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Pharmacotherapy Alcohol Use Disorders

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    • 1957 posts
    May 18, 2014 4:54:41 PM PDT

    Pharmacotherapy for Alcohol Use Disorders

    BrettMD's research findings:

    Research from JAMA — Pharmacotherapy for Adults With Alcohol Use Disorders in Outpatient Settings — A Systematic Review and Meta-analysis

    Conclusions and Relevance Both acamprosate and oral naltrexone were associated with reduction in return to drinking.

    When directly compared with one another, no significant differences were found between acamprosate and naltrexone for controlling alcohol consumption. Factors such as dosing frequency, potential adverse events, and availability of treatments may guide medication's choice.

    Alcohol use disorders (AUDs) are common, cause substantial morbidity, and result in 3-fold increased rates of early mortality (eTable 1 in theSupplement). 1-8 treating AUDs is difficult but may be aided by using medications. Pharmacotherapy for AUDs was initiated in the 1950s and consisted only of disulfiram (Antabuse). In the 1990s, naltrexone (oral and intramuscular formulations) and acamprosate were approved by the US Food and Drug Administration (FDA) (eTable 2 in the Supplement).

    Fewer than one-third of the patients with AUDs receive treatment, 6 and only a small percentage (<10%) receive medications to assist in reducing alcohol consumption. To evaluate the benefits and harms of medications for the treatment of adults with AUDs, a systematic review was conducted. A larger, more comprehensive technical report for the Agency for Healthcare Research and Quality was prepared (eTable 3 in the Supplement) 9.

    The article below summarizes findings from the larger report on the efficacy of various medications used for the treatment of AUDs in reducing alcohol intake or improving health outcomes and on the adverse effects of these medications.

    https://jama.jamanetwork.com/article.aspx?articleid=1869208

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    BrettMD's then and now comparison:

    Pharmacotherapy for alcohol use disorders has made progress since 1942 when amphetamine, vitamins, and psychotherapy alone were determined to be woefully inadequate for the treatment of alcoholism.

    JAMA Network | JAMA | THE CONDITIONED REFLEX TREATMENT OF CHRONIC ALCOHOLISM: VIII. A REVIEW OF SIX YEARS EXPERIENCE WITH THIS TREATMENT OF 1,526 PATIENTS http://jama.jamanetwork.com/article.aspx?articleid=257611

     

    Alcoholism treatment in 1942


    This post was edited by DrSocial Admin at April 5, 2015 9:06:55 AM PDT
    • Moderator
    • 1957 posts
    May 18, 2014 5:06:49 PM PDT

    Amphetamine for alcoholismJAMA Network | JAMA | AMPHETAMINE IN CHRONIC ALCOHOLISM http://jama.jamanetwork.com/article.aspx?articleid=289190

    To the Editor:—  The reply which recently appeared in Queries and Minor Notes to a letter relative to the use of amphetamine (benzedrine) in the treatment of chronic alcoholism as recommended by Dr. Wilfred Bloomberg might easily give rise to a regrettable misunderstanding. Dr. Bloomberg made the suggestion only after long experience with the drug in other conditions, for he (with Prinzmetal) was the first to report its effectiveness in the treatment of narcolepsy. He has further, in preparation, a detailed study of the effects of large doses given over a period of three years to some of his early patients and a careful survey of all the cases in which ill effects are reported to have followed the use of the drug. This study has led him to the belief that its use under medical supervision is entirely justified when dealing with such serious diseases as narcolepsy.


    This post was edited by DrSocial Admin at April 5, 2015 9:09:07 AM PDT
    • 445 posts
    April 5, 2015 9:46:41 AM PDT

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