Advertisement

Alcohol Pharmacotherapy

  • Jasmine Carpenter
  • Shannon Tulk
Chapter

Abstract

Alcohol use disorder has a higher prevalence in the military and veteran patient population compared to the general population. If left untreated, AUD can lead to a number of negative outcomes such as an increase in morbidity and mortality. Alcohol pharmacotherapy has been proven effective in decreasing alcohol consumption and prolonging periods of abstinence, however the use of these agents remains underutilized. This chapter will provide a general overview of the agents that are used for the indication of AUD.

Keywords

Alcohol use disorder Pharmacotherapy Naltrexone Medication-assisted treatment AUD 

References

  1. 1.
    Jonas DE, Amick HR, Feltner C, et al. Pharmacotherapy for adults with alcohol use disorders in outpatient settings: a systematic review and meta-analysis. JAMA. 2014;311(18):1889–900.CrossRefGoogle Scholar
  2. 2.
    Management of substance use disorder in the primary care setting. Washington, DC: VA/DoD Evidence-Based Clinical Practice Guideline Working Group, Veterans Health Administration, Department of Veterans Affairs, and Health Affairs, Department of Defense; 2009. Office of Quality and Performance publication 10Q-CPG/SUD-09.Google Scholar
  3. 3.
    ReVia® [package insert]. Pomona: Duramed Pharmaceuticals; 2013.Google Scholar
  4. 4.
    Center for Substance Abuse Treatment. Incorporating alcohol pharmacotherapies into medical practice. Treatment Improvement Protocol (TIP) Series 49. HHS Publication No. (SMA) 09-4380. Rockville: Substance Abuse and Mental Health Services Administration; 2009.Google Scholar
  5. 5.
    Anton RF, O’Malley SS, Ciraulo DA, et al. Combined pharmacotherapies and behavioral interventions for alcohol dependence: the COMBINE study: a randomized controlled trial. JAMA. 2006;295:2003–17.CrossRefGoogle Scholar
  6. 6.
    Anton RF. Naltrexone for the management of alcohol dependence. N Engl J Med. 2008;359(7):715–21.CrossRefGoogle Scholar
  7. 7.
    Oslin DW, Pettinati HM, Volpicelli JR, Wolf AL, et al. The effects of naltrexone on alcohol and cocaine use in dually addicted patients. J Subst Abus Treat. 1999;16(2):163–7.CrossRefGoogle Scholar
  8. 8.
    Vivitrol® [package insert]. Waltham: Alkermes, Inc.; 2010.Google Scholar
  9. 9.
    Bryson WC, Mcconnell J, Korthuis PT, Mccarty D. Extended-release naltrexone for alcohol dependence: persistence and healthcare costs and utilization. Am J Manag Care. 2011;17(Suppl 8):S222–34.PubMedPubMedCentralGoogle Scholar
  10. 10.
    Paille F, Guelfi J. Double-blind randomized multicentre trial of acamprosate in maintaining abstinence from alcohol. Alcohol Alcohol. 1995;30(2):239–47.PubMedGoogle Scholar
  11. 11.
    Pelc I, Verbanck P, Le Bon O, Gavrilovic M, Lion K, Lehert P. Efficacy and safety of acamprosate in the treatment of detoxified alcohol-dependent patients. A 90-day placebo-controlled dose-finding study. Br J Psychiatry. 1997;171(1):73–7.CrossRefGoogle Scholar
  12. 12.
    Sass H, Soyka M, Mann K, Zieglgänsberger W. Relapse prevention by acamprosate: results from a placebo-controlled study on alcohol dependence. Arch Gen Psychiatry. 1996;53:673–80.CrossRefGoogle Scholar
  13. 13.
    Campral® [package insert]. St. Louis: Forest Laboratories Inc; 2012.Google Scholar
  14. 14.
    Lhuintre J, Moore N, Saligaut C. Ability of calcium bis acetyl homotaurine, a GABA agonist, to prevent relapse in weaned alcoholics. Lancet. 1985;325:1014–6.CrossRefGoogle Scholar
  15. 15.
    Kiefer F, Mann K. Acamprosate: how, where, and for whom does it work? Mechanism of action, treatment targets, and individualized therapy. Curr Pharm Des. 2010;16(19):2098–102.CrossRefGoogle Scholar
  16. 16.
    Olive MF, Cleva RM, Kalivas PW, Malcolm RJ. Glutamatergic medications for the treatment of drug and behavioral addictions. Pharmacol Biochem Behav. 2012;100(4):801–10.CrossRefGoogle Scholar
  17. 17.
    Rösner S, Hackl-Herrwerth A, Leucht S, Lehert P, et al. Acamprosate for alcohol dependence. Cochrane Database Syst Rev. 2010;9:1–118.Google Scholar
  18. 18.
    Mann K, Lehert P, Morgan MY. The efficacy of acamprosate in the maintenance of abstinence in alcohol-dependent individuals: results of a meta-analysis. Alcohol Clin Exp Res. 2004;28(1):51–63.CrossRefGoogle Scholar
  19. 19.
    Maisel NC, Blodgett JC, Wilbourne PL, et al. Meta-analysis of naltrexone and acamprosate for treating alcohol use disorders: when are these medications most helpful? Addiction. 2013;108(2):275–93.CrossRefGoogle Scholar
  20. 20.
    Antabuse [package insert]. North Wales: Teva Pharmaceuticals; 2015.Google Scholar
  21. 21.
    Ait-Daoud N, Johnson BA. Medications for the treatment of alcoholism. In: Johnson BA, Ruiz P, Galanter M, editors. Handbook of clinical alcoholism treatment. Baltimore: Lippincott Williams & Wilkins; 2003. p. 119.Google Scholar
  22. 22.
    Fuller RK, Branchey L, Brightwell DR, et al. Disulfiram treatment of alcoholism. A Veterans Administration cooperative study. JAMA. 1986;256(11):1449.CrossRefGoogle Scholar
  23. 23.
    Skinner MD, Lahmek P, Pham H, Aubin HJ. Disulfiram efficacy in the treatment of alcohol dependence: a meta-analysis. PLoS One. 2014;9(2):e87366.CrossRefGoogle Scholar
  24. 24.
    Jørgensen CH, Pedersen B, Tønnesen H. The efficacy of disulfiram for the treatment of alcohol use disorder. Alcohol Clin Exp Res. 2011;35(10):1749–58.CrossRefGoogle Scholar
  25. 25.
    Martin BK, Clapp L, Alfers J, Beresford TP. Adherence to court-ordered disulfiram at fifteen months: a naturalistic study. J Subst Abuse Treat. 2004;26(3):233–6.CrossRefGoogle Scholar
  26. 26.
    Martin B, Mangum L, Beresford TP. Use of court-ordered supervised disulfiram therapy at DVA medical centers in the United States. Am J Addict. 2005;14(3):208–12.CrossRefGoogle Scholar
  27. 27.
    Johnson BA. Recent advances in the development of treatments for alcohol and cocaine dependence: focus on topiramate and other modulators of GABA or glutamate function. CNS Drugs. 2005;19(10):873–96.CrossRefGoogle Scholar
  28. 28.
    Johnson BA, Rosenthal N, Capece JA, Wiegand F, Mao L, Beyers K, et al. Topiramate for treating alcohol dependence: a randomized controlled trial. JAMA. 2007;298(14):1641–51.CrossRefGoogle Scholar
  29. 29.
    Johnson BA, Ait-Daoud N, Akhtar FZ, et al. Oral topiramate reduces the consequences of drinking and improves the quality of life of alcohol-dependent individuals: a randomized controlled trial. Arch Gen Psychiatry. 2004;61(9):905–12.CrossRefGoogle Scholar
  30. 30.
    Baltieri DA, Daro FR, Ribeiro PL, de Andrade AG. Comparing topiramate with naltrexone in the treatment of alcohol dependence. Addiction. 2008;103(12):2035–44.CrossRefGoogle Scholar
  31. 31.
    Batki S, Pennington D, Lasher B, et al. Topiramate treatment of alcohol use disorder in veterans with posttraumatic stress disorder: a randomized controlled pilot trial. Alcohol Clin Exp Res. 2014;38(8):2169–77.CrossRefGoogle Scholar
  32. 32.
    Topamax [package insert]. Titusville: Janssen Pharmaceuticals Inc; 2017.Google Scholar
  33. 33.
    Neurontin [package insert]. New York: Pfizer; 2015.Google Scholar
  34. 34.
    Mason J, Quello S, Goodell V, Shandan F, Kyle M, Begovic A. Gabapentin treatment for alcohol dependence: a randomized clinical trial. JAMA Intern Med. 2014;174(1):70–7.CrossRefGoogle Scholar
  35. 35.
    Anton RF, Myrick H, Wright TM, et al. Gabapentin combined with naltrexone for the treatment of alcohol dependence. Am J Psychiatry. 2011;168(7):709–17.CrossRefGoogle Scholar
  36. 36.
    Addolorato G, Leggio L. Safety and efficacy of baclofen in the treatment of alcohol-dependent patients. Curr Pharm Des. 2010;16(19):2113–7.CrossRefGoogle Scholar
  37. 37.
    Baraha E, Salemink E, Goudriaan A, et al. Efficacy and safety of high-dose baclofen: for the treatment of alcohol dependence: a multicentre, randomised, double-blind controlled trial. Eur Neuropsychopharmacol. 2016;26:1950–9.CrossRefGoogle Scholar
  38. 38.
    O’Shea R, Dasarathy S, McCullough A, the Practice Guideline Committee of the American Association for the Study of Liver Diseases and the Practice Parameters Committee of the American College of Gastroenterology. Alcoholic liver disease. Hepatology. 2010;51(1):307–28.CrossRefGoogle Scholar
  39. 39.
    Addolorato G, Leggio L, Ferrulli A, et al. Effectiveness and safety of baclofen for maintenance of alcohol abstinence in alcohol-dependent patients with liver cirrhosis: a randomized, double-blind, controlled study. Lancet. 2007;370(9603):1915–22.CrossRefGoogle Scholar
  40. 40.
    Dore GM, Lo K, Juckes L, et al. Clinical experience with baclofen in the management of alcohol-dependent patients with psychiatric comorbidity: a selected cases series. Alcohol Alcohol. 2011;46:714–20.CrossRefGoogle Scholar
  41. 41.
    Baclofen tablet [package insert]. Pulaski: AvKare Inc; 2014.Google Scholar
  42. 42.
    Zofran [package insert]. East Hanover: Norvartis Pharmaceuticals; 2017.Google Scholar
  43. 43.
    Barnes N, Sharp T. A review of central 5-HT receptors and their function. Neuropharmacology. 1999;38(8):1083–152.CrossRefGoogle Scholar
  44. 44.
    Johnson B, Campling G, Griffiths P, Cowen P. Attenuation of some alcohol-induced mood changes and the desire to drink by 5-HT3 receptor blockade: a preliminary study in health male volunteers. Psychopharmacology. 1993;112:142–4.CrossRefGoogle Scholar
  45. 45.
    Johnson B, Roache J, Javors M, et al. Ondansetron for reduction of drinking among biologically predisposed alcoholic patients: a randomized controlled trial. JAMA. 2000;284:963–71.CrossRefGoogle Scholar
  46. 46.
    Filho J, Baltieri D. A pilot study of full-dose ondansetron to treat heavy-drinking men withdrawing from alcohol in Brazil. Addict Behav. 2013;38:2044–51.CrossRefGoogle Scholar
  47. 47.
    Jones E, Fear NT. Alcohol use and misuse within the military: a review. Int Rev Psychiatry. 2011;23:166–72.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Jasmine Carpenter
    • 1
  • Shannon Tulk
    • 2
  1. 1.Veterans Affairs Medical Center, Washington DC, Pharmacy Service/Mental Health ServiceWashington, DCUSA
  2. 2.Minneapolis VA Health Care System, Pharmacy ServiceMinneapolisUSA

Personalised recommendations