rates for continuous abstinence, and not relapsing to heavy drinking in a number of clinical trials and meta-analyses. There are conflicting data on both drugs, especially for acamprosate, according to some recent US studies. However… 

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Effective, patient-tailored treatment will require greater understanding provided by many more preclinical and clinical studies, and medications that deserve further preclinical or clinical study are highlighted.

Glutamatergic substrates of drug addiction and alcoholism.

Treatment of alcohol dependence in patients with co-morbid major depressive disorder – predictors for the outcomes with memantine and escitalopram medication

BackgroundAlcohol dependence comorbid with major depressive disorder poses a major challenge in the clinical setting. The results in the treatment with selective serotonin re-uptake inhibitors have

The effects of alcohol on neurotransmitters appear to mediate the risk for alcohol use disorder : a brief update

These practice guidelines for the biological treatment of alcohol use disorders are an update of the first edition, published in 2008, and provide a clinically and scientifically relevant, evidence-based update of earlier recommendations.

Guidelines for biological treatment of substance use and related disorders, part 1: Alcoholism, first revision

These practice guidelines for the biological treatment of alcohol use disorders are an update of the first edition published in 2008 and provide a clinically and scientifically relevant, evidence-based update of earlier recommendations.

Baclofen improves abstinence in alcoholic cirrhosis: Still better to come?

Neurobiology, Genetics and Treatment of Alcohol Craving

The main drugs currently used in the treatment of alcohol craving and other potential drugs and future choices for treating alcohol craving were described.

Pharmaco-EEG-based assessment of the interaction between ethanol and oxcarbazepine.

Pharmaco-EEG-based assessment of interaction between ethanol and topiramate Bogus 3

Topiramate used at multiple doses enhanced the effect of ethanol on EEG recording from the frontal cortex and midbrain reticular formation and reduced the sensitivity of the hippocampus to theeffect of ethanol, which may be associated with the effectiveness of topiramate in the therapy of alcoholism in humans.



Efficacy of naltrexone and acamprosate for alcoholism treatment: a meta-analysis.

Both naltrexone and acamprosate are efficacious in reducing alcohol consumption in alcoholics, however, their specific role in alcoholism treatment remains to be more clearly defined.

Neuropharmacological treatments for alcoholism: scientific basis and clinical findings

Of the medications reviewed, acamprosate’s potential appears to be the most widely established and ondansetron, a serotonin3 antagonist, offers new hope for the treatment of early onset alcoholics; a type of alcoholism most difficult to manage with psychosocial measures alone.

Update on anticonvulsants for the treatment of alcohol withdrawal.

Controlled trials are underway exploring the efficacy and safety of newer anticonvulsants for the treatment of alcohol withdrawal, including gabapentin and vigabatrin, which appear to reduce alcohol withdrawal symptoms in preclinical and open-label clinical trials while lacking the toxicities of carbamazepine and divalproex.

Pharmacological treatment of alcohol dependence: a review of the evidence.

Evaluating the efficacy of 5 categories of drugs used to treat alcohol dependence found some evidence that drinking frequency is reduced but minimal evidence to support improved continuous abstinence rates, and recent reports documenting that naltrexone and acamprosate are more effective than placebo justify clinical interest in use of these medications for alcohol-dependent patients.

Double-Blind Clinical Trial of Sertraline Treatment for Alcohol Dependence

Sertraline treatment seemed to provide an advantage in reducing drinking in alcohol-dependent patients without lifetime depression, illustrated best with a measure of drinking frequency during treatment, however, sERTraline was no better than placebo in patients with a diagnosis of lifetime comorbid depression, and current depression did not change the results.

The use of divalproex in alcohol relapse prevention: a pilot study.

Naltrexone in the treatment of alcoholism.

A safe and well-tolerated opiate antagonist, naltrexone, was approved by the Food and Drug Administration for the adjunctive treatment of alcoholism and the pertinent preclinical and clinical research that led to the FDA's approval is described.

Naltrexone and cognitive behavioral therapy for the treatment of outpatient alcoholics: results of a placebo-controlled trial.

Motivated individuals with moderate alcohol dependence can be treated with greater effectiveness when naltrexone is used in conjunction with weekly outpatient cognitive behavioral therapy.

A double-blind, placebo-controlled pilot study of carbamazepine for the treatment of alcohol dependence.

Despite the small sample size, compliance difficulties after 4 months and a sizable drop-out rate, there were treatment effects favoring carbamazepine, and these pilot results are encouraging and support carbazepine as a possible pharmacologic tool in the treatment of alcohol dependence.

Pharmacotherapy, pharmacogenomics, and the future of alcohol dependence treatment, Part 2.

  • G. A. KennaJ. McGearyR. Swift
  • Medicine
    American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists
  • 2004
In addition to existing drug treatments for alcohol dependence, many other medications are under investigation, particularly for specific types of alcoholism, and Pharmacogenomics is expected to play an important role in this research effort.