Advances in development of medications for alcoholism treatment |
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Authors: | R Z Litten John P Allen |
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Institution: | (1) Treatment Research Branch, National Institute on Alcohol Abuse and Alcoholism, Willco Building, Suite 505, 60000 Executive Boulevard, Bethesda, MD 20852-7003, USA, US |
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Abstract: | Over the past decade, research on medications to treat alcohol problem has flourished. Naltrexone and acamprosate are tangible
fruits of such endeavors and each has now earned approval in a large number of countries. Recent studies on naltrexone indicate
that patient compliance is important if full benefits are to be achieved. Several laboratory studies with human subjects are
beginning to elucidate the mechanisms underlying efficacy of naltrexone, as well as explaining variability of response among
subpopulations of drinkers. In addition to these two agents, recent investigations have also demonstrated that the antidepressants
desipramine, imipramine, and fluoxetine reduce mood-related symptoms and, to some extent, drinking itself in alcoholics who
are depressed. Research to date suggests that opioid antagonists and selective serotonin reuptake inhibitors are more effective
in reducing alcohol intake when used in combination. Clinical issues, methodology, and directions for future research are
also reviewed in this article. In particular, issues addressed include alternative dosage regimens, necessary duration of
treatment, employment of medications in combination, integration of pharmacologic agents with behavioral interventions, enhancement
of patient compliance, and concurrent treatment of psychiatric comorbidity.
Received: 16 December 1997 / Final version: 15 April 1998 |
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Keywords: | Pharmacotherapy Medications Craving Comorbidity Depression |
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