New steps for treating alcohol use disorder

Psychopharmacology (Berl). 2018 Jun;235(6):1759-1773. doi: 10.1007/s00213-018-4887-7. Epub 2018 Mar 25.

Abstract

Alcohol use disorder is a complex syndrome with multiple treatment points including drug-induced pathology, withdrawal management, behavioral/cognitive strategies, and relapse prevention. These different components may be complicated by genotype and phenotype. A huge milestone for the treatment of alcohol use disorder across several countries in the last 10 years was the introduction of practice guidelines integrating clinical expertise and research evidence. These provide a summary of interventions that have been shown to be effective following rigorous and replicated clinical trials. Inspection of these guidelines reveals good consistency, but little evidence of progress in treatment approaches for alcohol use disorder over the past decade. In this mini-review, we discuss emerging treatments for alcohol use disorder that may supplement or improve the evidence-based treatments that are currently recommended. New medications, the emergence of digital technology, and other novel approaches such as transcranial magnetic stimulation are all discussed with reference to treatments already in practice. We also consider how individual differences in genotype and phenotype may affect outcomes. Together with improvements in technology, this knowledge offers a powerful tool for designing personalized approaches to treatment, and hence improving prognosis for rehabilitation programs.

Keywords: Alcohol use disorder; Drug repositioning; Precision medicine; Therapy; Transcranial magnetic stimulation.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Alcoholism / diagnosis
  • Alcoholism / psychology*
  • Alcoholism / therapy*
  • Anti-Anxiety Agents / therapeutic use
  • Humans
  • Narcotic Antagonists / therapeutic use
  • Psychotherapy / methods
  • Psychotherapy / trends*
  • Transcranial Magnetic Stimulation / methods
  • Transcranial Magnetic Stimulation / trends*
  • Treatment Outcome

Substances

  • Anti-Anxiety Agents
  • Narcotic Antagonists