Naltrexone blocks the high that makes a person crave alcohol. It will not prevent a person from the effects of alcohol. It is available as a pill and an injection in a muscle.

Some problems may be:

Headache
Fatigue
Nausea and vomiting
Anxiety, nervousness, and insomnia
Liver damage
Reactions at the injection site

Acamprosate

Acamprosate reduces the craving for alcohol by stabilizing the chemical balance in the brain.

Problems may be:

Headache
Weakness
Diarrhea
Rarely, suicidal thoughts

Second-line Therapy

Common names are:

Disulfiram
Topiramate
Gabapentin
Ondansetron

Disulfiram

Disulfiram makes a person sick when they drink alcohol. Alcoholic drinks, foods, products, and medicines may not be taken. If alcohol is used, it will cause symptoms that may last several hours, such as:

Nausea and vomiting
Lightheadedness, which may lead to fainting
Sweating and flushing
Weakness
Drowsiness
Confusion
Chest pain
Rapid heart beat
Problems breathing

Topiramate

Topiramate reduces the craving for alcohol by stabilizing the chemical balance in the brain.

Some problems may be:

Headache
Lightheadedness
Fatigue
Weight loss
Speech problems
Depression

Gabapentin

Gabapentin can reduce alcohol use, but it is possible that using it can lead to dependence.

High doses may cause problems, such as:

Lightheadedness
Sedation

Ondansetron

Ondansetron is a serotonin receptor blocker that can lower alcohol use in a person who started drinking at an early age.

Some problems may be:

Headache
Fever
Diarrhea

Benzodiazepines

Common names are:

Diazepam
Chlordiazepoxide
Lorazepam
Oxazepam

Benzodiazepines are anti-anxiety medicines. They are used to ease withdrawal symptoms lower the risk of seizures. They have a sedative effect. Benzodiazepines are usually not used for long periods of time because they can lead to dependence. They may also cause withdrawal symptoms when stopped.

Some problems may be:

Drowsiness
Lightheadedness

References:

Alcohol use disorder. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/alcohol-use-disorder. Accessed September 3, 2020.

Alcohol withdrawal syndrome. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/alcohol-withdrawal-syndrome. Accessed September 3, 2020.

Day E, Copello A, Hull M. Assessment and management of alcohol use disorders. BMJ. 2015 Feb 19;350:h715.

Diagnostic and Statistical Manual of Mental Disorders (DSM-5). American Psychiatric Association; 2013.

Last reviewed March 2020 by EBSCO Medical Review Board Adrian Preda, MD
Last Updated: 2/19/2021

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