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Advances in the treatment of alcohol dependence

Current Opinion in Psychiatry, ISSN: 0951-7367, Vol: 15, Issue: 3, Page: 255-260
2002
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Psychosocial therapies can help many alcohol-dependent patients reduce their drinking and maintain abstinence. These approaches alone, however, are not effective for all patients. Advances in neuroscience have helped identify many of the mechanisms underlying transition to dependence, paving the way for improved treatment options through the use of medication. Recent treatment studies with alcoholics have improved our knowledge on how to use therapeutic measures more precisely. Matching of anticraving/antidipsotropic drugs with treatment settings could improve therapeutic outcome. Naltrexone (blocking positive reinforcement by ethanol) seems to be especially effective when used in conjunction with instructions on drinking (harm) reduction; however, acamprosate (blocking negative reinforcement of conditioned alcohol withdrawal) seems to work well in settings with strict abstinence goals. Investigations are currently under way to test the efficacy of combinations like naltrexone/acamprosate with antidepressants. Psychosocial co-intervention trials and practice require further standardization. © 2002 Lippincott Williams & Wilkins.

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