John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.
Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.
Several medications are available to assist the person in abstaining from alcohol consumption.
Perhaps the oldest and one of the most commonly used medications is disulfiram (Antabuse). It interferes with alcohol metabolism, resulting in a metabolite that makes the person very uncomfortable and nauseated when consuming alcohol. The greatest problem with disulfiram is that people will often stop taking the medication to drink alcohol. To overcome this problem, disulfiram is available as an implantable device that is inserted under the skin. Fatalities have been reported when people taking disulfiram have ingested large amounts of alcohol. Disulfiram has been associated with several types of neurologic conditions, including optic neuritis, which can lead to visual disturbances and eye pain.
Other medications used in preventing relapse are naltrexone (ReVia), acamprosate (Campral), and a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs). Some researchers suggest that naltrexone and acamprosate seem to be the most effective medications studied, and that SSRIs are not as effective. Disulfiram seems to have a positive effect on maintaining an alcohol-free lifestyle, yet the magnitude of this effect seems to be rather limited. Therefore, naltrexone is being increasingly used. Studies suggest alcoholics who drink while on naltrexone drink less alcohol and have less severe relapses compared with those not on it. Acamprosate is sometimes used to stabilize the chemical imbalance in the brain cause by alcoholism. When compared to placebo (sugar pills), it was effective in helping people abstain from alcohol. It is generally recommended that these medications be used in conjunction with alcoholism counseling.