Knoxville, TN (PressExposure) August 15, 2009 -- The use of medications is one of the many ways that therapists use to help a person stop his/her dependence to alcohol. Drugs like naltrexone, disulfiram, acamprosate and topiramate have been successfully used to cure alcoholism. Rather than substituting for alcohol (which is usually the procedure for alcohol detoxification), these drugs are intended to reduce the desire to drink, either by directly reducing cravings as with acamprosate and topiramate, or by producing unpleasant effects when alcohol is consumed, as with disulfiram. These drugs can be effective if treatment is maintained, but compliance can be an issue as alcoholic patients often forget to take their medication, or discontinue use because of excessive side effects.
Other than naltrexone, disulfiram, acamprosate and topiramate, other drugs have also been found effective as an adult and adolescent alcohol treatment. Opioid antagonists such as nalmefene have also been used successfully in the treatment of alcohol addiction, which is often particularly challenging to treat.
Nalmefene Nalmefene (marketed as Revex) is an opioid receptor antagonist used primarily as an adult and adolescent alcohol treatment, and also has been investigated for the treatment of other addictions such as pathological gambling and addiction to shopping.
Nalmefene is an opiate derivative similar in both structure and activity to the opiate antagonist naltrexone. Advantages of nalmefene relative to naltrexone include longer half-life, greater oral bioavailability and no observed dose-dependent liver toxicity. As with other drugs of this type, nalmefene can precipitate acute withdrawal symptoms in patients who are dependent on opioid drugs, or more rarely when used post-operatively to counteract the effects of strong opioids used in surgery.
Clinical studies of its Dosage In clinical trials using this drug, doses used as an adult and adolescent alcohol treatment were in the range of 20mg - 80mg per day, orally. The doses tested for treating pathological gambling were between 25mg - 100mg per day. In both trials, there was little difference in efficacy between the lower and higher dosage regimes, and the lower dose (20mg and 25mg respectively) was the best tolerated, with similar therapeutic efficacy to the higher doses and less side effects. Nalmefene is thus around twice as potent as naltrexone when used for the treatment of addictions.
Side Effects Common side effects include: drowsiness hypertension tachycardia dizziness nausea
Occasional side effects include: vomiting fever hypotension vasodilatation chills headache
Rare side effects include: agitation arrhythmia bradycardia confusion hallucinations myoclonus itching