Alcoholism

Medications Treating Alcoholism



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Alcoholism is a chronic disease, and frequently tends to be genetically attributed to family members. Nearly 18 million Americans afflicted by this disease and 2.2 million of them seek help. Alcoholism affects 10 to 20 percent of men and three to ten percent of women. Symptoms associated to alcoholism is craving or compulsive desire to drink, causing impaired control, physical dependence, and increase tolerance or increasing amounts of alcohol, in order to feel its effects. Unfortunately, this disease contributes to over 50 percent of car and industrial fatalities, drowning, and child or domestic abuse. Despite the efforts of an alcoholic to stop drinking, this desire is not always successful and many have failed this attempt many times. Various types of medication are available for treating or preventing alcoholics from drinking. Besides, various types of herbal remedies are available (Milk thistle, Dandelion, Kudzu, Skullcap, and dessicated liver capsules). Certainly, anyone that abstains from alcohol, more likely remain sober.

Benzodiazepines (Valium or Librium), is prescribed to relieve withdrawal symptoms including seizures, during the first days or weeks, a person stops drinking. Withdrawal symptoms begin within six to 48 hours and peak about 24 to 35 hours, after the last drink. About 95 percent of these patients will experience mild to moderate symptoms, includes agitation, trembling, disturbed sleep, and lake of appetite. The medication is administered either intravenously or orally, depending on the severity of symptoms. Benzodiazepines is not usually prescribed more than two weeks or administered for more than three nights per week, because medication becomes addictive, within four weeks of daily use.



Prescribed Naltrexone (Revia) is medication (Approved by the Food and Drug Administration to treat alcoholism in 1994) helps reduce the desire for alcohol or a rapid detoxification, besides recommended therapy by a physician or psychotherapist. Naltexone eliminates the pleasurable feeling, attributed to alcohol or blocks the neurotransmitters in the brain, which is associated with alcohol dependence. The medication not recommended for pregnant women, individuals with liver or kidney damage, and those that cannot achieve abstinence, for at least five days, prior to starting the medication. Those taking the medication to eliminate the dependency on drugs like heroin or morphine, should stop taking those drugs, at least seven days to ten days, prior to starting Naltrexone are else, likely to experience withdrawal symptoms. Also, those patients must avoid taking codeine, which can be found in cough medicine are else, withdrawal symptoms will occur. Sides effects attributed to Naltrexone, includes nausea, headaches, dizziness, fatigue, insomnia, anxiety and sleepiness. Severe cases of nausea may require discontinuing the medication. Rarely, most severe side effect is liver toxicity, taking large does of Naltrexone. Patients may experience unusual bleeding or bruising, loss of appetite, pain in the upper right part of the stomach, dark urine or yellow of the skin or eyes. Recommended blood tests to monitor liver function, periodically during treatment, and discontinue treatment if liver problems occur. The medication is not likely to interfere with other medications such as antibiotics, aspirin and allergy medications. Discontinuation of Naltrexone will not cause any dependence or withdrawal symptoms. At least seventy-two hours prior to selective surgery the medication should be discontinued. Patient taking Naltrexone usually average length of time is three months or twelve weeks or more. The medication is available as a tablet and taken once a day. Never take a double dose to make up for a missed one, just continue the regular schedule the following day. Naltrexone is very expensive, averaging $200 a month.



Disulfiram (Antabuse or Antabus manufactured by Odyssey Pharmaceuticals) medication taken by chronic alcoholics discourages drinking, by experiencing nausea, vomiting and other unpleasant physical reaction, which is common, during a hangover, after consuming alcohol. Upon taking the medication, the effects are experienced five to ten minutes, after alcohol is consumed. The hangover symptoms continue for 30 minutes up to several hours. Recommended, treatment of support groups or psychotherapy, during the time taking Disulfiram. The medication should not be administered to those patients taking Ritalin or dopamine, can cause sleeplessness, paranoia, and extreme cases amphetamine psychosis (psychotic behavior).

Acamprosate calcium (Or Campral, manufactured by Forest Laboratories) used in Europe to prevent relapse in alcoholics, and US Food and Drug Administration approved the application, on July 29, 2004. The medication starts, prior two or seven days upon ceasing alcohol consumption. Most important advantage: Does not cause any problems to the liver, and acceptable for patients that have liver disease. Most common side effect is diarrhea. Patients taking the medication have seen poor results, when there is lack of social support. The medication can be combined with Naltrexone and Disulifram. Acamprosate is taken two 333 mg tablets three times a day, and preferable in conjunction with three meals a day. Patients should avoid this medication, having kidney disease, and pregnant or lactating women.

Topiramate (Marketed as Topamax by Johnson & Johnson) prescribed for treatment of epilepsy, appears to reduce the craving for alcohol. Scientists believe brain chemical dopamine, provides the pleasure from alcohol and Topiramate works by suppressing away the excess dopamine, released by drinking alcohol. Research study in University of Texas Health Science Center at San Antonia, revealed those taking Topiramate, had a decrease in heavy drink or become abstinent from drinking (Six times more likely to remain abstinent for a month). Side effects common taking Topiramate includes, dizziness, weight loss, and memory problems. Compared to Naltexone and Acaomprosate achieved better results, however appeared to have more severe side effects. However, Topamax has not been tested thoroughly on alcoholics and physicians don't know how long the medication should be taken. The National Insstitute of Alcohol Abuse and Alcoholism does not recommend Topamax, according to their 2005 clinical guide for treatig patients with drinking problems. In 2006 Dr. Bankole Johnson, chairman of the department of psychiatric medicine at the University of Virginia, recruiting patients for clinical trial of Topamax to treat alcoholism. Dr. Johnson predicts in a few years, the medication will be made available for treating alcoholics.



Patients undergoing chemotherapy, taking Zofran (Ondansetron), treats the side effects including nausea and vomiting. Researchers (University of Texas, Health Science Center in San Antonio) determined that a medium dose of Zofran, causes in most cases, alcoholics to abstain from drinking. In August 2003, 2000 edition of The Journal of the American Medical Association, reported Ondansetron was most effective treating the early onset of alcoholism, compared to less desirable results, for late onset of alcoholism. No major side effects were noted. The medication is useful when cognitive behavior therapy is conjunctively applied.

The US Food and Drug Administration approved a new medication (2006) for alcohol dependence or alcoholism called Vivtrol (manufactured by Alkermes and marketed by Cephalon Incorporated), which is a single monthly dose, 300 mg intramuscular injection to reduce the craving, for those trying to stop drinking. Clinical trials demonstrated that patients, who took the drug, and supported by counseling, reduced the drinking days from 19 a month to three. The medication expected to be sold in June 2006. Also, Vivtrol must be stored in a refrigerator. Previously, the medication was available in a pill and taken daily. The medication is taken, along with therapy from a physician or phsychosocial support (counseling). A black warning label will be attached to the medication, cautioning of liver toxicity. Analysts predict: Vivitrol sales of $30 million for the first year 2006, and increase to $85 million a year later.

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