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Review
. 2018 Feb 7:7:212308.
doi: 10.7573/dic.212308. eCollection 2018.

Practical outpatient pharmacotherapy for alcohol use disorder

Youngjung Kim  1 , Laura M Hack  2 , Elizabeth S Ahn  3 , Jungjin Kim  2
Affiliations
Review

Practical outpatient pharmacotherapy for alcohol use disorder

Youngjung Kim et al. Drugs Context. .

Abstract

Alcohol use disorder (AUD) is commonly encountered in clinical practice. A combination of psychosocial intervention and pharmacotherapy is the cornerstone of AUD treatment. Despite their efficacy, safety and cost-effectiveness, clinicians are reluctant to prescribe medications to treat individuals with AUD. Given the high rate of relapse with psychosocial intervention alone, increasing patient access to this underutilized treatment has the potential to improve clinical outcome in this difficult-to-treat population. Herein, we provide practical pharmacotherapy strategies to improve treatment outcome for AUD. We review the efficacy and side effects of both on- and off-label agents with a particular focus on clinical applicability. Recommendations are supported by findings from randomized controlled trials (RCT) and meta-analyses selected to be representative, where possible, of current treatment guidelines. The goal of this paper is to help readers use pharmacotherapy with greater confidence when treating patients with AUD.

Keywords: addiction; alcohol use disorder; alcoholism; pharmacotherapy.

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Conflict of interest statement

Disclosure and potential conflicts of interest: The authors have declared that there are no conflicts of interest regarding this unfunded study. The International Committee of Medical Journal Editors (ICMJE) Potential Conflicts of Interests form for the authors are available for download at: http://www.drugsincontext.com/wp-content/uploads/2018/01/dic.212308-COI.pdf

Figures

Figure 1
Figure 1
Suggested treatment algorithm for alcohol use disorder (AUD). GHB, gamma-hydroxybutyric acid; PTSD, post-traumatic stress disorder; SSRI, selective serotonin reuptake inhibitor.
See this image and copyright information in PMC

References

    1. Sacks JJ, Gonzales KR, Bouchery EE, Tomedi LE, Brewer RD. 2010 National and state costs of excessive alcohol consumption. Am J Prev Med. 2015;49(5):73–9. http://dx.doi.org/10.1016/j.amepre.2015.05.031. - DOI - PubMed
    1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders Fifth Edition, DSM-5. Arlington, VA, USA: 2013.
    1. Grant BF, Goldstein RB, Saha TD, Chou SP, Jung J, Zhang H, Pickering RP, Ruan WJ, Smith SM, Huang B, Hasin DS. Epidemiology of DSM-5 alcohol use disorder: results from the national epidemiologic survey on alcohol and related conditions III. JAMA Psychiatry. 2015;72(8):757–66. http://dx.doi.org/10.1001/jamapsychiatry.2015.0584. - DOI - PMC - PubMed
    1. Collaborators GBDCoD. Global, regional, and national age-sex specific mortality for 264 causes of death, 1980–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390(10100):1151–210. http://dx.doi.org/10.1016/S0140-6736(17)32152-9. - DOI - PMC - PubMed
    1. Pettinati HM, Weiss RD, Miller WR, Donovan D, Ernst DB, Rounsaville BJ. Medical management treatment manual: a clinical research guide for medically trained clinicians providing pharmacotherapy as part of the treatment for alcohol dependence. Bethesda (MD): US DHHS; 2004. [Last accessed: 12 January 2018]. Available at: https://pubs.niaaa.nih.gov/publications/combine/index.htm.

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