Evidence-Based Pharmacotherapies for Alcohol Use Disorder: Clinical Pearls

Jeremiah Fairbanks, Audrey Umbreit, Bhanu Prakash Kolla, Victor M Karpyak, Terry D Schneekloth, Larissa L Loukianova, Shirshendu Sinha
Mayo Clinic Proceedings 2020, 95 (9): 1964-1977
Pathologic alcohol use affects more than 2 billion people and accounts for nearly 6% of all deaths worldwide. There are three medications approved for the treatment of alcohol use disorder by the US Food and Drug Administration (FDA): disulfiram, naltrexone (oral and long-acting injectable), and acamprosate. Of growing interest is the use of anticonvulsants for the treatment of alcohol use disorder, although currently none are FDA approved for this indication. Baclofen, a γ-aminobutyric acid B receptor agonist used for spasticity and pain, received temporary approval for alcohol use disorder in France. Despite effective pharmacotherapies, less than 9% of patients who undergo any form of alcohol use disorder treatment receive pharmacotherapies. Current evidence does not support the use of pharmacogenetic testing for treatment individualization. The objective of this review is to provide knowledge on practice parameters for evidenced-based pharmacologic treatment approaches in patients with alcohol use disorder.

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