Does Baclofen Titrated to High Doses Reduce Alcohol Use?

Topics: Alcohol | Alcohol Use | Alcohol use disorder | Pharmacology | Research | Research Update

Review of: Rigal L et al, Addiction 2019 Dec 13 [Epub ahead of print] Baclofen is a muscle relaxant and anti-spasmodic that has been used off-label for treating alcohol use disorder for many years. The research base is mixed, with studies showing inconsistent efficacy and tolerability at different doses. In this latest randomized, placebo-controlled

Gabapentin for Alcohol Use Disorder, Redux

Topics: Alcohol | Alcohol Use | Alcohol use disorder | gabapentin | Pharmacology | Research | Research Update

Review of: Anton RF et al, JAMA Intern Med 2020;180(5):1–9 Gabapentin has had mixed results in the treatment of alcohol use disorder (AUD), but it is clearly effective in the treatment of alcohol withdrawal syndrome (AWS). In this study, researchers tested whether gabapentin might be effective specifically in treating adults with AUD who also had a

Treating Alcohol Use Disorder

Topics: Addiction Treatment | Alcohol | Alcohol use disorder | Alcoholism | Medication | Naltrexone | Substance Use Disorder | Therapy with Med Management

CATR: Can you tell us about the role of medications for alcohol use disorder (AUD)? Dr. Arias: Medications are a very important part of AUD treatment. They can and should be used as a first-line treatment in any reasonable medical setting—primary care or psychiatry, or a specialty addiction setting. Unfortunately, very few patients ever receive them.

Biomarkers of Alcohol Use

Topics: Addiction | Addiction Treatment | Alcohol | Alcohol use disorder | Alcoholism | Laboratory Testing in Psychiatry | Substance Use Disorder

We all want to know how much alcohol our patients are drinking. Asking patients directly about their drinking often generates useful information and helps build rapport, but this tactic is not always reliable. Denial and shame as well as issues related to secondary gain can sometimes contaminate self-report. Thankfully, there are many measures that can

Gabapentin Enacarbil XR Efficacy Less Than Expected for AUD

Topics: Addiction | Addiction Treatment | Alcohol | Alcohol use disorder | Alcoholism | Clinical practice | extended-release | Medication | Novel Medications | Pharmacology | Psychopharmacology | Research Update

Review of: Falk DE et al, Alcohol Clin Exp Res 2019;43(1):158–169 Gabapentin enacarbil extended-release (GE-XR) (Horizant) is an extended-release version of gabapentin. GE-XR is a prodrug, meaning that once ingested it is metabolized into gabapentin. It is currently approved for treatment of postherpetic neuralgia and restless legs syndrome. It di

An Off-Label Guide to Gabapentin

Topics: Alcohol use disorder | Anxiety | Anxiety Disorder | Cannabis | Free Articles | gabapentin | Pregabalin

Gabapentin (Neurontin) is not a medication that would make the FDA proud. Less than 1% of its outpatient use is for an FDA indication, and a good portion of the off-label use takes place in psychiatry. These trends sparked a backlash in the 2000s, when Pfizer paid a $1.3 billion fine for misleading marketing practices. Recent reports of misuse of gabape

Disulfiram: An Underused Strategy for Alcohol Use Disorders

Topics: Abstinence | Addiction | Addiction Treatment | Alcohol | Alcohol Use | Alcohol use disorder | Alcoholism | Disulfiram | Free Articles | Psychopharm Myths

Alcohol ranks third among preventable causes of death in the US, but it is by far the most undertreated. Fewer than 8% of people with alcohol use disorders (AUDs) receive treatment for their disease, and only a minority of them receive FDA-approved medications. Those medications are acamprosate (Campral), naltrexone (Vivitrol, ReVia), and disulfiram (An