Alcoholism - Resources

Medications

In the U.S., three drugs are specifically approved to treat alcohol dependence:

• Naltrexone (ReVia, Vivitrol, generic)
• Acamprosate (Campral)
• Disulfiram (Antabuse)

Naltrexone and acamprosate are categorized as anticraving drugs. Disulfiram is an aversion drug. Other types of medications, such as antidepressants, may also be used to treat patients with alcoholism.

Anticraving Medications

Anticraving drugs are opioid antagonists. These drugs reduce the intoxicating effects of alcohol and the urge to drink.

Naltrexone. Naltrexone (ReVia, Vivitrol, generic) is approved for the treatment of alcoholism and helps reduce alcohol dependence in the short term for people with moderate-to-severe alcohol dependency. ReVia, a pill that is taken daily by mouth, is the oral form of this medication. Vivitrol is a once-a-month injectable form of naltrexone.

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Naltrexone should be prescribed along with psychotherapy or other supportive medical management. The most common side effects are nausea, vomiting, and stomach pain, which are usually mild and temporary. Other side effects include headache and fatigue. High doses can cause liver damage. The drug should not be given to anyone who has used narcotics within 7 - 10 days.

It is important that patients take the pill form of naltrexone (Revia, generic) on a daily basis. Because many patients have difficulty sticking to this daily regimen, a monthly injection of Vivitrol may be an easier option. However, some patients suffer adverse injection-site reactions, including spreading skin infections and abscesses. Patients should monitor the injection site for pain, swelling, tenderness, bruising, or redness and contact their doctors if these symptoms do not improve within 2 weeks.

Naltrexone does not work in all patients. Some studies suggest that people with a specific genetic variant may respond better to the drug than those without the gene.

Research is being conducted on the effects of combining naltrexone with acamprosate (Campral), particularly for individuals who have not responded to single drug treatment.