Medications to Help Stop Drinking: Which Works Best?

Best Medications To Help You Stop Drinking

It's essential to seek medical advice before taking any medication to treat AUD, as medications can have side effects and interact with other medications or health conditions.

According to recent statistics, alcohol use disorder (AUD) affects millions of individuals worldwide. This chronic condition can lead to severe health issues such as liver disease, heart disease, and cancer. While numerous treatments are available to help those struggling with AUD, medications can be a powerful tool in aiding recovery.

If you or someone close to you is dealing with AUD, it's natural to wonder about the most effective medications to combat alcohol dependence. In this article, we'll delve into the most commonly used medications for treating AUD, examine their mechanisms of action, and highlight their potential side effects.

These 5 Medications Can Help You Stop Drinking

Alcohol use disorder (AUD) is a multifaceted medical condition that causes individuals to struggle with controlling their alcohol consumption. Successfully treating AUD frequently involves a combination of therapies, support groups, and medications.

Here we have five of the most commonly used and effective medications for those seeking to overcome AUD and stop drinking.

1. Naltrexone

Naltrexone is a medication that works by blocking the effects of alcohol on the brain. It reduces the cravings for alcohol and can make drinking less enjoyable. Naltrexone is available in pill form or as a monthly injection. It is an effective treatment for people who have already quit drinking or who are in the process of quitting.

How Naltrexone Works?

• Naltrexone works by blocking the opioid receptors in the brain that are responsible for the pleasurable effects of alcohol.
• This means that even if an individual drinks while taking naltrexone, they will not feel the same euphoria or pleasure that they would normally feel.
• By reducing the pleasurable effects of alcohol, naltrexone may help to decrease cravings for alcohol and make it easier to quit over time.

How Effective are Naltrexone?

Studies have shown that naltrexone can be effective in reducing alcohol cravings and promoting abstinence.

• One study found that individuals taking naltrexone were twice as likely to remain abstinent from alcohol than those taking a placebo.
• Another study showed that naltrexone was effective in reducing the number of heavy drinking days and increasing the number of days of abstinence.

Side Effects of Naltrexone

The most common side effect of naltrexone is nausea, but this usually goes away after a few days.

Some people may also experience:

• Headaches
• Dizziness
• Fatigue
• Appetite changes
• Incresed liver enzymes

More serious side effects are:

• Allergic reactions (such as difficulty breathing, hives, swelling of the face, lips, tongue, or throat)
• Liver damage (although this is rare and usually only occurs in individuals who already have liver disease)
• Depression or suicidal thoughts (although this is also rare and typically only occurs in individuals with a history of depression or suicidal ideation)

How to Take Naltrexone?

Naltrexone comes in two forms: a pill you take once a day and an injection called Vivitrol that you get once a month. The pill usually starts at 50 mg, while the injection is 380 mg given by a healthcare provider in the buttock muscle.

It's not clear how long people should take naltrexone, but some research suggests that stopping it could mean losing any benefits gained while taking it. Some sources recommend staying on naltrexone for at least one year if it's working well. It's important to talk to a healthcare provider to figure out the right treatment for you.

2. Acamprosate

Acamprosate is a medication that helps reduce the severity of withdrawal symptoms and cravings for alcohol. It works by restoring the balance of chemicals in the brain that are disrupted by long-term alcohol use. Acamprosate is taken orally, usually three times a day.

How Acamprosate Works

Acamprosate works by regulating the levels of glutamate in the brain. Glutamate is a neurotransmitter that is involved in learning and memory. Long-term alcohol use can disrupt the balance of glutamate in the brain, leading to withdrawal symptoms and cravings. Acamprosate helps restore this balance, reducing the severity of withdrawal symptoms and making it easier to quit drinking.

How Effective are Acamprosate?

Acamprosate has been shown to be effective in reducing the severity of withdrawal symptoms and cravings for alcohol.

In clinical trials, acamprosate has been shown to:

• Increase the number of days of abstinence
• Reduce the risk of relapse

One study found that individuals taking acamprosate were more than twice as likely to remain abstinent from alcohol than those taking a placebo.

However, acamprosate is not effective for everyone and may not work for those with severe liver disease or other medical conditions. It's important to talk to a healthcare provider to figure out the right treatment for you.

Side Effects of Acamprosate

The most reported side effects of acamprosate include gastrointestinal issues such as:

• diarrhea
• nausea
• stomach pain

Fortunately, these symptoms usually subside on their own after a few days. Other possible side effects may include:

• headaches
• dizziness

Serious Side Effects

While taking acamprosate, some individuals may experience more serious side effects, including:

• Allergic reactions
• Changes in mood or behavior
• Signs of liver problems such as:

• Yellowing of the skin or eyes
• Dark urine
• Persistent abdominal pain

How to Take Acamprosate?

Acamprosate is a pill for treating alcohol addiction. You take two pills three times a day, after you stop drinking. If you have kidney problems, you may need to take less. But if your kidneys are really bad, you can't take it. Take it as your doctor tells you and watch out for side effects.

3. Disulfiram

Disulfiram is a medication that works by making you sick if you drink alcohol. It is taken orally, usually once a day. Disulfiram is an effective treatment for people who are highly motivated to quit drinking, as the side effects can be severe.

How Disulfiram Works

Disulfiram works by blocking the enzyme that breaks down alcohol in the body. This causes a buildup of acetaldehyde, a toxic substance that can cause severe nausea, vomiting, and headache. These side effects usually occur within 10-30 minutes of drinking alcohol and can last for several hours. Over time, the unpleasant effects of disulfiram can help reduce the desire to drink.

How Effective are Disulfiram?

Disulfiram has been shown to be effective in reducing the desire to drink, but it is not as commonly used as naltrexone and acamprosate.

This is because disulfiram can have severe side effects if alcohol is consumed while taking it. The most common side effects of disulfiram are nausea, headache, and fatigue. However, the most significant side effect is the severe reaction that occurs if you drink alcohol while taking disulfiram.

This can include difficulty breathing, chest pain, and even death. As a result, disulfiram is typically only prescribed to individuals who are highly motivated to quit drinking and who are willing to accept the risks associated with this medication.

Read about: Combining Alcohol and Over-the-Counter Drugs

Side Effects of Disulfiram

Common side effects of disulfiram may include:

• Drowsiness
• Fatigue
• Headache
• Skin rash

However, the most significant side effect of disulfiram is the severe reaction that occurs if an individual drinks alcohol while taking the medication. Symptoms of this reaction can include difficulty breathing, chest pain, and even death. For this reason, disulfiram is typically only prescribed to individuals who are highly motivated to quit drinking and who are willing to accept the risks associated with this medication.

Other serious side effects that can occur while taking disulfiram include:

• Liver damage
• Psychotic symptoms such as paranoia or hallucinations
• Seizures

It's important to work closely with a healthcare provider while taking disulfiram to monitor for any concerning symptoms or complications. In some cases, it may be necessary to adjust the dosage or switch to a different medication to minimize adverse effects. Overall, however, disulfiram can be a safe and effective option for individuals seeking treatment for AUD.

How to Take Disulfiram?

Disulfiram is a tablet medication used in the treatment of alcohol use disorder (AUD). The typical recommended dose is once daily, usually taken in the morning as indicated by the FDA. The starting dose is typically 500 mg per day, which may be decreased to 250 mg per day after one to two weeks if necessary. If disulfiram causes drowsiness, it can be taken in the evening instead.

It's important to note that disulfiram begins working within a few hours, so it's recommended to be alcohol-free for at least 12 hours before taking the medication. This includes avoiding any products that contain alcohol, such as certain over-the-counter cough syrups or mouthwashes.

As with any medication, it's essential to follow the recommended dosage instructions and work closely with a healthcare provider to monitor for potential side effects or complications.

4. Topiramate

Topiramate is another medication that can be used to treat alcohol use disorder. It is an anticonvulsant medication that can help reduce cravings for alcohol and improve overall well-being.

How Topiramate Works

Topiramate works by increasing the levels of gamma-aminobutyric acid (GABA) in the brain, which helps to reduce anxiety and promote relaxation. It can also help to reduce the severity of withdrawal symptoms and make it easier to quit drinking.

How Effective are Topiramate?

Topiramate is a medicine that can help with alcohol use disorder (AUD). It can make people drink less often and stay sober more days. However, it doesn't seem to help with the urge to drink.

Most studies gave topiramate for three months, with a dose of 300 mg per day. One study with more than 350 people found that topiramate helps more than a fake pill.

Topiramate works about as well as another medicine called naltrexone. But naltrexone didn't work better than a fake pill, while topiramate did. Topiramate is not as good as another medicine called disulfiram at keeping people from drinking. But topiramate is better at reducing the urge to drink.

It's important to talk with a healthcare provider to choose the best treatment for each person's needs.

Side Effects of Topiramate

Topiramate can cause both common and serious side effects. Common side effects may include:

• Dizziness
• Fatigue
• Difficulty concentrating
• Nausea
• Diarrhea
• Weight loss
• Taste changes

Serious side effects that can occur while taking topiramate include:

• Vision problems, such as blurred vision or double vision
• Mood changes, such as depression or suicidal thoughts
• Kidney stones
• Increased body temperature and decreased sweating, which can lead to heat stroke in hot weather
• Metabolic acidosis, a condition in which there is too much acid in the blood

It's important to work closely with a healthcare provider while taking topiramate to monitor for any concerning symptoms or complications. Overall, topiramate can be a safe and effective option for individuals seeking treatment for AUD, but it's crucial to weigh the potential risks and benefits with a healthcare provider before starting this medication.

How to Take Topiramate?

Topiramate comes in tablets and sprinkle capsules. Your healthcare provider might start you on a lower dose and then increase it over time. The highest dose you might take is 150 mg twice a day, but that could cause side effects.

It's best not to drink alcohol while taking topiramate, but it can help reduce alcohol use in people who are still drinking.

Talk to your healthcare provider to learn more about topiramate and whether it's a good choice for you.

5. Gabapentin

Gabapentin is another medication that can be used to treat alcohol use disorder. It is an anticonvulsant medication that can help reduce cravings for alcohol and improve overall well-being.

How Gabapentin Works

Gabapentin can help treat AUD by improving symptoms of alcohol withdrawal and preventing relapse. It's similar to a chemical in the brain called GABA and helps to lower nerve activity in the brain. During alcohol withdrawal, the brain has less GABA, which can cause cravings, mood changes, and trouble sleeping.

Gabapentin increases GABA levels, which can reduce anxiety and promote relaxation, easing these symptoms. It can also help normalize brain function, lowering the risk of relapse. Work with a healthcare provider to find the best treatment options for AUD based on your needs and medical history.

How Effective are Gabapentin?

Research indicates that gabapentin may be an effective treatment option for AUD, as it has been shown to improve withdrawal symptoms and promote abstinence when compared to a placebo. In fact, higher doses of gabapentin (up to 1800 mg per day) may be more beneficial in treating AUD.

Combining gabapentin with naltrexone may also be more effective at preventing heavy drinking compared to naltrexone alone. However, it's worth noting that the effect of gabapentin on preventing heavy drinking may not continue once the medication is stopped.

Some studies suggest that gabapentin may be most effective in individuals who experience a lot of alcohol withdrawal symptoms. It's important to work closely with a healthcare provider to determine the most suitable treatment options based on individual needs and medical history.

Side Effects of Gabapentin

Here are some common and serious side effects of gabapentin:

• Dizziness
• Drowsiness
• Nausea

These side effects may improve once your body adjusts to the medication.

Serious side effects

If you experience any of these serious side effects, seek medical attention immediately:

• Trouble breathing when combined with certain medications like opioids or benzodiazepines.
• Increased suicidal thoughts or behavior.
• Severe allergic reactions.
• Extreme dizziness or drowsiness that can lead to falls or an inability to drive.
• Seizures if stopped abruptly.

It's crucial to discuss any concerns or questions about potential side effects with a healthcare provider before starting gabapentin treatment.

How to Take Gabapentin?

Gabapentin is a medication that is typically taken three times a day, and the appropriate dosage can vary based on individual needs. Studies have shown that doses between 900 mg to 1800 mg per day may be effective in treating AUD.

However, dosage recommendations should be determined by a healthcare provider based on an individual's medical history and needs. It's important to follow a healthcare provider's instructions carefully and not to adjust the dosage without consulting them first.

Seeking Medical Advice Before Taking Any Medication for AUD

It's essential to seek medical advice before taking any medication to treat alcohol use disorder (AUD). This is because medications can have side effects and interact with other medications or health conditions.

A healthcare provider can help determine which medication is best suited for an individual's needs based on their medical history and symptoms. They can also monitor for any potential side effects or complications that may arise while taking the medication.

It's important to be honest with a healthcare provider about any other medications being taken, including over-the-counter medications, supplements, or herbal remedies. Some medications may interact with each other, leading to potentially dangerous complications.

Individuals with certain health conditions, such as liver or kidney disease, may not be able to take certain medications used to treat AUD. A healthcare provider can help determine which treatment options are safe and effective based on an individual's specific circumstances.

Overall, seeking medical advice before taking any medication for AUD is crucial in ensuring safe and effective treatment. It can also help prevent potentially harmful interactions or complications that may arise from self-medicating.

Conclusion

In conclusion, there are several medications available that can be effective in treating alcohol use disorder. Disulfiram, topiramate, and gabapentin are all anticonvulsant medications that can help reduce cravings for alcohol and improve overall well-being. While each medication has its own unique benefits and potential side effects, it's important to work closely with a healthcare provider to determine the most suitable treatment options based on individual needs and medical history.

It's worth noting that medication alone may not be enough to treat AUD fully. Many individuals benefit from combining medication with therapy or support groups to address underlying issues related to their drinking behavior. Additionally, lifestyle changes such as exercise and stress management techniques can also play an essential role in recovery.

Sources

• GoodRx. (2021). Which Medications Are the Best to Stop Drinking? Retrieved from https://www.goodrx.com/conditions/alcohol-use-disorder/which-medications-are-the-best-to-stop-drinking.
• National Institute on Alcohol Abuse and Alcoholism. (2021). Treatment for Alcohol Problems: Finding and Getting Help.
• Substance Abuse and Mental Health Services Administration. (2015). Medications for Opioid Use Disorder Treatment Improvement Protocol (TIP) Series 63.
• Jonas, D. E., Amick, H. R., Feltner, C., Bobashev, G., Thomas, K., Wines, R., ... & Garbutt, J. C. (2014). Pharmacotherapy for adults with alcohol use disorders in outpatient settings: a systematic review and meta-analysis. Jama, 311(18), 1889-1900.
• Kenna, G.A., Haass-Koffler CL., Zywiak WH et al.. Role of the alpha2-adrenergic system in modulating stress-induced reinstatement of alcohol seeking after extinction in rats trained to self-administer alcohol; Alcohol Clin Exp Res; 33(10):1743–1756; 2009

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