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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.
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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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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 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.

Elisabeth Poorman1, Brianna M McQuade2, Sarah Messmer3

  • 1University of Illinois Chicago, Chicago, Illinois.

American Family Physician
|January 16, 2024
PubMed
Summary

Medications can effectively treat alcohol use disorder (AUD), reducing heavy drinking and preventing relapse. However, underutilization of these treatments persists, highlighting a need for expanded access to pharmacotherapy for AUD.

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Area of Science:

  • Addiction Medicine
  • Pharmacology
  • Public Health

Background:

  • Excessive alcohol use is a major cause of preventable death in the US, with a notable increase in alcohol-related fatalities during the pandemic.
  • The Substance Abuse and Mental Health Services Administration (SAMHSA) recommends pharmacotherapy combined with behavioral interventions for alcohol use disorder (AUD).
  • Despite available medications, treatment rates for AUD remain low, with only 7.3% receiving any treatment and 1.6% prescribed medication in 2019.

Purpose of the Study:

  • To review the evidence for various medications used in treating alcohol use disorder.
  • To highlight the gap between recommended treatments and actual patient care for AUD.
  • To advocate for systematic policies to increase medication use in AUD treatment.

Main Methods:

  • Systematic review of evidence supporting medications for alcohol use disorder.
  • Analysis of treatment utilization statistics for alcohol use disorder.
  • Evaluation of medication efficacy based on scientific evidence.

Main Results:

  • Naltrexone and gabapentin are strongly supported for reducing heavy drinking days.
  • Acamprosate effectively prevents relapse in abstinent patients.
  • Topiramate shows moderate evidence for decreasing heavy drinking days.
  • Varenicline and baclofen may also reduce heavy alcohol use.
  • Antidepressants are beneficial for reducing alcohol intake only in patients with co-occurring depression.

Conclusions:

  • Several medications demonstrate efficacy in treating alcohol use disorder.
  • Current underutilization of pharmacotherapy for AUD necessitates policy changes.
  • Expanding access to evidence-based medications is crucial for improving AUD treatment outcomes in both inpatient and outpatient settings.