Evidence-Based Pharmacotherapies for Alcohol Use Disorder: Clinical Pearls

Mayo Clin Proc. 2020 Sep;95(9):1964-1977. doi: 10.1016/j.mayocp.2020.01.030. Epub 2020 May 20.

Abstract

Pathologic alcohol use affects more than 2 billion people and accounts for nearly 6% of all deaths worldwide. There are three medications approved for the treatment of alcohol use disorder by the US Food and Drug Administration (FDA): disulfiram, naltrexone (oral and long-acting injectable), and acamprosate. Of growing interest is the use of anticonvulsants for the treatment of alcohol use disorder, although currently none are FDA approved for this indication. Baclofen, a γ-aminobutyric acid B receptor agonist used for spasticity and pain, received temporary approval for alcohol use disorder in France. Despite effective pharmacotherapies, less than 9% of patients who undergo any form of alcohol use disorder treatment receive pharmacotherapies. Current evidence does not support the use of pharmacogenetic testing for treatment individualization. The objective of this review is to provide knowledge on practice parameters for evidenced-based pharmacologic treatment approaches in patients with alcohol use disorder.

Publication types

  • Review

MeSH terms

  • Acamprosate / administration & dosage
  • Acamprosate / adverse effects
  • Alcohol Deterrents / administration & dosage
  • Alcohol Deterrents / adverse effects
  • Alcoholism / drug therapy*
  • Alcoholism / psychology
  • Anticonvulsants / administration & dosage
  • Anticonvulsants / adverse effects
  • Disulfiram / administration & dosage
  • Disulfiram / adverse effects
  • Evidence-Based Medicine
  • Humans
  • Mass Screening / methods
  • Naltrexone / administration & dosage
  • Naltrexone / adverse effects
  • Off-Label Use
  • Practice Guidelines as Topic

Substances

  • Alcohol Deterrents
  • Anticonvulsants
  • Naltrexone
  • Acamprosate
  • Disulfiram