 Alcohol dependence, or alcoholism, is a common medical illness. Prescription medicines such as ReVia (generic name naltrexone) and >Antabuse (disulfiram) are used in combination with other treatments, such as counseling and social support programs like Alcoholics Anonymous. Revia and Antabuse work in very different ways to control alcoholism. ReVia reduces the craving and pleasurable effects associated with alcohol. This, in turn, helps people stop drinking, and reduces their risk for relapse. Studies have shown that only one in four people relapse while taking ReVia, while two in four people who don't take ReVia start drinking again. ReVia may also help to reduce the amount of alcohol consumed by people who continue to drink. You must not have severe liver damage if you take this medicine. ReVia is typically given for up to 12 weeks. Antabuse works by producing a severe physical reaction if a person drinks alcohol while taking the drug. Awareness of this possibility discourages people from drinking. The reaction includes severe nausea, vomiting, flushing, rapid heartbeats, and chest pain. Unlike ReVia, however, Antabuse does not affect cravings for alcohol. Studies have shown that two out of 10 people with alcohol dependence who take Antabuse stay sober, while only one out of 10 people not taking Antabuse do. The biggest problem with Antabuse, however, is that people often stop taking this medicine and start drinking again.
Acamprosate (Campral) was approved in 2004 to be used as maintenance therapy once a person has abstained from alcohol. There are other medicines that are being evaluated to treat alcoholism. A recent study showed that ondanestron (brand name Zofran) reduced alcohol intake and improved abstinence rates in people with early-onset alcoholism (25 years or younger). This use is not yet FDA approved. Sources:
The American Psychiatric Press Textbook of Psychopharmacology. American Psychiatric Press Inc., 1998.
Pharmacotherapy: A Pathophysiologic Approach. Appleton & Lange, 1999.
Swift, RM. “Drug Therapy for Alcohol Dependence”. New England Journal of Medicine. 340 (1999).
Kranzler, H.R. "Medications for Alcohol Dependence—New Vistas". The Journal of the American Medical Association, 284 (2000).
Johnson, B.A., Roache, J.D., Javors M.A., DiClemente, C.C., Cloninger, C.R., Prihoda, T.J., Bordnick, P.S., Ait-Douad, N., Hnsler, J. "Ondansetron for Reduction of Drinking Among Biologically Predisposed Alcoholic Patients".The Journal of the American Medical Association, 284 (2000).
Drug Facts and Comparisons. Facts & Comparisons, 2007.
Micromedex® Healthcare Series. Thomson Micromedex, 2007.
This answer prepared 11/20/2000.
This information updated 1/3/2006.
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