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La Revue Du Praticien Jun 2015
Topics: Alcohol Deterrents; Central Nervous System Depressants; Ethanol; Humans; Patient Compliance; Substance Withdrawal Syndrome
PubMed: 26298916
DOI: No ID Found -
American Journal of Health-system... Mar 2007To review medication adherence rates with various pharmacotherapies and the role of pharmacists in improving medication adherence in patients with alcohol dependence. (Review)
Review
PURPOSE
To review medication adherence rates with various pharmacotherapies and the role of pharmacists in improving medication adherence in patients with alcohol dependence.
SUMMARY
Nonadherence diminishes the effectiveness of treatment for all chronic diseases, including alcohol dependence. Rates of adherence to pharmacotherapies for alcohol dependence range widely, both within and among agents. Factors undermining adherence include high pill burden and adverse effects, both of which occur with common treatments for alcohol dependence. There is a clear need for interventions that improve patient adherence to treatment.
CONCLUSION
Adherence-enhancing psychosocial interventions have demonstrated some efficacy, but there is a dearth of controlled trials on this subject. Pharmacist-based interventions have successfully identified and treated nonadherence in other chronic disease states, utilizing tools such as medication reminders, extended-release formulations, and patient education. Similar interventions may improve treatment adherence, and thus drinking outcomes, in patients with alcohol dependence.
Topics: Acamprosate; Alcohol Deterrents; Alcohol-Related Disorders; Behavior Therapy; Disulfiram; Humans; Naltrexone; Patient Compliance; Pharmacists; Professional Role; Taurine; Treatment Refusal
PubMed: 17322179
DOI: 10.2146/ajhp060648 -
Current Pharmaceutical Design 2010Alcohol dependence represents a chronic, relapsing condition with a multifactorial aetiology that includes genetic, neurobiological,psychological, and environmental...
Alcohol dependence represents a chronic, relapsing condition with a multifactorial aetiology that includes genetic, neurobiological,psychological, and environmental components. Evidence for the effectiveness of medications in alcohol dependence treatment along with the increased number of compounds available is increasing the use of adjunctive pharmacotherapies. In particular, pharmacotherapies could conceivably address some of the biological aspects of alcohol dependence. Treating a complex behavioral disorder such as alcohol dependence with both pharmacotherapy and psychosocial therapy may give people the best options for recovery. To address the exciting developments in the use of pharmacotherapies for alcohol dependence, we planned this special issue for Current Pharmaceutical Design, entitled "Old and new pharmacotherapies in the management of patients with alcohol dependence". The overall purpose of this special issue is to provide a resource, that researchers and clinicians interested in the pharmacotherapy of alcohol dependence may use, as well as to stimulate how current findings and ongoing research may improve the treatment of our alcohol-dependent patients
Topics: Alcohol Deterrents; Alcoholism; Biomedical Research; Combined Modality Therapy; Humans; Psychotherapy
PubMed: 20482504
DOI: 10.2174/138161210791516413 -
Current Drug Abuse Reviews May 2009Despite the availability of currently approved medications and various psychosocial therapies, alcohol abuse and dependence are increasingly prevalent in the United... (Review)
Review
Despite the availability of currently approved medications and various psychosocial therapies, alcohol abuse and dependence are increasingly prevalent in the United States, and carry a significant socioeconomic burden. Recently, the novel anti-epileptic topiramate has shown great promise as a new treatment for this disorder. The objective of this review is to discuss the limitations of the currently available options for treating alcohol dependence, to review the results of clinical trials assessing the efficacy of topiramate in treating alcohol dependence, and to describe the pharmacological characteristics and mechanisms of action of topiramate as related to this indication. We systematically reviewed Medline, EMBASE, Cochran Reviews and PsycINFO search terms included combinations of the terms "pharmacotherapy" "topiramate", "alcoholism" and "alcohol dependence." Searches were last updated 24 October 2008. Currently approved treatments include disulfiram, naltrexone tablets and injection, and acamprosate. Of these, naltrexone has shown the most benefit, however the effect size is small and may reach its most promising potential when combined with medical management. Alternatively, through multiple mechanisms of action, topiramate in clinical trials has demonstrated safety and efficacy in decreasing both craving and withdrawal symptoms and increasing quality of life measures among alcohol-dependent individuals. The findings of this review suggest that topiramate is a promising new option for the treatment of alcohol dependence, and may offer substantial benefits over currently approved medications. While the manufacturer will not pursue approval of an indication for the treatment of alcohol dependence, the drug will soon be available generically, making it more affordable for a greater proportion of the public.
Topics: Alcohol Deterrents; Alcohol Drinking; Alcohol-Induced Disorders; Alcoholism; Anticonvulsants; Fructose; Humans; Substance Withdrawal Syndrome; Topiramate
PubMed: 19630744
DOI: 10.2174/1874473710902020135 -
Southern Medical Journal Feb 2008
Topics: Alcohol Deterrents; Alcoholism; Humans; Narcotic Antagonists
PubMed: 18364607
DOI: 10.1097/SMJ.0b013e3181622889 -
International Journal of Environmental... Aug 2011The purpose of this study was to conduct a literature review of cost-benefit studies on pharmacotherapy and psychotherapy treatments of alcohol dependence (AD). A... (Review)
Review
The purpose of this study was to conduct a literature review of cost-benefit studies on pharmacotherapy and psychotherapy treatments of alcohol dependence (AD). A literature search was performed in multiple electronic bibliographic databases. The search identified seven psychotherapy studies from the USA and two pharmacotherapy studies from Europe. In the psychotherapy studies, major benefits are typically seen within the first six months of treatment. The benefit-cost ratio ranged from 1.89 to 39.0. Treatment with acamprosate was found to accrue a net benefit of 21,301 BEF (528 €) per patient over a 24-month period in Belgium and lifetime benefit for each patient in Spain was estimated to be Pta. 3,914,680 (23,528 €). To date, only a few studies exist that have examined the cost-benefit of psychotherapy or pharmacotherapy treatment of AD. Most of the available treatment options for AD appear to produce marked economic benefits.
Topics: Acamprosate; Alcohol Deterrents; Alcoholism; Belgium; Cost-Benefit Analysis; Humans; Psychotherapy; Spain; Taurine; Time Factors; Treatment Outcome; United States
PubMed: 21909311
DOI: 10.3390/ijerph8083351 -
CMAJ : Canadian Medical Association... Jun 2000Problem drinking is a serious health issue, but often patients whose alcohol consumption places them at risk are not diagnosed by physicians. Case finding is an... (Review)
Review
Problem drinking is a serious health issue, but often patients whose alcohol consumption places them at risk are not diagnosed by physicians. Case finding is an essential component of "best practice." In many cases if given the appropriate advice, counselling and behavioural interventions, problem drinkers can be helped to reduce their use of alcohol and improve functioning in other areas of their lives. Some patients may benefit from more comprehensive therapy including the prescription of disulfiram, calcium carbimide or naltrexone. For those with serious problems with alcohol, referral to specialized addiction treatment programs and other community resource centres may also be appropriate.
Topics: Alcohol Deterrents; Alcoholism; Behavior Therapy; Counseling; Humans; Referral and Consultation; Self-Help Groups
PubMed: 10870503
DOI: No ID Found -
British Journal of Clinical Pharmacology Feb 2014Acamprosate is one of the few medications licensed for prevention of relapse in alcohol dependence, and over time it has proved to be significantly, if moderately,... (Review)
Review
Acamprosate is one of the few medications licensed for prevention of relapse in alcohol dependence, and over time it has proved to be significantly, if moderately, effective, safe and tolerable. Its use is now being extended into other addictions and neurodevelopmental disorders. The mechanism of action of acamprosate has been less clear, but in the decade or more that has elapsed since its licensing, a body of translational evidence has accumulated, in which preclinical findings are replicated in clinical populations. Acamprosate modulates N-methyl-d-aspartic acid receptor transmission and may have indirect effects on γ-aminobutyric acid type A receptor transmission. It is known to decrease brain glutamate and increase β-endorphins in rodents and man. Acamprosate diminishes reinstatement in ethanolized rodents and promotes abstinence in humans. Although acamprosate has been called an anticraving drug, its subjective effects are subtle and relate to diminished arousal, anxiety and insomnia, which parallel preclinical findings of decreased withdrawal symptoms in animals treated with acamprosate. Further understanding of the pharmacology of acamprosate will allow appropriate targeting of therapy in individuals with alcohol dependence and extension of its use to other addictions.
Topics: Acamprosate; Alcohol Deterrents; Alcoholism; Animals; Humans; Rodentia; Secondary Prevention; Substance Withdrawal Syndrome; Taurine
PubMed: 23278595
DOI: 10.1111/bcp.12070 -
Clinical Drug Investigation Jan 2014A liquid formulation of sodium oxybate (Alcover(®)), the sodium salt of γ-hydroxybutyric acid (GHB), is approved in Italy and Austria for use in alcohol withdrawal... (Review)
Review
A liquid formulation of sodium oxybate (Alcover(®)), the sodium salt of γ-hydroxybutyric acid (GHB), is approved in Italy and Austria for use in alcohol withdrawal syndrome and for the maintenance of abstinence in alcohol dependence. This article reviews the efficacy and tolerability of sodium oxybate in alcohol withdrawal syndrome and in the maintenance of abstinence in alcohol dependence, as well as summarizing its pharmacological properties. Results of randomized controlled trials indicate that sodium oxybate was at least as effective as diazepam and clomethiazole in patients with alcohol withdrawal syndrome, rapidly alleviating symptoms, and was at least as effective as naltrexone or disulfiram in the maintenance of abstinence in alcohol-dependent patients. Sodium oxybate was generally well tolerated. The risk of sodium oxybate abuse is generally low when it is administered to alcohol-dependent patients at its approved dosage, under the supervision of a designated family member and with continuous strict medical surveillance. However, certain patient groups, such as patients with alcohol dependence and borderline personality disorder or who are in remission from heroin or cocaine addiction, may not be suitable candidates for sodium oxybate therapy because of an increased risk of abuse. In conclusion, sodium oxybate is a useful option for the treatment of alcohol withdrawal syndrome and for the maintenance of abstinence in alcohol dependence.
Topics: Alcohol Abstinence; Alcohol Deterrents; Alcohol Drinking; Alcoholism; Animals; Behavior, Addictive; Disease Models, Animal; Drug Interactions; Humans; Sodium Oxybate; Substance Withdrawal Syndrome
PubMed: 24307430
DOI: 10.1007/s40261-013-0158-x -
The Primary Care Companion For CNS... Nov 2016
Topics: Adult; Alcohol Deterrents; Alcoholism; Humans; Male; Naltrexone; Narcotic Antagonists; Pancreatitis
PubMed: 27922226
DOI: 10.4088/PCC.16l01953