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Medications for Alcohol Use Disorder (AUD)

Here are the basics about each of the medicines below. Only common problems with them are listed.

One or more medicines may be given to:

  • Manage withdrawals
  • Decrease pleasure from drinking
  • Create negative symptoms when a person drinks alcohol, such as headaches

Prescription Medications for AUD

First-line therapy:

  • Naltrexone
  • Acamprosate

Second-line therapy:

  • Disulfiram
  • Topiramate
  • Gabapentin
  • Ondansetron

Benzodiazepines:

  • Diazepam
  • Chlordiazepoxide
  • Lorazepam
  • Oxazepam

Prescription Medications for AUD

 

First-line therapy

Common names are:

 

Naltrexone

Naltrexone blocks the high that makes a person crave alcohol. It will not prevent a person from the effects of alcohol. It is available as a pill and an injection in a muscle.

Some problems may be:

  • Headache
  • Fatigue
  • Nausea and vomiting
  • Anxiety, nervousness, and insomnia
  • Liver damage
  • Reactions at the injection site
 

Acamprosate

Acamprosate reduces the craving for alcohol by stabilizing the chemical balance in the brain.

Problems may be:

  • Headache
  • Weakness
  • Diarrhea
  • Rarely, suicidal thoughts
 

Second-line Therapy

Common names are:

 

Disulfiram

Disulfiram makes a person sick when they drink alcohol. Alcoholic drinks, foods, products, and medicines may not be taken. If alcohol is used, it will cause symptoms that may last several hours, such as:

  • Nausea and vomiting
  • Lightheadedness, which may lead to fainting
  • Sweating and flushing
  • Weakness
  • Drowsiness
  • Confusion
  • Chest pain
  • Rapid heart beat
  • Problems breathing
 

Topiramate

Topiramate reduces the craving for alcohol by stabilizing the chemical balance in the brain.

Some problems may be:

  • Headache
  • Lightheadedness
  • Fatigue
  • Weight loss
  • Speech problems
  • Depression
 

Gabapentin

Gabapentin can reduce alcohol use, but it is possible that using it can lead to dependence.

High doses may cause problems, such as:

  • Lightheadedness
  • Sedation
 

Ondansetron

Ondansetron is a serotonin receptor blocker that can lower alcohol use in a person who started drinking at an early age.

Some problems may be:

 

Benzodiazepines

Common names are:

  • Diazepam
  • Chlordiazepoxide
  • Lorazepam
  • Oxazepam

Benzodiazepines are anti-anxiety medicines. They are used to ease withdrawal symptoms lower the risk of seizures. They have a sedative effect. Benzodiazepines are usually not used for long periods of time because they can lead to dependence. They may also cause withdrawal symptoms when stopped.

Some problems may be:

  • Drowsiness
  • Lightheadedness
REFERENCES:

Alcohol use disorder. EBSCO DynaMed website. Available at:https://www.dynamed.com/condition/alcohol-use-disorder. Accessed September 3, 2020.

Alcohol withdrawal syndrome. EBSCO DynaMed website. Available at:https://www.dynamed.com/condition/alcohol-withdrawal-syndrome. Accessed September 3, 2020.

Day E, Copello A, Hull M. Assessment and management of alcohol use disorders. BMJ. 2015 Feb 19;350:h715.

Diagnostic and Statistical Manual of Mental Disorders (DSM-5). American Psychiatric Association; 2013.

Last reviewed March 2020 by EBSCO Medical Review Board Adrian Preda, MD  Last Updated: 2/19/2021