Diagnosis and Pharmacotherapy of Alcohol Use Disorder
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Discussion
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Implication
Clinical review demonstrates widespread underutilization of effective pharmacotherapy in adults with alcohol use disorder, highlighting the therapeutic value of first-line medications.
Key Points
- To review screening strategies, diagnostic criteria, and evidence-based pharmacotherapies for the clinical management of alcohol use disorder.
- Synthesized clinical literature, randomized clinical trials, and professional practice guidelines evaluating diagnosis and treatment options for alcohol use disorder.
- Assessed four FDA-approved pharmacotherapies (disulfiram, oral and extended-release injectable naltrexone, acamprosate) alongside off-label agents and pharmacogenetic testing.
- Alcohol use disorder impacts up to 14% of US adults annually, yet only 1 in 6 adults are ever screened for heavy drinking by a clinician, and fewer than 9% of eligible patients receive medications.
- Once-daily naltrexone decreases the likelihood of returning to any alcohol use by 5% and reduces binge-drinking risk by 10%.
- Randomized clinical trials demonstrate the efficacy of off-label medications like topiramate, while current evidence remains insufficient to support pharmacogenetic treatment selection.
Cite This Study
Kranzler et al. (2018) studied this question.