Patients treated with acamprosate and standard care showed significantly greater improvement, with 64 percent reporting no alcohol-related problems for 1 year compared with 50.2 percent of those receiving standard care alone. Although the study physicians had prior experience treating alcoholism and had participated in at least one clinical trial, the general conclusion from this study was that general practitioners could effectively use acamprosate to manage alcohol dependence. Naltrexone also reduced the risk of having a heavy-drinking day, but this effect was most evident in those receiving medical management but not CBI. Acamprosate showed no significant effect on drinking versus placebo, either by itself or with any combination of naltrexone, CBI, or both. These results suggest that health care providers could use a primary care model of counseling with pharmacotherapy to improve treatment outcomes.

  • The balance of these systems in the brain of a person who has been drinking heavily for a long time gets thrown off, Holt says.
  • This is a good option for anyone who has difficulty regularly taking the pill.
  • It is important to caution individuals that they can experience the reaction with any product containing alcohol such as certain mouthwashes and cold remedies, alcohol-containing mouthwash, and food prepared with alcohol.

It works in the brain by blocking the high that people experience when they drink alcohol or take opioids like heroin and cocaine. Disulfiram was first developed in the 1920s for use in manufacturing processes. The alcohol-aversive effects of Top 5 Tips to Consider When Choosing a Sober House for Living Antabuse were first recorded in the 1930s. Workers in the vulcanized rubber industry who were exposed to tetraethylthiuram disulfide became ill after drinking alcohol. You and your doctor will decide how long you should take naltrexone.


The researchers conducted three studies that examined the use of spironolactone to treat alcohol misuse. In the United States, 17 million adults ages 18 years or older have alcohol use disorder, according to the Agency for Healthcare Research and Quality (AHRQ), part of the Department of Health and Human Services. In 2019, only 1.6 percent of adults with AUD took a pill to help them stop drinking, according to a report published in JAMA Psychiatry that looked at national survey data.

The implementation and widespread use of medications to treat alcohol problems faces a unique set of barriers in primary care. Although primary care providers are proficient at prescribing a wide variety of medications, they generally are unfamiliar with medications for treating alcohol problems other than those used to treat alcohol withdrawal. Indeed, a growing body of research to support basic screening methods, brief interventions, and especially medication therapy has yet to have a major impact on how primary care providers care for individuals at risk for or with alcohol problems (D’Amico et al. 2005). The results of studies on how to enhance the use of screening and brief intervention, however, may inform how to promote medication treatments for alcohol problems in primary care. In addition, the success of strategies to implement screening and brief-intervention practices in primary care appears to rely on a variety of complex provider and organizational characteristics (Babor et al. 2005). Understanding and addressing these characteristics may be particularly important if these medications are to gain acceptance in primary care.

Medications to Treat Alcohol Withdrawal

This is a good option for anyone who has difficulty regularly taking the pill. Daily drinking can have serious consequences for a person’s health, both in the short- and long-term. Many of the effects of drinking every day can be reversed through early intervention. Other supplements such as L-glutamine and milk thistle are thought to decrease cravings and aid in detoxifying the liver, respectively. There is some evidence that milk thistle aids in the regeneration of liver cells. However, these supplements have not been thoroughly substantiated with scientific research to confirm the efficacy of their actions and benefits.

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  • Topiramate facilitates GABA function and antagonizes glutamate, which should decrease mesocorticolimbic dopamine after alcohol and reduce cravings.

In contrast, ondansetron (a selective serotonin-3 [5HT3] antagonist approved for nausea) shows some efficacy for reducing heavy drinking among patients with early-onset or Type-B alcoholism (Kranzler et al. 2003; Johnson et al. 2000). Administered in either a tablet form (ReVia and Depade) or injectable form (Vivitrol), individuals who abuse alcohol will no longer experience a euphoric reward from drinking once they begin the naltrexone treatment. It is important to remember that naltrexone does not mitigate the symptoms of alcohol withdrawal.

Proper Use Of Naltrexone

Other people might only need to take the medication at times when they know they’ll feel triggered to drink. For example, if someone usually relapses at the holidays or the anniversary of the death of a loved one, they might decide with their doctor to take it just around that time, Schmidt says. Your doctor may suggest a medicine to help treat your alcohol use disorder. Medicines are usually used together with talk therapy and support groups. If you have alcohol use disorder, medication may help you stop drinking while you take it. Keep in mind medication can’t help change your mindset or lifestyle, though, which are just as important during recovery as stopping drinking.

  • None of the medications used to treat AUD have been proven completely safe during pregnancy or lactation, so they should be used cautiously in women of childbearing age.
  • Disulfiram is not a cure for alcoholism, but rather a deterrent utilized to discourage alcohol consumption.
  • While undergoing withdrawal, it is important to stay hydrated, as dehydration can make withdrawal symptoms worse.
  • The resulting system of care possesses, at its core, a philosophical belief that total abstinence is gained not through the use of medication to treat alcohol dependence but instead through blood, sweat, and personal tears working through the 12 steps.

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition. Both rat and mouse studies showed decreased alcohol consumption with the spironolactone injections. Additionally, the authors noted that the spironolactone did not impair coordination or movement, nor did it affect their food and water intake.

Naltrexone In Treating Alcoholism

An illness marked by consumption of alcoholic beverages at a level that interferes with physical or mental health, and social, family, or occupational responsibilities. People with alcohol dependence, the most severe alcohol disorder, usually experience tolerance (a need for markedly increased amounts of alcohol to achieve intoxication or the desired effect), and withdrawal symptoms when alcohol is discontinued or intake is decreased. They also spend a great deal of time drinking alcohol, and obtaining it.

Several of these medications are approved by the FDA and are available by prescription only. A few supplements are also available over-the-counter (OTC), described as agents that can help curb alcohol cravings. In some cases, especially in-patient rehabilitation settings, Naltrexone is prescribed for a short period of time. However, research suggests that long-term use for more than 3 months is the most effective for keeping alcoholics in recovery.

Alcohol Withdrawal Syndrome

Naltrexone has a greater effect on reducing relapse to heavy drinking than it does on maintaining abstinence. Extended-release intramuscular naltrexone resulted in reduced relapse to heavy drinking in a large, randomized trial. The main adverse effects are nausea and/or vomiting, abdominal pain, sleepiness, and nasal congestion. Data from these specialty care settings indicate that adoption of medication for the treatment of alcohol disorders is uncommon in both the public and private sector (Ducharme et al. 2006).

It works by causing a severe adverse reaction when someone taking the medication consumes alcohol. Nalmefene is another opioid antagonist, and it blocks delta, kappa, and mu receptors; naltrexone acts primarily on mu receptors. One randomized trial with 100 patients using 10 mg PO bid has been completed, and nalmefene appears to have efficacy similar to naltrexone (reduces relapse to heavy drinking in patients who sample alcohol). At present, the drug is approved only for intravenous use for opiate addiction. Numerous studies have tested selective serotonin reuptake inhibitors (approved for depression), often with disappointing results including counter-therapeutic effects among patients with early-onset alcoholism. However, studies show that these medications (e.g., sertraline) may be efficacious among individuals with later-onset alcoholism (Kranzler et al. 1996; Pettinati et al. 2000) or in combination with naltrexone for patients with major depression (Pettinati et al. 2010).

Important safety information about VIVITROL

This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject. They may change your treatment or suggest ways you can deal with the side effects.

How safe is naltrexone?

Naltrexone is considered safe to use and associated with few side effects; however, all medications have a side effect profile. Side effects as a result of naltrexone use are reported to be relatively rare, but they do occur in some instances.