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Medications for Alcohol Use Disorder.
Bradford T Winslow1, Mary Onysko1, Melanie Hebert2
1Swedish Family Medicine Residency Program, Littleton, CO, USA.
Screening adults for alcohol misuse is recommended, but few receive treatment. Approved medications like acamprosate and naltrexone show modest effects, while others require further study for effective alcohol use disorder treatment.
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Area of Science:
- Addiction Medicine
- Pharmacology
- Public Health
Background:
- The U.S. Preventive Services Task Force recommends screening for alcohol misuse and brief counseling.
- A small percentage of American adults with high-risk alcohol use receive treatment.
- Effective pharmacological interventions for alcohol use disorder (AUD) are crucial.
Purpose of the Study:
- To review current FDA-approved medications for AUD.
- To evaluate the efficacy of other potential medications for reducing alcohol consumption.
- To identify areas for future research in AUD pharmacotherapy.
Main Methods:
- Review of U.S. Food and Drug Administration (FDA)-approved medications for AUD.
- Examination of evidence for medications like acamprosate, disulfiram, and naltrexone.
- Assessment of emerging medications including topiramate, gabapentin, sertraline, fluoxetine, and ondansetron for alcohol use reduction.
Main Results:
- Acamprosate and naltrexone modestly reduce alcohol consumption and increase abstinence.
- Evidence for disulfiram's effectiveness is inconsistent.
- Topiramate and gabapentin may reduce alcohol intake, but lack long-term data.
- Antidepressants do not reduce alcohol use in non-mood disordered patients; sertraline and fluoxetine may help depressed patients.
- Ondansetron shows potential in specific populations.
Conclusions:
- Current FDA-approved medications offer modest benefits for AUD treatment.
- Several other medications show promise but require further investigation, particularly for long-term efficacy and specific subpopulations.
- Further research into genetically targeted and as-needed medications is needed to improve alcohol use disorder treatment outcomes.

