Choosing The Best Alcoholism Medication For The PatientThe treatment protocols for chronic alcoholism are seldom one-sided because the effects of alcoholism encompass the physical, mental and psychological health of the addict. The use of alcoholism medications is one strategy which can increase the effectiveness of any therapy as long as they are carefully monitored and judiciously prescribed. There are several types of medications for a specific chronic alcoholism treatment phase. Here are the phases of alcoholism treatment and the medications that are given to the patient during that phase: The initial phase for using medication is in the detoxification stage. Such alcoholism medication significantly reduces the withdrawal symptoms by blocking autonomic hyperactivity (rapid heart rate, sweating, nausea and “the shakes”). The most commonly used drugs for this are:
This is recommended for outpatient alcoholism treatment to ensure the safety of the patient as well as the people around them. Of the three classes of medications, benzodiazepines are the preferred withdrawal medication because it is a gamma amino butyric acid (GABA) agonist, meaning it supplements the low levels of GABA in the patient’s system, believed to be the cause of autonomic hyperactivity. Clinicians typically prescribe benzodiazepines with a long half-life such as chlordiazepoxide because it can be given once and it self-tapers gradually. Antihypertensives include propranolol and clonidine. Anticonvulsants to ward of “the shakes” include carbamazepine. Once the alcoholism treatment program is completed, the important thing is to prevent a relapse. Some clinicians prescribe disulfiram which inhibit the body from metabolizing alcohol, blocking the “high” of alcohol in the system and inducing nausea, cramps and sweating. In other words, it takes the fun out of drinking. Other relapse prevention medications that work in the same way although through a different mechanism include opioid antagonist agents such as naltrexone which blocks opioid receptors for beta-endorphin which induces a state of well-being when alcohol is imbibed. Because drinking has a significant genetic linkage, people who are predisposed to alcoholism usually have an overproduction of beta-endorphins. Acamprosate is a glutamatergic N-methyl-D-aspartate (NMDA) antagonist that blocks the NMDA receptors, and has been found in clinical studies to decrease alcohol consumption. Since alcohol abuse often involves or co-inhabits with psychiatric conditions (impulse control disorder, antisocial personality disorder), some clinical treatments involve the use of serotonin specific reuptake inhibitors (SSRIs) which increases the serotonin levels in the brain, indicated in some studies as having a positive effect on alcohol intake reduction. It is based on the belief that there may be involvement of serotonin in alcohol dependence. However, conflicting results have made the use of SSRIs inappropriate for alcoholism treatment alone, unless it is for a co-existing psychiatric disorder. SSRIs include fluoxamine and citaopram. Early reports show that alcohol helps patients with mood disorders, especially bipolar disorder patients. This led to the idea that lithium may be effective in the treatment of alcoholism. However subsequent studies do not support this theory. Much more effective in the treatment of mood disorders is the use of tricyclic antidepressants (TCAs) such as impramine and amytrptyline. These substances essentially mildly sedate the patient to promote mood stability. While most of these medications are used as supplements to alcoholism treatment, alcoholism medication is a subject of intense research and development because of the high relapse rates for alcoholism. Improved medications and new formulations have helped to increase the efficacy of alcoholism treatment programs and the reduction of relapse. |