Traditional Pharmacotherapy of Alcohol Dependence
J Clin Psychiatry 2006;67(suppl 14):14-22
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Over a span of about 55 years, 4 medications have achieved U.S. Food and Drug Administration
(FDA)–approved labeling in alcohol dependence: disulfiram (1951), oral naltrexone (1994), acamprosate
(2004), and naltrexone for extended-release injectable suspension (2006). Although these
medications have different mechanisms of action and specific FDA-approved clinical indications, the
efficacy of each is increased significantly when the medication is combined with psychosocial
therapy. The distinct nature of each medication allows the potential to combine them in treatment—analogous to the treatment of hypertension. While these drugs are the cornerstones of current pharmacotherapy
treatment for alcohol dependence, they are still widely underutilized. This article reviews
the mechanisms of action, efficacy, safety/tolerability, and clinical use of disulfiram, oral naltrexone,