U.S Food and Drug Administration approves of only three medications—disulfiram, naltrexone, and acamprosate— to treat alcoholism. Almost one third of Americans consume enough alcohol to be considered at risk for alcohol dependence, and alcohol abuse and dependence are associated with more than 100,000 deaths from alcohol-related diseases and injuries each year.
There are a number of anti-alcohol medications designed to stem an individual’s craving for, and intake of, alcohol. However, we emphasize here that they must be prescribed by a physician and generally are more effective when used as part of an overall therapy program to combat alcohol abuse or alcoholism. Some of the available agents include:
Naltrexone and acamprosate are U.S. Food and Drug Administration (FDA)-approved options for treatment of alcohol dependence in conjunction with behavior therapy. Naltrexone, an anticraving agent, reduces relapse rates and cravings and increases abstinence rates.
Disulfiram, which was the first FDA-approved agent to combat alcohol abuse and dependence, has less evidence to support its continued use to treat alcohol dependence. It is an aversive agent that has been used for more than 40 years but has significant adverse effects and compliance difficulties with no clear evidence that it increases abstinence rates, decreases relapse rates, or reduces cravings.
Topiramate and ondansetron are recommended to reduce drinking frequency and increase abstinence, but have not yet been approved for such indications.
Fluoxetine and other selective serotonin reuptake inhibitors (SSRIs) are under trial drugs. However, they are recommended for patients with co-existent depressive disorders.
Serotonergic and anticonvulsant agents promise to play more of a role in the treatment of alcohol dependence. Although not approved by the U.S. Food and Drug Administration for this indication, the anticonvulsant topiramate and several serotonergic agents (e.g., fluoxetine, ondansetron) have been shown in recent studies to increase abstinence rates and decrease drinking.
Although we have listed above some drugs effective in reducing alcohol craving and treating alcoholism, we strongly recommend here that they should be taken under strict medical guidance and prescriptions.