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The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included, so ask your doctor if you need to take any special precautions. Use each of these medications as recommended by your doctor, or according to the instructions provided.

Certain medications can help alleviate symptoms of alcohol withdrawal and help prevent relapse. Your doctor may prescribe medication to reduce cravings for alcohol. Medications are usually prescribed alongside counseling or other psychosocial treatment. Also, alcoholism and alcohol abuse are usually treated with a combination of medications, rather than just one medication. Treatment will vary on a case-by-case basis. Contact your doctor if you have further questions about usage or side effects.

Alcohol Abuse Therapy Adjunct

  • Naltrexone (ReVia)

Alcohol Abuse Deterrent

  • Disulfiram (Antabuse)

Acamprosate

  • Campral

Benzodiazepines

  • Diazepam (Valium)
  • Chlordiazepoxide (Librium)
  • Alprazolam (Xanax)
  • Lorazepam (Ativan)
  • Midazolam (Versed)
  • Oxazepam (Serax)

Selective Serotonin Reuptake Inhibitors (SSRIs)

  • Fluoxetine (Prozac)
  • Sertraline (Zoloft)
  • Paroxetine (Paxil)
  • Citalopram (Celexa)
  • Fluvoxamine (Luvox)

Azapirones

  • Buspirone (BuSpar)
  • Naltrexone (ReVia, Vivitrol)

Naltrexone is used to help you to stay away from alcohol, but it is not a cure for addiction. It may work by blocking the high that makes you crave alcohol. It will not, however, prevent you from experiencing the effects of alcohol. Naltrexone is available as a pill (ReVia) and an injection in the muscle (Vivitrol).

Possible side effects include:

  • Stomach cramps
  • Headache
  • Muscle or joint pain
  • Anxiety, nervousness, and insomnia
  • Fatigue
  • Nausea and vomiting
  • Adverse reactions at the injection site can occur with Vivitrol
  • Disulfiram (Antabuse)

Disulfiram helps you overcome your drinking problem by making you very sick if you drink alcohol. However, it does not cure alcoholism. While you take this medicine, and for at least 12 hours before you begin taking it, you should not drink even the smallest amount of alcohol. You should not use any foods, products, or medicines that contain alcohol, nor should you come into contact with any chemicals that contain alcohol while using this medicine.

If you have been diagnosed with heart disease or schizophrenia, talk to your doctor before taking this medicine. Do not take this medicine if you are allergic to disulfiram.

If you use alcohol while taking this medicine, you may experience some of the following symptoms:

  • Nausea and vomiting
  • Chest pain
  • Dizziness or fainting
  • Sweating and flushing
  • Difficulty breathing
  • Confusion
  • Weakness
  • Rapid heart beat
  • Drowsiness

If you experience mild reactions, you will most likely recover completely. However, reactions may worsen leading to breathing problems, heart problems, seizure, unconciousness, and possibly death. Symptoms will last from 30 minutes to several hours. If you have mild or moderate reactions, see a doctor for help. If you experience severe reactions, go to the emergency room right away.

  • Campral

Acamprosate (Campral) reduces your craving for alcohol by inhibiting a chemical in your brain called gamma aminobutyric acid (GABA). Several studies have indicated that it may help you remain abstinent.

Possible side effects include:

  • Diazepam (Valium)
  • Chlordiazepoxide (Librium)
  • Alprazolam (Xanax)
  • Lorazepam (Ativan)
  • Oxazepam (Serax)

Benzodiazepines are anti-anxiety drugs that may be used to relieve withdrawal symptoms of alcoholism and reduce the risk of seizures. These drugs produce a sedative effect. Benzodiazepines are usually not used for long periods of time because they can lead to dependence and may cause withdrawal symptoms when discontinued.

Possible side effects include:

  • Drowsiness
  • Dizziness

Depression and anxiety are conditions that may occur with alcoholism and alcohol abuse. Because of this, certain medications may be used to treat these conditions as well.

  • Paroxetine (Paxil)
  • Sertraline (Zoloft)
  • Fluoxetine (Prozac)
  • Citalopram (Celexa)
  • Fluvoxamine (Luvox)

Selective serotonin reuptake inhibitors (SSRIs) affect the concentration of the neurotransmitter serotonin, which plays a role in anxiety and depression. They are helpful if you have a coexisting psychiatric problem, such as an anxiety disorder or depression. Improvement is usually seen in 4-6 weeks after beginning treatment.

Possible side effects include:

  • Nausea
  • Diarrhea
  • Insomnia
  • Weight gain
  • Sexual dysfunction. Dysfunction includes decreased arousal, erectile dysfunction, and/or delayed time to orgasm.
  • Risk of severe mood and behavior changes, including suicidal thoughts in some patients. Young adults may be at a higher risk for this side effect.
  • Buspirone (BuSpar)

This anti-anxiety drug may be used in the treatment of a coexisting anxiety disorder. It takes from 2-4 weeks for improvement to be evident. For this reason, this drug is not useful for treating acute anxiety and insomnia. The primary advantages of buspirone are that it is less sedating than benzodiazepines, and it does not result in physical dependence or tolerance.

Buspirone should be taken with food to increase absorption. Avoid alcohol in excessive amounts when taking this medication due to possible adverse reactions.

Possible side effects include:

  • Drowsiness
  • Headache
  • Nausea
  • Dizziness

Contact your doctor if your medication does not seem to be working after the allotted period of time or if you have any side effects that are troublesome or persistent.

If you are taking medications, follow these general guidelines:

  • Take your medication as directed. Do not change the amount or the schedule.
  • Know what side effects could occur. Discuss them with your doctor.
  • Talk to your doctor before you stop taking the medication.
  • Plan ahead for refills if you need them.
  • Do not share your medication with anyone.
  • Drugs can be dangerous when mixed. Talk to your doctor if you are taking more than one drug, including over-the-counter products and supplements.
References:

Antidepressant use in children, adolescents, and adults. US Food and Drug Administration website. Available at: http://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/UCM096273. Updated August 12, 2010. Accessed March 29, 2013.

Buspirone. National Alliance on Mental Illness website. Available at: http://www.nami.org/Template.cfm?Section=About_Medications&Template=/TaggedPage/TaggedPageDisplay.cfm&TPLID=51&ContentID=66277. Updated August 2010. Accessed March 29, 2013.

Disulfiram. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what. Updated January 18, 2013. Accessed March 29 ,2013.

Kleber HD, Weiss RD, Anton RF Jr, et al. Practice Guideline for the Treatment of Patients with Substance Use Disorders. 2nd ed. American Psychiatric Association website. Available at: http://www.psych.org/psych_pract/treatg/pg/SUD2ePG_04-28-06.pdf. Accessed April 14, 2007.

Myrick H, Brady K. Current review of the comorbidity of affective, anxiety, and substance use disorders. Curr Opin Psychiatry. 2003;16:261-270.

5/14/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: Vivitrol (naltrexone). US Food and Drug Administration website. Available at: http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm106211.htm. Accessed May 14, 2010.

2/18/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: Serretti A, Mandelli L. Antidepressants and body weight: a comprehensive review and meta-analysis. J Clin Psychiatry. 2010;71(10):1259-1272.

Last reviewed March 2013 by Brian Randall, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.