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Fighting Alcoholism With Medications

Drugs combined with support can help alcoholics kick alcohol addiction.

Campral

Campral, taken by mouth three times daily, acts on chemical messenger systems in the brain. It appears to reduce the symptoms that alcoholics may experience when they abstain from booze over long periods. These symptoms can include insomnia, anxiety, restlessness, and unpleasant changes in mood that could lead to relapse. In European clinical trials and in pooled data from several studies, Campral increased the proportion of alcoholics who were able to refrain from drinking for several weeks or months.

However, in the COMBINE trial and another U.S. study, there was no apparent benefit to the use of Campral, either alone or in combination with naltrexone. Patients in the European trials tended to be more severely alcohol dependent than those in the U.S. studies, and most patients in European studies had been abstinent for longer periods before starting Campral, two factors that could account for the difference in the findings, according to the NIAAA.

"We use medicines to help detoxify people, but even after detoxification occurs the neurochemistry is still not in very good balance, and probably even more importantly, when your brain thinks it's going to get alcohol, that elicits these compensatory neural changes so that the body goes through the equivalent of a little mild withdrawal, and [Campral] blocks that," Volpicelli explains.

Topamax

Topamax is approved by the FDA for the treatment of seizures but not for alcoholism. It has a mechanism of action similar to that of Campral and may similarly help patients avoid or reduce the symptoms associated with long-term abstinence.

In a study published in The Journal of the American Medical Association in October 2007, researchers from the U.S. and Germany reported that Topamax was better than placebo at reducing the percentage of heavy drinking days over a 14-week period.

Treating Alcoholism: Drugs Alone Aren't Enough

"All these medications work best in the context of psychosocial treatment. Just giving somebody pills without that is not as effective," says Herman.

According to Weiss, at least three forms of psychosocial therapy have been shown to be effective at treating alcoholism, with roughly similar success rates. These include:

  • Cognitive behavioral therapy, a form of psychotherapy focusing on identifying and modifying negative thoughts and thought patterns.
  • 12-step facilitation, in which patients are encouraged to enter 12-step programs such Alcoholics Anonymous.
  • Motivational enhancement therapy, a patient-centered approach in which counselors try to get patients to think about and express their motivations for change and to develop a personal plan that can help them make the necessary changes.
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Reviewed on March 10, 2008

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