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CNS Depressants: Alcohol and Nicotine01:27

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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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Depressant drugs, including alcohol and sedative-hypnotics, diminish central nervous system activity by enhancing the action of gamma-aminobutyric acid (GABA), a neurotransmitter that reduces brain activity and promotes relaxation. These substances can have various therapeutic uses but also pose significant risks, especially when misused or combined.
Alcohol is a common depressant that can induce a sense of relaxation and reduced inhibition at low doses. Contrary to its occasional...
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Antidepressant Drugs: MAOIs and Other Agents01:23

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Atypical antidepressants, including bupropion (Wellbutrin), mirtazapine (Remeron), nefazodone (Serzone), trazodone (Desyrel), and vilazodone (Viibryd), offer unique mechanisms of action. Bupropion weakly inhibits dopamine and norepinephrine reuptake, aiding depression treatment and smoking cessation, with a low risk of sexual dysfunction. Mirtazapine enhances serotonin and norepinephrine neurotransmission, leading to sedation, increased appetite, and weight gain. As a result, it helps treat...
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Drug Therapy01:28

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The advent of drug therapy has profoundly shaped modern mental health care, providing targeted treatments for a range of psychological disorders. Psychotherapeutic drugs, classified into antianxiety, antidepressant, and antipsychotic medications, address symptoms across anxiety disorders, mood disorders, and schizophrenia. While these medications have transformed patient outcomes, they require careful management due to their potential side effects and limitations.
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Sedatives and Hypnotics Drugs: Miscellaneous Agents01:17

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Sedatives and hypnotics encompass a wide range of substances, each with its unique mechanism of action, uses, and potential adverse effects.
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Murine Drinking Models in the Development of Pharmacotherapies for Alcoholism: Drinking in the Dark and Two-bottle Choice
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Medications for Alcohol Use Disorder.

Bradford T Winslow1, Mary Onysko1, Melanie Hebert2

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American Family Physician
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Summary

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.