Pharmacology in Alcohol Use Disorder: Naltrexone, Acamprosate, and Disulfiram

Majority of patients with alcohol use disorder do not get any treatment and the reason for this is because the access to addiction treatment is very limited. One of possible drugs is naltrexone which reduces dopamine release. It is generally well tolerated, however there are few side effects like somnolence and GI distress, rarely hepatotoxicity. The effect of naltrexone consists in decrease of euphoric effects after alcohol so it can be helpful on reduction in heavy drinking. The second used drug is acamprosate, which is GABA agonist. Kidney failure is an absolute contraindication for using this medication. Clinical effect of acamprosate is to promote and maintain abstinence. The last discussed drug is disulfiram, which inhibits acetaldehyde dehydrogenase leading to accumulation of acetaldehyde - substance responsible for unpleasant reaction after consumption of alcohol (nausea, headache, hypotension). It is contraindicated in patients with psychotic disorder.
Video by Psychopharmacology Institute