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CNS Depressants: Alcohol and Nicotine

Ethanol, a clear colorless alcohol, has been consumed by humans for millennia, but its effects on the body are far from benign. At lower doses, it induces decreased inhibitions and loquaciousness, leading to its social appeal. However, it can cause severe consequences at higher doses, such as coma and respiratory depression, due to its zero-order elimination kinetics. Chronic ethanol abuse wreaks havoc on multiple organ systems, particularly the CNS and the liver. Abrupt cessation of ethanol...
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Drug dependence, abuse, and addiction are complex phenomena that can precipitate various abnormal states. Physical dependence refers to a state of pharmacological adaptation to a drug. This adaptation often results in tolerance—a reduced response to the drug after repeated administrations. When the drug use is abruptly stopped, withdrawal symptoms occur due to the body's need to readjust from the pharmacologically induced imbalance. However, tolerance and withdrawal symptoms do not necessarily...
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The Motivation for Alcohol Reward: Predictors of Progressive-Ratio Intravenous Alcohol Self-Administration in Humans
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Acamprosate for alcohol dependence.

Susanne Rösner1, Andrea Hackl-Herrwerth, Stefan Leucht

  • 1Psychiatric Hospital, University of Munich, Nussbaumstr. 7, Munich, Germany, 80336.

The Cochrane Database of Systematic Reviews
|September 9, 2010
PubMed
Summary

Acamprosate aids alcohol dependence recovery by reducing drinking risk and increasing abstinence duration. This glutamate antagonist is a safe, effective adjunct to psychosocial programs for relapse prevention.

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Area of Science:

  • Neuroscience
  • Pharmacology
  • Clinical Medicine

Background:

  • Alcohol dependence is a major global health risk.
  • Psychosocial programs offer moderate success in relapse prevention.
  • Acamprosate, a glutamate antagonist, may enhance treatment efficacy.

Purpose of the Study:

  • Evaluate acamprosate's effectiveness and tolerability.
  • Compare acamprosate against placebo and other pharmacological agents.

Main Methods:

  • Systematic review of double-blind randomized controlled trials (RCTs).
  • Searched major databases (PubMed, EMBASE, etc.) and contacted manufacturers.
  • Individual patient data meta-analyses used for primary outcomes.

Main Results:

  • Acamprosate significantly reduced drinking risk (RR 0.86) and increased abstinence duration (MD 10.94 days) versus placebo.
  • Diarrhea was the most frequent side effect.
  • No significant difference in effects between industry-funded and non-profit trials; no publication bias detected.

Conclusions:

  • Acamprosate is effective and safe for maintaining abstinence post-detoxification.
  • Moderate treatment effects are valuable given alcoholism's relapsing nature.
  • Offers a needed therapeutic option for alcohol dependence.