The short answer is a resounding ‘Yes!’

With the millions of people out their struggling with alcohol dependence, the use of medications to help curb and eventually stop alcoholism is a practice that has been used for decades and continues to have encouraging results. If you or someone you know is struggling with this disease to a point of physical illness, loss of productivity in daily tasks, and strained personal relationships, medication might be a good fit for your particular case.

Today, our esteemed Dr. Bader will go into the history behind this topic, as well as three of the available medications that treat alcoholism.

Is ‘Anti-Drinking’ Medication a New Option?

Actually, one of the oldest medications for alcoholism has been around and prescribed to patients as early as 1950. This medication is called Disulfiram (or Antabuse) and it has a long history of helping individuals stay sober. The extreme hangover-like side effects that occurred from taking this particular medication eventually spurred the creation of several other medication options overtime – these types instead attack the alcohol dependency at a biological level, making it less likely for individuals to drink or drink heavily. When combined with therapy and/or engagement in 12-step meetings, the impact of these medications over the years has been quite profound.

What Medications Are Available Today?

Currently there are three medications that are FDA approved to treat alcohol dependence: Naltrexone, Acamprosate, and Disulfiram.

*Author’s Note: Other medications including Topiramate (Topamax) and Gabapentin (Neurontin) are not approved by the FDA but have been used “off label” and found to be effective in helping those struggling with alcohol dependence.

Here is a little information about each medication option:

Naltrexone (ReVia/Vivitrol)

Naltrexone is the most widely prescribed medication for alcohol dependence. Acting as an opiate ‘blocker’, it reduces cravings for alcohol and can help maintain total abstinence over time.

Pros

• Can reduce the amount one drinks if actively drinking.
• Reduces the cravings and withdrawals created from alcohol use.
• Naltrexone is available in a once monthly injection form (Vivitrol).

Cons

• Most common side effects are abdominal cramping and diarrhea.
• Should not be used if you have significant liver damage.
• Liver enzymes need to be monitored while on the medication.
• You cannot use opiates (pain pills) while on the medication.

Acamprosate (Campral)

Acamprosate is thought to work by stabilizing the chemical imbalance in the brain created by alcohol use.

Pros

• Acamprosate can potentially help with sleep problems, anxiety, and mood swings caused by prolonged withdrawal.
• Helps people struggling with alcohol dependence remain sober.
• Metabolized by the kidneys instead of the liver (a good alternative for people with liver damage).

Cons

• Needs to be taken three times daily.
• Most common side effects are diarrhea and headaches.

Disulfiram (Antabuse)

As the oldest (came into the industry in 1951) and most heavily tested medication for alcoholism, Disulfiram works by blocking the breakdown of alcohol at a step that causes the accumulation of acetaldehyde (a key ingredient for the symptoms of a ‘hangover’).

Pros

• It has been tested and administered the longest (since 1951).
• Has been effective for individuals that regularly take the medication – supervised administration is often used to aid compliance (ie: by a family member or significant other)

Cons

• Drinking while on Disulfiram causes the effects of a severe hangover which may last from 30 minutes up to a few hours and includes flushing of the skin, elevated heart rate, nausea, vomiting, and throbbing headache.
• Should not be taken if alcohol has been consumed in the past 12 hours.
• Does not reduce cravings for alcohol like Naltrexone does.
• Should not be used in individuals with severe heart disease.

As you can see, medication can be a vey useful and effective tool in the treatment of alcohol dependence. If you, or someone you know, are struggling with alcohol use, be sure to discuss this potential treatment option with your provider.

Live Mentally Healthy,
Cognitive Psychiatry of Chapel Hill