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AlcoholScience, Policy and Public Health$
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Peter Boyle, Paolo Boffetta, Albert B. Lowenfels, Harry Burns, Otis Brawley, Witold Zatonski, and Jürgen Rehm

Print publication date: 2013

Print ISBN-13: 9780199655786

Published to Oxford Scholarship Online: May 2013

DOI: 10.1093/acprof:oso/9780199655786.001.0001

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PRINTED FROM OXFORD SCHOLARSHIP ONLINE (oxford.universitypressscholarship.com). (c) Copyright Oxford University Press, 2021. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use. date: 23 June 2021

Drug therapy: reviewing the evidence

Drug therapy: reviewing the evidence

(p.332) Chapter 41 Drug therapy: reviewing the evidence

Michael Soyka

Oxford University Press

This chapter reviews studies on drug therapy for alcohol addiction. The basic principle for treating withdrawal from alcohol is adequate sedation and seizure prophylaxis. Second-choice drugs, which can also be given in combination, primarily include substances to prevent blood pressure spikes, e.g., atenolol or clonidine. For a long time, disulfiram was the only drug used for relapse prevention, although evidence for its efficacy is relatively limited. Disulfiram blocks the enzyme acetaldehyde dehydrogenase, so that acetaldehyde accumulates when alcohol is consumed. The almost inevitable intolerability reactions are supposed to prevent the person from drinking alcohol again. A few new substances are also available that have a somewhat better evidence base than disulfiram and do not make use of “punishment” strategies. These include acamprosate, opiate antagonists, baclofen, gabapentin, and quetiapine.

Keywords:   drug therapy, alcohol abuse, rehabilitation, alcohol withdrawal, alcoholics, treatment, disulfiram

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