From: Care for hospitalized patients with unhealthy alcohol use: a narrative review
Medication | Drinking Outcome | Effect estimate | Source | Factors Influencing Medication Choice |
---|---|---|---|---|
 |  | (95% CI or p-value) |  |  |
Naltrexone | Heavy drinking day (≥ 60 grams alcohol) | Relative risk 0.83 | Meta-analysis of 50 | Avoid in patients with opioid abuse or use; caution in liver disease and advanced kidney disease |
(0.76-0.90) | randomized controlled trial (RCT’s) [87] | |||
Acamprosate | Any drinking | Relative risk 0.86 | Meta-analysis of 24 | Avoid with advanced kidney disease (e.g., creatinine clearance < 30 ml/min) |
(0.81-0.91) | RCT’s [86] | |||
Disulfiram | Any drinking | Slight majority of trials found improved abstinence. | Review of 11 RCT’s [85] | Avoid if alcohol-disulfiram reaction medically dangerous; number of medical conditions associated with accidental reaction; avoidance of alcohol-containing products |
Topiramate* | % heavy drinking days | 8.4% reduction | Multicenter RCT [83] | Caution with advanced liver or kidney disease; risk for metabolic acidosis with predisposing conditions; avoid abrupt discontinuation |
(3.1-13.8) | ||||
Ondansetron* | Average number of drinks on days alcohol was consumed | If alcoholism onset before age 25, 4.28 relative to 6.9 in placebo(p=0.004) | RCT [84] | Not shown to be beneficial for later-onset alcohol dependence; may prolong QT interval |