Alcohol use disorder (AUD), which is otherwise known as alcohol dependence or alcoholism, is a medical condition characterized by an impaired ability to control alcohol use.
AUD can have detrimental consequences on an individual’s health, social life, relationships, and mental well-being. With the right tools and support, it is possible for people to overcome AUD.
Prescription medications can help individuals maintain long-term sobriety or achieve moderation with drinking.
Antabuse is one of these, but it may not be the best solution for all patients. There are many potential alternatives that are also worth exploring.
This article compares several Antabuse alternatives, including how they work, their uses, effectiveness, dosage, price, and more.
If you are seeking treatment for Alcohol Use Disorder, it’s crucial to get in touch with a medical professional.
A doctor will be able to gain an understanding of your situation, recommend the most appropriate medication for your needs, and work with you to create a tailored treatment plan that includes counseling and psychosocial support.
Let’s get into it.
A Comparison Guide To Antabuse Alternatives
Disulfiram
While often confused, Antabuse and Disulfiram are in fact the same thing. Antabuse is the brand name for disulfiram.
How it works: Disulfiram prevents the body from metabolizing alcohol normally, through blocking the ALDH enzyme, which is used in the chemical breakdown of alcohol.
When disulfiram is present, ALDH cannot break down acetaldehyde (a toxic byproduct of alcohol) which results in an upsurge of acetaldehyde in the body. This causes an onset of highly unpleasant symptoms.
Uses: Disulfiram is used as a deterrent to drinking.
Effectiveness: A study from 2014, which analyzed 22 separate studies and trials, found that disulfiram deters patients from alcohol use in around 72% of cases.
Dose: Typically, patients will be prescribed 500 mg per day for the initial phase of treatment, which will be reduced to around 250 mg per day for maintenance treatment. The exact dose varies for each individual.
Side effects: Disulfiram purposefully causes unpleasant side effects when combined with alcohol in any amount.
However, disulfiram may also produce side effects that occur without alcohol consumption.
These are considered normal as the body gets used to the medication and can include drowsiness, acne, headaches, and a metallic taste in the mouth.
Price: Disulfiram is priced at around $46 for a supply of 30 tablets (one month’s worth).
Naltrexone
Naltrexone is another FDA-approved medication that is often prescribed to treat AUD. It reduces the rewarding effects of alcohol and subsequently reduces cravings for it. It is often known by its brand names of Revia or Depade.
How it works: The pleasurable effects of alcohol are mediated within the brain’s opiate system. This means the same part of the brain that is triggered by opioid use, is also where you “feel” the rewarding effects of alcohol.
Naltrexone blocks the opiate receptors in the brain from “feeling” the rewarding sensation of alcohol, so it works to weaken the association between alcohol and pleasure. This, in turn, reduces one’s cravings for alcohol.
Uses: Naltrexone has traditionally been used in the treatment of opioid use disorder (OUD). More recently it has been approved by the FDA to treat Alcohol Use Disorder.
It is used to encourage total sobriety ormoderation.
This means that individuals may still choose to drink, but due to the absence of alcohol’s rewarding and pleasurable effects occurring in the brain, may naturally reduce consumption (i.e. stop after one or two drinks).
Effectiveness: Based on patients’ experiences, Naltrexone may be highly effective in reducing overall alcohol consumption
Dose : Naltrexone is typically taken once daily or on an as-needed basis. A dose of 50 mg per day is recommended for most patients, but this may vary depending on individual factors.
Side effects: Naltrexone is typically well-tolerated, but may produce mild side effects, including nausea, headaches, or drowsiness.
Price : Naltrexone is priced at around $48 for a supply of 30 tablets (one month’s worth).
Acamprosate
Acamprosate is a medication prescribed to AUD patients to help them maintain long-term sobriety. This medication is often known by its brand name Campral.
How it works: When individuals drink large amounts of alcohol for an extended period, their brain chemistry is altered.
Acamprosate may help the brain to work normally again, but its mechanism of action is not completely understood.
The medication may reduce the excessive excitement associated with alcoholism.
Uses: Acamprosate is indicated for the maintenance of alcohol abstinence, in patients who have already achieved sobriety.
Effectiveness: Empirical evidence suggests that the medication effectively reduces cravings for alcohol following detox. More research is needed to verify its efficacy.
Dose : The typical dose of acamprosate is 2000 mg per day, which is generally split into 6 tablets ( 2 x 333 mg tablets, taken 3 times daily).
Side effects: Acamprosate may cause diarrhea, gas, nausea, loss of appetite, dry mouth, dizziness, itching, weakness, anxiety or depression.
Price : Acamprosate is priced at around $150 for a supply of 180 tablets (one month’s worth).
Topiramate
Topiramate, often known by the brand name Topamax, may be a promising medication for reducing alcohol use.
How it works: While it is still in its early days of research, it is suggested that topiramate may target the reward centers of the brain to reduce the attraction of alcohol cues and weaken the association between alcohol and reward.
Therefore, it may work similarly to Naltrexone.
Uses: Whilst typically prescribed as an anti-seizure medication, topiramate has more recently been investigated for the treatment of AUD.
It is not yet FDA-approved for this purpose, but it appears to be useful in reducing heavy drinking, cravings for alcohol, and promoting abstinence.
Effectiveness: Preliminary evidence suggests that topiramate may have great efficacy in reducing cravings for alcohol, though the reasons for this are not yet clear.
More medical research, testing, and trialing is needed to determine the appropriate dose of topiramate for treating AUD.
Final Thoughts
Among the aforementioned medications, Antabuse (disulfiram) and Naltrexone are the most well-researched options.
Experts have a clear understanding of their mechanism of action and their effectiveness in treating AUD.
If you, or someone you know, is struggling with alcohol use, reach out to a medical professional to explore viable options for your situation. Every individual is different, and there is no one-size-fits-all approach to treating Alcohol Use Disorder.
