Prescribing Notes

Alcohol dependence

Alcohol abuse can be treated with disulfiram as adjunctive therapy. Alcohol ingestion by a patient on disulfiram will produce flushing and nausea. Withdrawal symptoms can be controlled with benzodiazepines and mild symptoms with β-blockers. Acamprosate can be used to maintain abstinence after alcohol withdrawal. It appears to reduce the reinforcing properties of alcohol that lead to dependence. It does not have a disulfiram-like action, an antidepressant effect or affect conditioning and therefore does not constitute a withdrawal treatment. Naltrexone is also licensed to maintain abstinence after alcohol withdrawal. Nalmefene is licensed for the reduction of alcohol consumption in patients with alcohol dependence who have a high drinking risk level, without physical withdrawal symptoms and who do not require immediate detoxification.