 The Long RunMishka Shubaly |
AlcoholismThe following online article provides more information about four of the medications described below: Rawson RA, McCann MJ, Hasson L. Pharmacotherapies for Substance-Abuse Treatment. Counselor Magazine. October, 2000. What it does: An anticonvulsant, mood stabilizing medication that can help reduce alcohol cravings How it works: Reduces brain levels of the neurotransmitter dopamine (which is believed to create the pleasurable sensations alcoholics get from drinking), potentially resetting the brain's chemistry Side effects: Numbness and tingling in the hands and feet, difficulty concentrating, confusion, nervousness, headache, drowsiness and mood swings. For a more complete list of side effects visit this NIH page. Special Alert: The FDA is notifying healthcare providers and patients with new data indicating an increased risk of cleft lip and/or cleft palate in infants exposed to topiramate (Topamax®) during pregnancy. Availability: Physician prescription Research: In a 2008 study Topiramate was more effective than placebo in reducing body mass index, all liver enzyme levels, cholesterol levels, and systolic and diastolic blood pressure which might lower the risk of fatty liver degeneration and cirrhosis as well as heart disease. It significantly decreased obsessive thoughts and compulsions about using alcohol, increased participants’ well-being, and improved some aspects of quality of life, thereby lessening the risk of relapse. For more information: www.nlm.nih.gov/medlineplus/druginfo/meds/a697012.html 
BACLOFEN (Lioresal or Gablofen®) What it does: A muscle relaxant found to reduce alcohol cravings How it works: Increases the amount of GABA, a neurotransmitter in the brain which has a relaxing effect Side effects: Drowsiness, dizziness, weakness, upset stomach, confusion. For a more complete list of side effects visit this NIH page. Availability: Physician prescription Research: Baclofen was effective in inducing abstinence from alcohol and reducing alcohol craving and consumption in alcoholics. This small study suggests that baclofen may be a potentially useful drug in the treatment of alcohol-dependent patients. For more information: www.nlm.nih.gov/medlineplus/druginfo/meds/a682530.html
What it does: Naltrexone is an opioid antagonist that can help reduce the desire for alcohol and lessen alcohol’s positive effects. How it works: It blocks the parts of your brain that feel pleasure when you use alcohol. When these areas of the brain are blocked, you feel less need to drink alcohol, and may be able to stop drinking more easily. Side effects: Nausea, headache, constipation, dizziness, anxiety and insomnia. For a more complete list of side effects visit this NIH page. Availability: Physician prescription Research: Naltrexone has been shown to improve treatment outcomes in alcoholics when combined with treatments such as Alcoholics Anonymous meetings, addiction counseling, family therapy, group therapy, and hospital or residential treatment. However, adherence to daily oral doses has often been a problem. Long-acting naltrexone injections may help with the problem of inconsistent use of the medication. In a clinical study conducted at 24 sites, once-a-month Naltrexone injections combined with psychotherapy significantly reduced heavy drinking in patients being treated for alcohol dependency within the first month of treatment, and this response was maintained over the six-month treatment period with few side effects. For more information: www.nlm.nih.gov/medlineplus/druginfo/meds/a685041.html
What it does: Antabuse has been in use since 1951. Studies show that it reduces the craving for alcohol and reduces the risk of relapse. How it works: Antabuse causes unpleasant effects if you drink even small amounts of alcohol such as flushing, headache, nausea and vomiting. It begins to effect alcohol metabolism within 1-2 hours and reaches a peak in 12 hours. It is slowly excreted from the body over 2 weeks. Side effects: Skin rash, headache, drowsiness, weakness, upset stomach, tiredness. For a more complete list of side effects visit this NIH page. Availability: Physician prescription Research: In a systematic review six of eleven studies reported a significantly better effect on abstinence for patients treated with disulfiram, with patients having significantly more days until relapse and fewer drinking days. For more information: www.nlm.nih.gov/medlineplus/druginfo/meds/a682602.html
What it is: This drug is widely used in Europe to reduce alcohol cravings in problem drinkers who have quit. It was approved by the FDA after studies showed that more participants who were given the drug stayed away from alcohol, compared with those who were given a placebo. However, Campral might not be effective for people who are currently drinking when they start taking the drug, or for those who are misusing other substances. How it works: Campral reduces alcohol relapse by reducing the bad feelings that result when a person abstains. It works by stimulating GABA, a neurotransmitter transferring chemical messages between neurons in the brain. GABA can also be taken as part of amino acid therapy. (For more information on amino acid therapy see this chart on amino acids in the Holistic section of this web site.) Side effects: Diarrhea, gas, upset stomach, loss of appetite, dry mouth, dizziness. For a more complete list of side effects visit this NIH page. Availability: Physician prescription Research: A recent systematic review of 24 studies with 6,915 participants showed that acamprosate appears to be an effective and safe treatment in alcohol dependent patients for supporting continuous abstinence after detoxification from alcohol. When added to psychosocial treatment strategies, acamprosate reduced the risk of returning to any drinking after detoxification compared with treatment with a placebo. The cumulative abstinence time was also clearly increased. For more information: www.nlm.nih.gov/medlineplus/druginfo/meds/a604028.html
What it is: Ondansetron is used to treat the nausea and vomiting caused by certain chemotherapies. It has been found to stop cravings, decrease alcohol consumption and increase abstinence in people who are early-onset alcoholics. How it works: Ondansetron appears to work by acting on serotonin, one of the brain's many neurotransmitters. An imbalance between two chemical messengers in the brain, serotonin and dopamine, is believed to create a craving for alcohol. Ondansetron blocks a serotonin receptor, which decreases alcohol-induced dopamine release, resulting in a decrease in alcoholic-drinking behavior. Side effects: Diarrhea, headache, constipation, weakness, dizziness, tiredness. For a more complete list of side effects visit this NIH page. Availability: Physician prescription Research: A total of 271 patients with diagnosed alcoholism received treatment with ondansetron (1 microg/kg, 4 microg/kg, or 16 microg/kg twice a day) or placebo for 11 weeks plus group cognitive behavioral therapy. Patients with early-onset alcoholism taking ondansetron had fewer drinks per day. Ondansetron, 4 microg/kg twice per day, was better than placebo in increasing the percentage of days abstinent per week. Results suggest that ondansetron (particularly the 4 microg/kg twice per day dosage) is an effective treatment for patients with early-onset alcoholism. For more information: www.kap.samhsa.gov/products/manuals/tips/pdf/TIP49_LitRev.pdf |
