Medications for Alcohol Dependence

  1. Naltrexone
    (Depade, ReVia)
    • Action: Blocks opioid receptors, reducing craving and drinking response
    • Contraindication: opioid use, acute opioid withdrawal, acute hepatitis, liver failure
    • Adverse Reaction: precipitate severe withdrawal if opioid dependent; hepatotoxicity
    • Interaction: opioid
    • *Monitor liver function
  2. Extended-Release Injectable Naltrexone
    • Action: same (block opioid receptors, reducing cravings and response)
    • C: Same (opioid); inadequate muscle mass for deep injection; rash/infection at inj site
    • Ad Reaction: same (withdrawal for opioid); infection; depression; rare events (allergic pneumonia, suicidal ideation)
    • Drug Interaction: opioids
    • *Monitor liver function
  3. Acamprosate
    • Action: glutamate & GABA neurotransmitter systems
    • C:renal impairment
    • Ad Reaction: suicidal ideation and behavior
    • Interaction: none
    • *Renal Function
  4. Disulfiram
    • Action:Inhibits alcohol metabolism, causing acetaldehyde buildup and reaction of flushing, sweating, nausea, and tachycardia if alcohol is consumed
    • C: alcohol or metronidazole use; CAD; severe myocardial disease; hypersensitivity to rubber (thiuram) derivatives
    • Ad Reaction: Disulfiram-alcohol reaction; hepatotoxicity; optic neuritis, peripheral neuropathy, psychotic reactions
    • Drug Interaction:*warfarin; any nonprescription drug containing alcohol*; isoniazid; metronidazole; phenytoin
    • *First evaluate liver function, then monitor
Card Set
Medications for Alcohol Dependence
psych drugs for alcohol dependence