Medications Used to Treat Alcoholism

How They Were Developed for Treating Alcohol Use Disorders

Medications used to treat alcoholism

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Currently, there are only three medications approved by the U.S. Food and Drug Administration for the treatment of alcohol abuse and alcohol dependence. None of these medications are prescribed to people who are still drinking alcohol. They are only for those who have already stopped drinking and are trying to maintain abstinence.

There are no medications on the market that are prescribed for people who are still drinking alcohol that will cause them to stop drinking.

Antabuse (Disulfiram) as a Drinking Deterrent

Antabuse (disulfiram) was the first medicine approved for the treatment of alcohol abuse and alcohol dependence. It works by causing a severe adverse reaction when someone taking the medication consumes alcohol. Most people who take it will vomit after a drink of alcohol. This, in turn, is thought to create a deterrent to drinking.

Disulfiram was first developed in the 1920s for use in manufacturing processes. The alcohol-aversive effects of Antabuse were first recorded in the 1930s. Workers in the vulcanized rubber industry who were exposed to tetraethylthiuram disulfide became ill after drinking alcohol.

In 1948, Danish researchers trying to find treatments for parasitic stomach infections discovered the alcohol-related effects of disulfiram when they too became ill after drinking alcohol. The researchers began a new set of studies on using disulfiram to treat alcohol dependence.

Shortly thereafter, the U.S. FDA approved disulfiram to treat alcoholism. It was first manufactured by Wyeth-Ayerst Laboratories under the brand name Antabuse.

Initially, disulfiram was given in larger dosages to produce aversion conditioning to alcohol by making the patients very sick if they drank. Later, after many reported severe reactions (including some deaths), Antabuse was administered in smaller dosages to support alcohol abstinence.

Naltrexone for Alcohol Cravings

Naltrexone is sold under the brand names Revia and Depade. An extended-release, monthly injectable form of naltrexone is marketed under the trade name Vivitrol. It works by blocking in the brain the "high" that people experience when they drink alcohol or take opioids like heroin and cocaine.

Naltrexone was first developed in 1963 to treat addiction to opioids. In 1984, it was approved by the FDA for the treatment of drugs such as heroin, morphine, and oxycodone. At the time, it was marketed by DuPont under the brand name Trexan.

In the 1980s, animal studies discovered that naltrexone also reduced alcohol consumption. Human clinical trials followed in the late 80s and early 90s. These showed that when combined with psychosocial therapy, naltrexone could reduce alcohol cravings and decrease relapse rates in alcoholics.

The FDA approved the use of naltrexone to treat alcohol use disorders in 1994. DuPont then renamed the drug Revia.

Campral (Acamprosate) for Discomfort

Campral (acamprosate), is the most recent medication approved for the treatment of alcohol dependence or alcoholism in the U.S. It works by reducing the physical distress and emotional discomfort people usually experience when they quit drinking.

In 1982, the French company Laboratoires Meram developed acamprosate for the treatment of alcohol dependence. It was tested for safety and efficacy from 1982 until 1988 when it was authorized for use by the French government to treat alcoholism. It was first marketed under the name Aotal.

For more than 20 years, acamprosate was widely used throughout Europe for treating alcoholics. It was not approved for use in the U.S. by the FDA until July 2004. It was first marketed in the United States in January 2005 under the brand name Campral.

Campral is currently marketed in the United States by Forest Pharmaceuticals.

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Article Sources

  1. Winslow BT, Onysko M, Hebert M. Medications for Alcohol Use DisorderAm Fam Physician. 2016;93(6):457-465.

  2. Incorporating Alcohol Pharmacotherapies into Medical Practice. Rockville, MD: Dept. of Health & Human Services, Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment; 2009.