NEFAZODONE (Serzone) is an antidepressant which has been found in one study to cause significant reduction in alcohol cravings, drinks/week and days of alcohol used. Serzone has been associated with some severe liver problems which have led Bristol Myers Squib Canada to withdraw it from the market in Canada. Anyone using it in the United States or elsewhere should have their physician closely monitor their liver function tests.

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ONDANSETRON (Zofran) which is used to treat the nausea and vomiting caused by certain chemotherapies has been found to stop cravings and decrease alcohol consumption and increase abstinence in people who are early-onset alcoholics. FDA approval for Ondansetron for early-onset alcoholism treatment is currently being considered.

NALTREXONE can help lessen alcohol's positive effects. It blocks the parts of your brain that "feel" pleasure when you use alcohol and narcotics. When these areas of the brain are blocked, you feel less need to drink alcohol, and can stop drinking more easily.

Naltrexone has been shown to improve treatment outcomes in alcoholics when combined with psychosocial treatments such as Alcoholics Anonymous meetings, addiction counseling, family therapy, group therapy, and hospital or residential treatment, among others. However, adherence to daily oral doses has often been a problem, making its use in the treatment of alcohol dependence limited.  While nausea is the most common side effect, other side effects include headache, anxiety, dizziness, fatigue, vomiting and insomnia.

The recent development of long-acting naltrexone injections may help with this problem of inconsistent use of the medication.  In a recent clinical study conducted at 24 sites, once-a-month Naltrexone injections combined with psychotherapy was found to significantly reduce heavy drinking in patients being treated for alcohol dependency.  Results found a reduction in heavy drinking within the first month of treatment, and this response was maintained over the six-month treatment period.  There were few side effects. 
 
Garbutt, J, et al. "Efficacy and Tolerability of Long-Acting Injectable Naltrexone for Alcohol Dependence: A Randomized Controlled Trial." JAMA. 293(13): 1617-1625, 2005.

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DISULFIRAM (Antabuse) has been in use since 1951. Studies have shown that it reduces the craving for alcohol and reduces the risk of relapse. It works by making you feel sick to your stomach if you have a drink. If you do have a drink Antabuse causes flushing, headache, nausea and vomiting, dizziness and lowered blood pressure, among other effects. It can cause severe side effects, although these are rare. Disulfiram 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.

CAMPRAL (genereic name: acamprosate), a drug that is widely used in Europe to reduce alcohol cravings in problem drinkers who have quit, has now been approved by the U.S. Food and Drug Administration. The FDA approved Campral after studies showed that more subjects who were given the drug stayed away from alcohol, compared with those who were given a placebo. However, they cautioned that 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. The drug will be available in the U.S. by the end of 2004.

Campral reduces alcohol relapse by reducing the bad feelings that result when a person abstains. It works by stimulating GABA, an amino acid that acts as 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 the chart on amino acids under Nutrition in the Holistic section of this web site).

The following online article provides more information about the above four medications:
Richard A. Rawson, PhD, Michael J. McCann, M.A., Albert L. Hasson, MSW “Pharmacotherapies for Substance-Abuse Treatment.” Counselor Magazine. October, 2000.
counselormagazine.com

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