Pharmacologic treatment of chronic alcoholism

Of the many drug therapies mentioned in this review, only the alcohol-sensitizing drugs have current therapeutic applications in primary alcoholics. When alcohol abuse occurs in association with anxiety, depression, or schizophrenia, treatment with the anxiolytic, antidepressant, and neuroleptic drugs, respectively, may facilitate the alcoholic's ability to participate in other programs. Patients should receive drugs that are appropriate to treatment goals as well as to their psychosocial status. Even if a drug therapy is shown to be efficacious under controlled experimental conditions, its effectiveness may be compromised by a large number of factors that include poor compliance by the patient, a lack of a treatment strategy, or failure to optimize the treatment conditions. New pharmacotherapies with actions directed at central neurochemical pathways mediating alcohol consumption are urgently needed. However, even if such agents become available, they too will only be adjuncts to behavioral and social therapies directed at stabilizing all aspects of the alcoholic's life.