Practical outpatient pharmacotherapy for alcohol use disorder

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Abstract

Alcohol use disorder (AUD) is commonly encountered in clinical practice. A combination of psychosocial intervention and pharmacotherapy is the cornerstone of AUD treatment. Despite their efficacy, safety and cost-effectiveness, clinicians are reluctant to prescribe medications to treat individuals with AUD. Given the high rate of relapse with psychosocial intervention alone, increasing patient access to this underutilized treatment has the potential to improve clinical outcome in this difficult-to-treat population. Herein, we provide practical pharmacotherapy strategies to improve treatment outcome for AUD. We review the efficacy and side effects of both on- and off-label agents with a particular focus on clinical applicability. Recommendations are supported by findings from randomized controlled trials (RCT) and meta-analyses selected to be representative, where possible, of current treatment guidelines. The goal of this paper is to help readers use pharmacotherapy with greater confidence when treating patients with AUD.

Keywords: alcohol use disorder, alcoholism, addiction, pharmacotherapy.

Citation: Kim Y, Hack LM, Ahn ES, Kim J. Practical outpatient pharmacotherapy for alcohol use disorder. Drugs in Context 2018; 7: 212308. DOI: 10.7573/dic.212308

Disclosure and potential conflicts of interest: The authors have declared that there are no conflicts of interest regarding this unfunded study. The International Committee of Medical Journal Editors (ICMJE) Potential Conflicts of Interests form for the authors are available for download at: http://www.drugsincontext.com/wp-content/uploads/2018/01/dic.212308-COI.pdf

Acknowledgments: Jungjin Kim conceived the idea, supervised the preparation of the manuscript, streamlined and provided the final edits. Youngjung Kim provided substantial contributions to the literature review, the writing of the manuscript and designed the final figure and the table. Laura Hack provided substantial contributions to the review and writing of the manuscript and the creation of the table. Elizabeth Ahn provided contribution to the literature review and writing of the manuscript.

Funding declaration: There was no funding associated with this article.

Copyright: Copyright © 2018 Kim Y, Hack LM, Ahn ES, Kim J. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0 which allows anyone to copy, distribute, and transmit the article provided it is properly attributed in the manner specified below. No commercial use without permission.

Correct attribution: Copyright © 2018 Kim Y, Hack LM, Ahn ES, Kim J. https://doi.org/10.7573/dic.212308. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0.

Article URL: http://www.drugsincontext.com/practical-outpatient-pharmacotherapy-for-alcohol-use-disorder

Correspondence: Jungjin Kim, Department of Psychiatry, Emory University School of Medicine, 12 Executive Park Drive, Suite 331, Atlanta, GA 30329, USA. jungjin.kim@emory.edu

Provenance: invited; externally peer reviewed.

Submitted: 4 December 2017; Peer review comments to author: 20 December 2017; Revised manuscript received: 14 January 2018; Accepted: 15 January 2018; Publication date: 7 February 2018.

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