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Medications for Alcohol Use Disorder (AUD)

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.

Medications may be recommended as a part of treatment to help manage withdrawal symptoms, decrease pleasure associated with drinking, create negative physical symptoms like nausea after drinking, or to help manage related psychological conditions. Medications are usually prescribed alongside counseling or other psychosocial treatment. AUD is also 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 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 include:

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
Acamprosate

Acamprosate reduces your craving for alcohol by inhibiting a brain chemical 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

Second-line Therapy

Common names include:

Disulfiram

Disulfiram helps you overcome your drinking problem by making you very sick if you drink alcohol. However, it is not a cure for addiction. 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.

Topiramate

Topiramate reduces your craving for alcohol by blocking receptors for a brain chemical called gamma aminobutyric acid (GABA).

Possible side effects include:

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

Gabapentin can reduce your alcohol use, but there is some concern that it might result in addiction on its own.

It is generally well tolerated, but in high doses possible side effects include:

  • Sedation
  • Lightheadedness
Ondanestron

Ondansetron is a serotonin receptor blocker that can reduce your alcohol use if you started drinking at an early age or if you have a specific genetic component responsible for transporting the chemical serotonin.

Possible side effects include:

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    TOP

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 the medication as directed. Do not change the amount or the schedule.
  • Ask what side effects could occur. Report them to your doctor.
  • Talk to your doctor before you stop taking any prescription medication.
  • Do not share your prescription medication.
  • Medications can be dangerous when mixed. Talk to your doctor or pharmacist if you are taking more than one medication, including over-the-counter products and supplements.
  • Plan ahead for refills as needed.

References:

Alcohol use disorder. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated April 17, 2018. Accessed April 18, 2018.
Antidepressant medication overview. EBSCO DynaMed Plus website. Available at: https://www.dyname.... Updated September 30, 2016. Accessed April 18, 2018.
Buspirone. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T233385/Buspirone. Updated March 6, 2018. Accessed April 18, 2018.
Disulfiram. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T233214/Disulfiram. Updated March 6, 2018. Accessed April 18, 2018.
2/18/2011 DynaMed Plus Systematic Literature Surveillance. https://www.dyname...: Serretti A, Mandelli L. Antidepressants and body weight: A comprehensive review and meta-analysis. J Clin Psychiatry. 2010;71(10):1259-1272.
Last reviewed March 2018 by EBSCO Medical Review Board Adrian Preda, MD
Last Updated: 4/18/2018

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