Mamidipalli Sai Spoorthy, Sanghamitra Godi, Lokesh Kumar Singh
Background: Among the three pharmacological agents available for alcohol de-addiction, acamprosate and naltrexone are considered anti-craving agents. Among these two, acamprosate is better tolerated, has low abuse potential, and is safe in overdose. But the mechanism of action of acamprosate still remains unclear. Case Report: This case report gives a description of a 46-year-old male patient diagnosed with alcohol dependence syndrome with prior admissions and failed treatments with naltrexone and baclofen...
October 2019: Addiction & Health
Katie Witkiewitz, Nick Heather, Daniel E Falk, Raye Z Litten, Deborah S Hasin, Henry R Kranzler, Karl F Mann, Stephanie S O'Malley, Raymond F Anton
AIMS: To examine whether World Health Organization (WHO) risk level reductions in drinking were achievable, associated with improved functioning, and maintained over time among patients at varying initial alcohol dependence severity levels. DESIGN AND SETTING: Secondary data analysis of multisite randomized clinical trials: the US COMBINE Study and the UK Alcohol Treatment Trial (UKATT). PARTICIPANTS: Individuals with alcohol dependence enrolled in COMBINE (n=1383; 68...
February 13, 2020: Addiction
José Carlos F Galduróz, Andréia Gomes Bezerra, Gabriel Natan Pires, Renata Pauluci, Ana Regina Noto
BACKGROUND: Pharmacological treatment for alcohol dependence has only three approved drugs: disulfiram, naltrexone and acamprosate. The effects of these drugs are, however, limited, presenting several side effects and a modestly higher efficacy compared to placebo. The administration of omega-3 might bring new perspectives to relapse prevention. METHODS: This systematic review aimed to analyze the available literature, compiling the studies that used omega-3 to prevent relapse in alcohol dependents...
January 28, 2020: Current Neuropharmacology
David Wiercigroch, Hasan Sheikh, Jennifer Hulme
BACKGROUND: Substance use is prevalent in Canada, yet treatment is inaccessible. The Rapid Access to Addiction Medicine (RAAM) clinic opened at the University Health Network (UHN) in January 2018 as part of a larger network of addictions clinics in Toronto, Ontario, to enable timely, low barrier access to medical treatment for substance use disorder (SUD). Patients attend on a walk-in basis without requiring an appointment or referral. We describe the RAAM clinic model, including referral patterns, patient demographics and substance use patterns...
January 13, 2020: Substance Abuse Treatment, Prevention, and Policy
Pierre A Geoffroy, Michel Lejoyeux, Benjamin Rolland
Introduction : Insomnia has been implicated in the development, maintenance, worsening, and relapse of alcohol use disorder (AUD). Areas covered : The authors review the possible pharmacological and non-pharmacological treatment options of insomnia for patients with alcohol-use disorder and provide their expert opinion. Expert opinion : Abstinence, or at least a decrease in alcohol use, may improve insomnia symptoms. Second, sleep education is a cornerstone intervention that should be completed by more structured behavioral therapies or Cognitive Behavioral Therapy for Insomnia (CBT-I)...
January 3, 2020: Expert Opinion on Pharmacotherapy
Asha Patnaik, Barjinder S Buttar, Basma Ataallah, Vikas Kumar
Alcoholism is a worldwide health issue that affects people from all walks of life. Effective alcohol abuse treatment programs, which combine cognitive behavioral therapy with medications, are necessary to provide the appropriate care that patients need. Treatment options include Naltrexone, Acamprosate, or Disulfiram. Due to poor compliance, Disulfiram is used as a second line agent. These medications play an integral role in treating alcohol abuse. Healthcare providers must be aware of their side effect profiles...
November 20, 2019: Curēus
Benjamin J Oldfield, Kathleen A McGinnis, E Jennifer Edelman, Emily C Williams, Adam J Gordon, Kathleen Akgün, Stephen Crystal, Lynn E Fiellin, Julie R Gaither, Joseph L Goulet, P Todd Korthuis, Brandon D L Marshall, Amy C Justice, Kendall Bryant, David A Fiellin, Kevin L Kraemer
INTRODUCTION: Infrequent use of and poor retention on evidence-based medications for alcohol use disorder (MAUD) represent a treatment gap, particularly among people living with HIV (PLWH). We examined predictors of MAUD initiation and retention across HIV status. METHODS: From Veterans Aging Cohort Study (VACS) data, we identified new alcohol use disorder (AUD) diagnoses from 1998 to 2015 among 163,339 individuals (50,826 PLWH and 112,573 uninfected, matched by age, sex, and facility)...
February 2020: Journal of Substance Abuse Treatment
Andrew S Huhn, J Gregory Hobelmann, Aaron Ramirez, Eric C Strain, George A Oyler
BACKGROUND: Alcohol use disorder (AUD) is a growing problem among older adults. The aim of this study was to quantify trends in first-time treatment admissions for older adults with AUD in the U.S., and examine the medical and specialty clinical services offered by treatment facility type. METHODS: Patient level data were collected from the Treatment Episode Data Set for Admissions between 2004-2017. Joinpoint regression was used to identify unique trends in first-time treatment admissions for older adults with AUD...
October 28, 2019: Drug and Alcohol Dependence
Francesca Panin, Alessandra T Peana
Background: Sleep disorders are commonly associated with acute and chronic use of alcohol and with abstinence. To date, there are four approved drugs to treat alcohol use disorder (AUD): disulfiram, acamprosate, naltrexone, and nalmefene. These AUD therapies reduce the craving and risk of relapse into heavy drinking, but little is known about their effect on sleep. As recent evidences indicate a crucial role of sleep disorders in AUD, claiming that sleep problems may trigger alcohol abuse and relapses, it is fundamental to clarify the impact of those drugs on the sleep quality of AUD patients...
2019: Frontiers in Pharmacology
Lorenzo Leggio, Daniel E Falk, Megan L Ryan, Joanne Fertig, Raye Z Litten
Compared to other medical disorders, including other brain diseases, the number of medications approved for alcohol use disorder (AUD) is very small. Disulfiram, naltrexone (oral and long-acting), and acamprosate are approved by the US Food and Drug Administration (FDA) to treat patients with AUD. These medications are also approved in other countries, including in Europe, where the European Medicines Agency (EMA) also approved nalmefene for AUD. Furthermore, baclofen was recently approved for AUD in France...
October 19, 2019: Handbook of Experimental Pharmacology
James R Walker, Jeffrey E Korte, Aimee L McRae-Clark, Karen J Hartwell
OBJECTIVE: U.S. Food and Drug Administration (FDA)-approved medications exist for the treatment of alcohol use disorders. However, their effectiveness depends on proper adherence to the prescribed regimen. Differences in adherence across medications may have implications for clinical outcomes and may provide helpful information in considering treatment options. This study aims to identify significant differences in adherence if present. METHOD: A retrospective chart review was conducted in the Veterans Integrated Service Networks (VISN)-7 region of Veterans Affairs hospital and community-based outpatient clinics within South Carolina and Georgia...
September 2019: Journal of Studies on Alcohol and Drugs
Irina E Antonescu, Karina F Rasmussen, Sibylle Neuhoff, Xavier Frette, Maria Karlgren, Christel A S Bergström, Carsten Uhd Nielsen, Bente Steffansen
In drug development, estimating fraction absorbed (Fa ) in man for permeability limited compounds in important but challenging. To model Fa of such compounds from apparent permeabilities (Papp ) across filter-grown Caco-2 cell monolayers, it is central to elucidate the intestinal permeation mechanism(s) of the compound. The present study aims to refine a computational permeability model in order to investigate the relative contribution of paracellular and transcellular routes to the Papp across Caco-2 monolayers of the permeability limited compound acamprosate having a bioavailability of ~11%...
September 27, 2019: Molecular Pharmaceutics
Rajesh R Tampi, Aarti Chhatlani, Hajra Ahmad, Kripa Balaram, Joel Dey, Ricardo Escobar, Thejasvi Lingamchetty
Substance use disorders (SUDs) are a growing problem among older adults. Acamprosate, disulfiram, and naltrexone are United States Food and Drug Administration (referred to as FDA) approved for the treatment of alcohol use disorder, and buprenorphine is approved for the treatment of opiate use disorder among adults. However, the data on the use of these medications for the treatment of SUDs among older adults are unclear from randomized controlled trials (referred to as RCTs). A review of the literature indicates that there are only two RCTs that evaluated the use of pharmacologic agents for SUDs among older adults (≥ 50 years)...
September 19, 2019: World Journal of Psychiatry
Alice Egerton
RATIONALE: Proton magnetic resonance spectroscopy (1 H-MRS) is a cross-species neuroimaging technique that can measure concentrations of several brain metabolites, including glutamate and GABA. This non-invasive method has promise in developing centrally acting drugs, as it can be performed repeatedly within-subjects and be used to translate findings from the preclinical to clinical laboratory using the same imaging biomarker. OBJECTIVES: This review focuses on the utility of single-voxel 1 H-MRS in developing novel glutamatergic or GABAergic drugs for the treatment of psychiatric disorders and includes research performed in rodent models, healthy volunteers and patient cohorts...
September 5, 2019: Psychopharmacology
Kamini Vijeepallam, Vijayapandi Pandy, Dharmani Devi Murugan, Murali Naidu
In the current study, the effect of methanolic extract of Mitragyna speciosa leaf (MMS) against the rewarding and reinforcing properties of ethanol using a mouse model of conditioned place preference (CPP) and runway model of drug self-administration was studied. Subsequently, the effect of MMS on dopamine level in the nucleus accumbens (NAc) of the mouse brain was further investigated. From the data obtained, MMS (50 and 75 mg/kg, p.o.) significantly reversed the ethanol-place preference in mice, which is similar to the effect observed in the reference drugs acamprosate (300 mg/kg, p...
August 8, 2019: Metabolic Brain Disease
M S Zastrozhin, V Yu Skryabin, S S Miroshkin, E A Bryun, D A Sychev
Genetics of alcohol addiction is currently a contradictive and complex field, where data in the most studies reflect methods' limitations rather than meaningful and complementary results. In our review, we focus on the genetics of alcohol addiction, leaving genetics of acute alcohol intoxication out of the scope. A review of the literature on pharmacogenetic biomarkers development for the pharmacotherapy personalization reveals that today the evidence base concerning these biomarkers is still insufficient. In particular, now the researches with the design of randomized controlled trials and meta-analysis investigating the effect of the SNPs as biomarkers on the therapy efficacy are available for naltrexone only...
2019: Application of Clinical Genetics
Ahmed Naguy, Sara Alenezi, Salem Alwetayan
No abstract text is available yet for this article.
July 3, 2019: American Journal of Therapeutics
Norbert Scherbaum, Rüdiger Holzbach, Gunnar Stammen, Ute Kirchof, Udo Bonnet
Acamprosate and naltrexone are medications of proven efficacy in the treatment of alcohol dependence. In order to investigate the prescription of these drugs in outpatient routine treatment in Germany (frequency of prescription, duration, medical specialty of prescribing physician), data of a large statutory health insurance were analyzed. Persons were included who were discharged from inpatient treatment with an alcohol-related disorder among their diagnoses during a one year observation period and with no diagnosed additional substance-related disorder (apart from nicotine- and cannabis-related disorders)...
May 27, 2019: Pharmacopsychiatry
Sari Castrén, Niklas Mäkelä, Hannu Alho
PURPOSE OF REVIEW: Only a few pharmacological treatments are available for treating alcohol use disorders (AUDs). Disulfiram, naltrexone and acamprosate are Food and Drug Administration (FDA)-approved and nalmefene is EMA-approved in European Union. Off-label medications, such as baclofen, gabapentin, ondansetron and topiramate are medications commonly prescribed for the treatment of AUD. The aim of this review is to give an update on recent randomized controlled trials (RCTs) and reviews evaluating pharmacological treatment for AUD...
July 2019: Current Opinion in Psychiatry
Raffaele Pezzilli, Fabio Caputo, Gianni Testino, Valentino Patussi, Giovanni Greco, Livia Macciò, Maria Raffaella Rossin, Davide Mioni, Patrizia Balbinot, Claudia Gandin, Francesca Zanesini, Luca Frulloni, Sarino Aricò, Luigi C Bottaro, Rinaldo Pellicano, Emanuele Scafato
Current estimates of the prevalence of chronic pancreatitis, one of the most common causes of exocrine pancreatic insufficiency, are in the range of 3-10 per 100,000 people in many parts of the world. Alcohol consumption is a very important risk factor for exocrine pancreatic insufficiency and is involved in nearly half of all cases. The main hypothesis regarding the role of chronic alcohol consumption in pancreatitis is that there must be additional environmental or genetic risk factors involved for ongoing damage to occur...
October 2019: Minerva Medica
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