Pharmacotherapy of Alcohol Use Disorders

Abstract

Therapeutic interventions to treat alcoholism have increased in number, including several pharmacotherapies. Aspects of epidemiology, gender, and psychiatric comorbidity as well as a brief overview of neurobiology are presented as an introduction. The medications used clinically for the treatment of alcoholism, disulfiram and naltrexone, approved by the Food and Drug Administration in the United States for the treatment of alcoholism and acamprosate, a medication used extensively in Europe that is currently being evaluated in the United States, are reviewed in detail. An overview of the serotonergic agents is also provided. Finally, future directions, including new medications and some clinical strategies that show promise but are not yet used extensively clinically, are mentioned.

Keywords:

• alcohol
• alcohol abuse
• alcohol use-related disorders
• “craving”
• dependence
• pharmacotherapy

Additional information

Notes on contributors

Alessandra Buonopane

Dr. Ismene Petrakis is an Associate Professor of Psychiatry at the Yale University School of Medicine and the Director of the Substance Abuse Treatment Program at VA Connecticut Healthcare System, West Haven. She is also the Director of the Addiction Psychiatry Residency at Yale University School of Medicine, the principal investigator of a National Institute of Drug Abuse (NIDA) training grant and is involved in the education of medical students and residents at many stages of their training, particularly around clinical issues of addictive disorders. Her research interests include developing an understanding of the neurobiology of alcohol dependence and in testing potentially effective treatments for individuals with alcohol dependence and comorbid Axis I psychiatric disorders.Dr. Petrakis received her undergraduate degree at Northwestern University and her medical training at the University of Pittsburgh, School of Medicine. She completed her residency training and Addiction Psychiatry Fellowship at Yale University School of Medicine. Since completing her training, Dr. Petrakis has over 10 years of experience in the clinical treatment of addictive disorders, research in this field and in the education of residents, medical students, post-doctoral fellows and other mental health trainees in the assessment, accurate diagnosis and treatment of patients with substance use disorders.

Ismene L. Petrakis

Alessandra Buonopane, M.D. completed her medical degree and residency in neurology in Rome, Italy, and then completed a residency in psychiatry and a fellowship in addiction psychiatry at Yale University, School of Medicine. Currently, she is the Medical Director of the APT Foundation Methadone Program, which is affiliated with the Department of Psychiatry at Yale University School of Medicine. Currently her research interests include psychopharmacology, psychiatric treatment of underserved populations and dual diagnosis patients. Besides her clinical and research work, Dr. Buonopane is involved in the training of advanced residents in Yale's Addiction Psychiatry residency.