NEW PHARMACOLOGICAL AGENTS IN THE TREATMENT OF ALCOHOLISM

Pharmacotherapy of alcoholism is improving rapidly with the introducti on of new agents. New knowledge about the neurobiology of alcoholism i s necessary for the clinician, who has to establish the diagnosis. Use ful pharmacological agents for the treatment of alcohol dependence can be classified into four groups: (1) agents for the treatment of the w ithdrawal syndrome, (2) aversive agents, (3) therapeutic agents for co morbidity, (4) new agents to reduce craving for alcohol or prevent rel apse. These new agents derive from research in four directions, based on neurobiological hypotheses: (a) the glutamatergic hypothesis with a camprosate, (b) the opioid hypothesis with naltrexone, (c) the seroton ergic hypothesis with the new antidepressants, and (d) other hypothese s, including dopaminergic, peptidic etc. Of these new agents, acampros ate has undergone most study in controlled clinical trials around Euro pe. Its efficacy has been demonstrated statistically, it is well toler ated and does not interact with alcohol. Acamprosate can be associated with disulfiram therapy. Future perspectives for treatment and resear ch are discussed, in particular with regard to therapeutic association s. Future perspectives for treatment and research are discussed, in pa rticular with regard to therapeutic associations.