Medications and alcohol craving

The use of medications as an adjunct to alcoholism treatment is based on th e premise that craving and other manifestations of alcoholism are mediated by neurobiological mechanisms. Three of the four medications approved in th e United States or Europe for treating alcoholism are reported to reduce cr aving; these include naltrexone (ReVia(TM)) acamprosate, and tiapride. The remaining medication, disulfiram (Antabuse(R)) may also possess some anticr aving activity. Additional medications that have been investigated include ritanserin, which has not been shown to decrease craving or drinking levels in humans, and ondansetron, which shows promise for treating early onset a lcoholics, who generally respond poorly to psychosocial treatment alone. Us e of anticraving-medications in combination (e.g., naltrexone plus acampros ate) may enhance their effectiveness. Future studies should address such :i ssues as optimal dosing regimens and the development of strategies to enhan ce patient compliance.