Medications in Alcohol usage disorder

Q: Which of the following drug can be used in alcohol use disorder while patient is still actively drinking?

A) naltrexone 
B) acamprosate



Answer: A

Naltrexone and acamprosate are the two drugs commonly used in patients with alcohol use disorder. Naltrexone has an advantage that it can be initiated while patient is still drinking. Also, Naltrexone due to its dosage frequency has more compliance. Naltrexone can be taken as a pill per day or as a monthly injection. While acamprosate requires a patient to take two pills three times a day. 

In severe liver disease, acamprosate is preferred and in severe renal insufficiency, naltrexone is preferred. Naltrexone is also preferred in patients who have a concurrent issue with opioid drug usage.


#toxicology
#pharmacology


References:

1. Rösner S, Hackl-Herrwerth A, Leucht S, et al. Acamprosate for alcohol dependence. Cochrane Database Syst Rev 2010; :CD004332. 

2. Rösner S, Leucht S, Lehert P, Soyka M. Acamprosate supports abstinence, naltrexone prevents excessive drinking: evidence from a meta-analysis with unreported outcomes. J Psychopharmacol 2008; 22:11.