Open AccessPharmacoprophylaxis of alcohol dependence: Review and update Part I: Pharmacology
Author(s) -
Sandeep Grover,
Gaurav Bhateja,
Debasish Basu
Publication year - 2007
Publication title -
indian journal of psychiatry/indian journal of psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.485
H-Index - 34
eISSN - 1998-3794
pISSN - 0019-5545
DOI - 10.4103/0019-5545.31514
Subject(s) - acamprosate , disulfiram , naltrexone , topiramate , medicine , alcohol dependence , pharmacology , relapse prevention , alcohol , drug , psychiatry , psychology , chemistry , opioid , epilepsy , biochemistry , receptor
Alcohol dependence is a major problem in India. The pharmacological armamentarium for relapse prevention of alcohol has widened with the addition of new drugs. In this article, we review the pharmacology and efficacy of the four most important such drugs: disulfiram, naltrexone, acamprosate and topiramate. The first part of this two-part review series concerns the comparative pharmacology and the second part concerns the efficacy studies. Overall, all four of these drugs have modest but clinically significant usefulness as pharmacoprophylactic agents for relapse prevention or minimization of alcohol dependence. Combinations might be helpful, especially for naltrexone and acamprosate. The issue of supervision and compliance remains important, especially for such drugs as disulfiram and naltrexone. Topiramate is a promising new agent and requires further study. Disulfiram, while very effective in compliant patients, presents challenges in terms of patient selection and side effects. For patients with hepatic impairment, acamprosate is a good choice.