Overview of Pharmacotherapies

Potential targets for pharmacotherapy are guided by our increasing understanding of the neuropharmacological consequences of chronic alcohol consumption and also the neurobiological mechanisms of alcohol-seeking behaviour and reward. Four medications: acamprosate, naltrexone, disulfiram and nalmefene have been approved for use in Australia as part of a comprehensive treatment plan for AUD. Prescribers are referred to the MIMS Annual for detailed information for these medications.  

Acamprosate and naltrexone have been shown to improve treatment outcomes, typically when combined with a psychosocial intervention (see Chapter 9). The evidence for disulfiram is weaker, but the drug remains an option for relapse prevention in certain circumstances and can be effective as part of a comprehensive treatment approach. Nalmefene is currently unavailable. Several off-label pharmacotherapies also exist with varying levels of evidence for effectiveness (e.g., Baclofen, Topiramate).