Alcoholism - Medications

SSRIs. Selective serotonin reuptake inhibitors (SSRIs) target the neurotransmitter serotonin and are of particular interest in the treatment of alcoholism. They include fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), citalopram (Celexa), and fluvoxamine (Luvox). Studies indicate that these antidepressants may reduce cravings and desire for alcohol, even in selected people who are not depressed. Studies report reductions in alcohol ranging from 10 - 70% in people with alcoholism who take SSRIs. Research is under way to determine which individuals with alcoholism might best respond to SSRIs. For example, one study suggested that they may be more effective for men than women. Some may be specifically helpful for people with both alcoholism and certain anxiety disorders, such as social anxiety.

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Designer Antidepressants. A number of drugs have now been developed that target other neurotransmitters, such as norepinephrine, alone or in addition to serotonin. They include nefazodone (Serzone), venlafaxine (Effexor), and mirtazapine (Remeron). Some research suggests they may have some benefits for treating alcoholism. However, nefazodone has been linked to increased risk for liver damage and should be used with caution by people with alcohol dependence.

OtherDrugs

Topiramate. Topiramate (Topamax) is ananti-seizuredrug used to treat epilepsy. It also helps control impulsivity. Early studies indicate it might reduce craving in patients with alcoholism, and may also help them stop smoking. Most side effects are mild to moderate and include mood swings and behavioral problems, dizziness, fatigue, visual disturbances, tremor, impaired concentration and thinking, weight loss and diarrhea, and a higher risk for kidney stones.

Odansetron.Ondansetron (Zofran) is ordinarily used to prevent nausea and vomiting due to chemotherapy. It also has actions that affect serotonin, a neurotransmitter that helps regulate alcohol's effects. In one study, ondansetron helped reduce drinking in people with early-onset alcoholism, although not in people who began drinking after age 25. These results suggest that thisdrug is helpful in patients with genetically related alcoholism, although not with alcoholism caused by other factors.