by Scholten A

Medications for Alcoholism and Alcohol Abuse

The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included, so ask your doctor if you need to take any special precautions. Use each of these medications as recommended by your doctor, or according to the instructions provided.
Certain medications can help alleviate symptoms of alcohol withdrawal and help prevent relapse. Your doctor may prescribe medication to reduce cravings for alcohol. Medications are usually prescribed alongside counseling or other psychosocial treatment. Also, alcoholism and alcohol abuse are usually treated with a combination of medications, rather than just one medication. Treatment will vary on a case-by-case basis. Contact your doctor if you have further questions about usage or side effects.

Prescription Medications for Alcoholism and Alcohol Abuse

Alcohol Abuse Deterrent —disulfiram
  • Diazepam
  • Chlordiazepoxide
  • Lorazepam
  • Oxazepam

Prescription Medications for Alcoholism and Alcohol Abuse

Alcohol Abuse Adjunct Therapy
Common name—naltrexone
Naltrexone is used to help you to stay away from alcohol, but it is not a cure for addiction. It may work by blocking the high that makes you crave alcohol. However, it will not, prevent you from experiencing the effects of alcohol. Naltrexone is available as a pill and an injection in the muscle.
Possible side effects include:
  • Liver damage
  • Headache
  • Anxiety , nervousness, and insomnia
  • Fatigue
  • Nausea and vomiting
  • Adverse reactions at the injection site
Alcohol Abuse Deterrent
Common name—disulfiram
Disulfiram helps you overcome your drinking problem by making you very sick if you drink alcohol. However, it does not cure alcoholism. While you take this medication, and for at least 12 hours before you begin taking it, you should not drink even the smallest amount of alcohol. You should not use any foods, products, or medications that contain alcohol, nor should you come into contact with any chemicals that contain alcohol while using this medication.
If you have been diagnosed with heart disease or schizophrenia , talk to your doctor before taking this medication. Do not take this medication if you are allergic to disulfiram.
If you use alcohol while taking this medication, you may experience some of the following symptoms:
  • Nausea and vomiting
  • Chest pain
  • Lightheadedness, which may lead to fainting
  • Sweating and flushing
  • Difficulty breathing
  • Confusion
  • Weakness
  • Rapid heart beat
  • Drowsiness
If you experience mild reactions, you will most likely recover completely. However, reactions may worsen leading to breathing problems, heart problems, seizure, unconsciousness, and possibly death. Symptoms will last from 30 minutes to several hours. If you have mild or moderate reactions, see a doctor for help. If you experience severe reactions, call for emergency medical services right away.
Acamprosate
Acamprosate reduces your craving for alcohol by inhibiting a chemical in your brain called gamma aminobutyric acid (GABA). Several studies have indicated that it may help you remain abstinent.
Possible side effects include:
  • Diarrhea
  • Headache
  • Weakness
  • Rarely, suicidal thoughts
Benzodiazepines
Common names include:
  • Diazepam
  • Chlordiazepoxide
  • Lorazepam
  • Oxazepam
Benzodiazepines are anti-anxiety drugs that may be used to relieve withdrawal symptoms of alcoholism and reduce the risk of seizures . These drugs produce a sedative effect. Benzodiazepines are usually not used for long periods of time because they can lead to dependence and may cause withdrawal symptoms when discontinued.
Possible side effects include:
  • Drowsiness
  • Lightheadedness

Special Considerations

Contact your doctor if your medication does not seem to be working after the allotted period of time or if you have any side effects that are troublesome or persistent.
If you are taking medications, follow these general guidelines:
  • Take your medication as directed. Do not change the amount or the schedule.
  • Know what side effects could occur. Discuss them with your doctor.
  • Talk to your doctor before you stop taking the medication.
  • Plan ahead for refills if you need them.
  • Do not share your medication with anyone.
  • Drugs can be dangerous when mixed. Talk to your doctor if you are taking more than one drug, including over-the-counter products and supplements.

References

Antidepressant use in children, adolescents, and adults. US Food and Drug Administration website. Available at: http://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/UCM096273. Updated August 12, 2010. Accessed February 24, 2014.

Buspirone. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated January 18, 2013. Accessed February 24, 2014.

Disulfiram. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated January 18, 2013. Accessed February 24, 2014.

Kleber HD, Weiss RD, et al. Guideline Watch: Practice Guideline for the Treatment of Patients with Substance Use Disorders. 2nd ed. American Psychiatric Association website. Available at: http://psychiatryonline.org/content.aspx?bookid=28&sectionid=1682762. Accessed February 24, 2014.

Myrick H, Brady K. Current review of the comorbidity of affective, anxiety, and substance use disorders. Curr Opin Psychiatry. 2003;16:261-270.

5/14/2010 DynaMed's Systematic Literature Surveillance. http://www.ebscohost.com/dynamed: Vivitrol (naltrexone). US Food and Drug Administration website. Available at: http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm106211.htm. Updated August 28, 2013. Accessed February 24, 2014.

2/18/2011 DynaMed's Systematic Literature Surveillance. http://www.ebscohost.com/dynamed: Serretti A, Mandelli L. Antidepressants and body weight: a comprehensive review and meta-analysis. J Clin Psychiatry. 2010;71(10):1259-1272.

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