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Pharmacological Approaches to Reducing Craving in Patients with Alcohol Use Disorders

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Abstract

Research on the concept of craving may lead to better understanding of the biobehavioural circuitries that contribute to the complexity of alcohol use disorders (AUDs). The experiences described as craving or desire to drink are often associated with physical responses such as increased salivation and heart rate, and alteration of stress hormones, as well as psychological responses such as anxiety and depression. Greater craving has been associated with an increased probability of alcohol relapse. Reversal of craving, which is understood as a symptom of protracted abstinence, offers the possibility of preventing relapses and treating alcoholism. Various medications have been studied to establish whether they are able to reduce craving; however, the results obtained from clinical studies have been inconsistent. Here, we review the interdisciplinary models developed to evaluate craving, then the different approaches used to assess and measure craving and, finally, the medications utilized and tested to lessen craving in patients suffering from AUDs.

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Acknowledgements

Drs Haass-Koffler, Leggio and Kenna have no conflicts of interest that are directly relevant to the content of this review. The authors would like to express their thanks for the 5T32AA007459-28 training grant from the National Institute on Alcohol Abuse and Alcoholism (NIAAA), which supports the work of Dr Haass-Koffler. Dr Leggio’s current work is supported by the Division of Intramural Clinical and Biological Research of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and the Intramural Research Program of the National Institute on Drug Abuse (NIDA). Dr Kenna has received funding from the National Institute on Alcohol Abuse and Alcoholism for the following drugs: R01-AA016079 (ondansetron and sertraline), R03AA020169 (baclofen), R21AA019709 (ghrelin), R01 AA015753 (aripiprazole and topiramate), R21AA019994 (doxazosin) and R21AA021128 (metadoxine); and has received a consultancy fee from CT San Remo (GET73).

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Authors and Affiliations

  1. Center for Alcohol and Addiction Studies, Brown University, Box G-S121-5, Providence, RI, 02812, USA

    Carolina L. Haass-Koffler, Lorenzo Leggio & George A. Kenna

  2. Section on Clinical Psychoneuroendocrinology and Neuropsychopharmacology, Laboratory of Clinical and Translational Studies (LCTS), National Institute on Alcohol Abuse and Alcoholism (NIAAA), National Institutes of Health (NIH), Bethesda, MD, USA

    Lorenzo Leggio

  3. Intramural Research Program, National Institute on Drug Abuse (NIDA), National Institutes of Health (NIH), Baltimore, MD, USA

    Lorenzo Leggio

  4. Department of Psychiatry and Human Behavior, Brown University, Providence, RI, USA

    George A. Kenna

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  1. Carolina L. Haass-Koffler
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  2. Lorenzo Leggio
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  3. George A. Kenna
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Correspondence to George A. Kenna.

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Haass-Koffler, C.L., Leggio, L. & Kenna, G.A. Pharmacological Approaches to Reducing Craving in Patients with Alcohol Use Disorders. CNS Drugs 28, 343–360 (2014). https://doi.org/10.1007/s40263-014-0149-3

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