Drugs

Disulfiram ('Antabuse' tablets or implant) blocks the action of acetaldehyde dehydrogenase, causing accumulation of acetaldehyde if alcohol is taken. Drinking therefore becomes both unpleasant and dangerous, with the risk of cardiac arrhythmia or extreme hypotension. Disulfiram can be helpful, but generally a patient with the willpower to take a tablet every day may have the willpower to remain abstinent without tablets. Because of the potential risk, disulfiram is mainly prescribed by specialists.

Many other drugs have been tried, including lithium, fluoxetine, and naltrexone; however, none of these have become established. Recently, acamprosate was introduced; it has been suggested as a useful adjunct to psychological treatments, but evidence is not yet conclusive.

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