Different Alcohol Addiction Medication Options Available

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Several types of medication can help you quit and reduce your alcohol cravings so your abstinence journey gets a bit easier. These include disulfiram, naltrexone, and acamprosate, as well as other drugs not explicitly labeled as alcohol addiction medications, such as topiramate and gabapentin.

Let’s explore these alcohol addiction treatment aids and how they can help you both quit alcohol and maintain your sobriety.

FDA-Approved Medications for Alcohol Addiction

While many drugs can help manage alcohol use disorder, only three are currently FDA-approved for this use; disulfiram, naltrexone, and acamprosate. Here’s an overview of each:

Disulfiram

Disulfiram was the first drug to gain FDA approval for alcohol use disorder back in 1951. While there isn’t much evidence of its effectiveness in treating alcohol dependence, many alcoholic recovery programs still use it today.

Disulfiram changes the way your body processes alcohol so that you get sick if you drink. It causes you to experience things like a throbbing headache, chest pain, vomiting, and trouble breathing, even from a small amount of alcohol.

That’s why you’re less likely to relapse while taking disulfiram, because the unpleasant symptoms outweigh the euphoria you get from drinking.

With time, your mind will begin to associate drinking with those negative symptoms, and your alcohol cravings will slowly decrease.

Your healthcare provider will likely prescribe disulfiram oral pills once daily for a few weeks or months. The duration depends on your previous alcohol consumption and where you stand in your recovery plan.

How Disulfiram Works

Whenever you drink alcohol, your body starts breaking it down in several steps.

First, it converts the alcohol to acetaldehyde. Next, an enzyme called acetaldehyde dehydrogenase (ALDH) breaks it down into small molecules that are metabolized and eliminated from your body.

Disulfiram is an ALDH inhibitor, meaning it prevents your body from breaking down acetaldehyde. As the level of acetaldehyde increases in your blood, you start to experience more unpleasant symptoms because of its toxic effects.

All of this can happen within 10-30 minutes of your last drink and can last for several hours, depending on the alcoholic content of your drink.

Who Can Take Disulfiram

Disulfiram can be given to anyone struggling with alcohol abuse as long as they understand what would happen if they go back to drinking.

Before you start disulfiram, you’ll need to wait at least 12 hours since your last drink to make sure any trace of alcohol has left your system.

There are certain cases where you’re not allowed to take disulfiram, such as:

  • Severe heart conditions
  • Mental illness
  • Alzheimer’s or dementia
  • Liver disease  

Side Effects of Disulfiram

  • Sleepiness
  • Exhaustion
  • Headache
  • Impotence or erectile dysfunction
  • Acne
  • Skin rash
  • A metallic or garlic-like taste

Naltrexone

If you drink alcohol while on naltrexone, you won’t experience negative side effects as you would with disulfiram. However, you won’t feel the euphoria that usually comes with alcohol either.

Naltrexone severs the relationship between alcohol and pleasure by blocking the feel-good receptors in your brain.  

Even if you relapse at some point, you won’t feel the same effect you usually did, so your alcohol craving will slowly decrease with time. You’ll start to have fewer heavy drinking days until you stop drinking altogether.

Naltrexone can be taken as an oral pill once daily or as a monthly injection. Your healthcare provider can determine which is better for you in the long run, especially since you might need to take it for several months.  

It works best if you start naltrexone at least four days after you’ve stopped drinking.

How Naltrexone Works

Naltrexone is an opioid antagonist, which means it blocks specific receptors in your brain that are responsible for alcohol’s euphoric effects.

However, these receptors also work with opioid painkillers, which means naltrexone could unintentionally stop the effects of these opioids, as well. That’s why it’s essential to let your doctor know if you’re taking any opioid prescription painkillers.  

Who Can Take Naltrexone

Anyone suffering from substance abuse or alcohol use disorders can take naltrexone, but you’ll need a prescription from a healthcare provider.

However, it’s contraindicated if you have a history of hepatitis or any kind of liver disease since naltrexone might make liver damage worse.

Naltrexone Side Effects

  • Mild abdominal pain
  • Anxiety and restlessness
  • Mild joint or muscle pain
  • Nausea or vomiting
  • Tiredness

Acamprosate

Acamprosate is used to treat alcohol dependence and prevent relapse in heavy drinkers.

Your doctor will usually prescribe it if you’ve been drinking for too long and feel your cognitive functions have been somewhat affected. This usually happens because alcohol can change the way your brain is wired and disturb the balance of neurotransmitters that relay messages between different parts of the central nervous system.

Alcoholism makes your brain too excited when you drink, and that’s one of the reasons you develop cravings.  

When you take acamprosate, it restores the natural balance and returns brain functions back to normal.

How Acamprosate Works

Two neurotransmitters, GABA (gamma-aminobutyric acid) and glutamate, are responsible for the amount of activity a brain experiences. The former controls feelings of calm and relaxation, while the latter stimulates excitement and anxiety.

Acamprosate balances and stabilizes these two neurotransmitters so your brain isn’t over-excited.

GABA also affects your alcohol cravings. Studies show that people who have a GABA deficiency are more likely to be alcohol dependent, suffer from alcohol misuse, or relapse. By balancing your GABA levels, acamprosate helps with maintaining abstinence.

However, you’ll likely need to take acamprosate for several months to get the most benefits. Many people have a hard time sticking to it because the typical dose is two pills three times a day, which can be tricky to remember.  

Who Can Take Acamprosate

Acamprosate is usually prescribed for heavy drinkers and people who can’t take naltrexone, such as those on opioids or suffering from liver disease.

However, anyone who has a kidney disease should not take acamprosate without a doctor’s approval.

Side Effects of Acamprosate

  • Fatigue and lethargy
  • Loss of appetite
  • Diarrhea and flatulence
  • Nausea
  • Anxiety or depression
  • Lightheadedness
  • Dry mouth and sweating
  • Sleep disturbances
  • Itching

Off-Label Medications

Some medications can help with alcohol addiction or relapse prevention despite not being FDA-approved for this specific purpose. These are called off-label uses, which do not indicate any issues if your healthcare provider prescribed them for you.

These medications are:

Topiramate

One of the lesser-used medications for alcohol addiction is topiramate, which is an anticonvulsant medication that helps you drink less.

It works similarly to acamprosate by balancing your GABA and glutamate neurotransmitters, lowering cravings.

One study showed that topiramate also reduces depression, anxiety, and chance of relapse in people going through alcohol withdrawal.  

Being an anti-seizure medication, it’s usually the number one choice for people with AUD who have epilepsy or seizure disorders.

Gabapentin

Some alcohol addiction programs have added gabapentin, another anticonvulsant, to their regimens.

Studies have shown that it can be effective in cases of mild alcohol addiction, but you need to take it within a full-fledged treatment plan for the best results.

Gabapentin is especially helpful in the early stages of abstinence, where it can improve your mood and help you sleep better.

However, the main risk with gabapentin is its high potential for addiction. That’s why it’s not recommended for anyone who has a history of drug abuse.  

Explore Treatment Options for Alcohol Use Disorder with Curednation

There’s no reason to tackle your alcohol addiction alone when you can empower yourself with the help of healthcare providers and medication.

Curednation’s telehealth services can guide you from the comfort of your home. Book your appointment today and take the first step towards sobriety.  

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