Medications for the Treatment of Alcohol Dependence—Current State of Knowledge and Future Perspectives from a Public Health Perspective

No single effective drug for alcohol abuse has been identified, despite centuries of effort, due to the complexity of alcohol dependence. Psychotherapy remains the main treatment, with few FDA-approved medications—acamprosate, disulfiram, and naltrexone—and nalmefene approved by the EMA available to augment it. Recent reports suggest baclofen, topiramate, varenicline, and gabapentin may be useful. Clinical trials with psilocybin and MDMA show promise as breakthroughs, but much more research is needed before new pharmacological treatments become widely available.

Study at a glance

Abstract

No single effective therapy for alcohol abuse has been found, despite it being a serious sociological and economic problem for hundreds of years. It seems difficult to find a single drug as a panacea for the alcohol problem due to the complexity of the pathophysiology of alcohol dependence. The purpose of this narrative review is to review existing and potentially future pharmaceuticals for the treatment of alcohol dependence in the most affordable way possible. Psychotherapy is the mainstay of treatment for alcoholism, while few drugs approved by legislators are available in the augmentation of this treatment, such as acamprosate, disulfiram, and naltrexone, approved by the FDA, and nalmefene by the EMA. There are recent reports in the literature on the possibility of using baclofen, topiramate, varenicline, and gabapentin in the treatment of alcohol dependence. Moreover, the results of recent clinical trials using psychoactive substances such as psilocybin and MDMA appear to be a breakthrough in the modern treatment of alcohol abuse. Despite this initial optimism, a lot of scientific effort is still needed before new pharmacological methods supporting the treatment of alcohol dependence syndrome will be widely available.