How Do Medications Against Alcoholism Work

How Do Medications Against Alcoholism Work?

Alcoholism – also known as alcohol use disorder – is a condition that involves problems in controlling liquor consumption. This leads to continuous alcohol drinking – even when it causes a bevy of problems. In most cases, alcoholics need to drink more to get the same buzz they did before. As a result, they often suffer from withdrawal symptoms whenever they minimize or stop drinking alcohol.

Since alcoholism – even the mild cases – can lead to serious problems, the person needs to get treatment right away. The regimen often includes detox for withdrawal, psychological counseling, psychiatric treatment, support, and life skills education.

Another cornerstone of alcoholism treatment is the use of medication. Below, you’ll find out the different remedies prescribed for alcohol use – and how they work on the body.

1. Disulfiram (Antabuse)

Disulfiram, which was approved by the FDA in 1951, is the first drug to be used for alcoholism. It works by modifying the way your body processes alcohol.

Disulfiram can make you sick when you take alcohol. These unpleasant symptoms will motivated you to cut your alcohol intake.

Disulfiram (Antabuse)

While effective, some people find it hard to comply with Disulfiram because of its effects. Although this is the case, it’s highly recommended for those who have received an ultimatum from the law – or his/her family members. After all, somebody watching you is motivation enough to continue with your Disulfiram regimen.

More than just interacting with liquor, Disulfiram also interacts with food and medications that contain alcohol (vinegar, sauces, cough syrups, etc.) As such, you should avoid them the way you do alcohol. That is 12 hours before intake up to several weeks after you have stopped taking Disulfiram.

Disulfiram is best taken throughout recovery. However, some people take it when they know they have a high chance of relapsing. This is why most ex-alcoholics often use Disulfiram during the holidays or certain events. After all, such occasions can tempt sober alcoholics to drink liquor once again.

Common Disulfiram side effects include headaches, drowsiness, tiredness, metallic taste in the mouth, mild acne, skin rashes, and impotence.

2. Naltrexone (Vivitrol)

Naltrexone, which can be taken as a pill or injection, works by making you feel drunk – sans the pleasure that alcohol usually gives.

Apart from stripping this feeling off, Naltrexone can help you fight cravings. As it can separate alcohol from feelings of pleasure, you’ll be less likely to give in to the triggers of alcohol use. After all, you won’t feel good anymore even if you drink lots of liquor.

 Naltrexone (Vivitrol)

Naltrexone should be taken 4 days after detox. This will prevent the onset of complications such as nausea and vomiting.

Side effects of Naltrexone include:

  • Headaches
  • Dizziness
  • Sleepiness or sleeping problems
  • Toothaches
  • Nausea
  • Vomiting
  • Cold-like symptoms
  • Loss of appetite
  • Muscle cramps
  • Painful joints

More than just promoting complete abstinence, Naltrexone may decrease the number of drinks or heavy drinking days. As a result, Naltrexone may improve 30/60-day abstinence rates and reduce alcohol-related ER consultations.

3. Acamprosate

Acamprosate is a medication that helps relieve withdrawal symptoms that linger even after you have stopped drinking for quite a while. Such signs include restlessness, anxiety, and insomnia.


Acamprosate works on the two chemical messengers in the brain, namely gamma-aminobutyric acid (GABA) and glutamate. GABA helps hold back certain brain cells, which can help you manage your fear and anxiety even when you feel over-excited. Glutamate, on the other hand, helps stimulate certain nerve cells.

Since the balance between these messengers is disturbed in alcoholism, Acamprosate may help provide some stability by leveling out such abnormalities.

Acamprosate, which works best on a person who has already stopped drinking, requires taking a pill 2-3 times a day. So if you are one to forget your pills, then you will need to set a reminder to succeed with this regimen.

Acamprosate side effects include:

  • Dizziness
  • Weakness
  • Anxiety
  • Sleep problems
  • Sweatiness
  • Nausea
  • Dry mouth
  • Diarrhea
  • Stomach upset
  • Flatulence
  • Itchiness

4. Gabapentin

Gabapentin, an anti-seizure drug, is used as an ‘off-label’ treatment for alcoholism. It is, however, already being prescribed in other countries for alcohol use.


Like Acamprosate, it works by balancing the GABA and glutamate levels in the brain.

One study has shown that Gabapentin, in a dose-dependent manner, may help promote abstinence and reduce heavy drinking. Results show that those who received 1800 mg of Gabapentin for 12 weeks had a 17% abstinence rate. It was only 11.1% in the 900 mg Gabapentin group.

A lower no-heavy drinking rate was also seen in the 1800 mg group (44.7%). The 900 mg group only had 29.6%.

Apart from these benefits, Gabapentin may improve mood and reduce cravings too.

While effective, you need to be wary of Gabapentin’s numerous side effects. They include:

  • Drowsiness
  • Tiredness
  • Dizziness
  • Headaches
  • Memory problems and unusual thoughts
  • Anxiety
  • Uncontrollable shaking or unsteadiness
  • Blurred vision
  • Sudden eye movements
  • red, itchy eyes
  • Flu-like symptoms
  • Ear pain
  • Dry mouth
  • Nausea
  • Vomiting
  • Heartburn
  • Increased appetite
  • Constipation
  • Some swelling
  • Joint pain
  • Weight gain

5. Topiramate

Similar to Gabapentin, Topiramate is an anti-seizure drug that can help manage alcoholism symptoms. It works similarly by preventing fluctuations in the person’s GABA and glutamate levels.


Several studies support Topiramate’s efficacy against alcoholism. One such research involved 90 patients who underwent a detox program before treatment. They received 75 mg of Topiramate a day for 16 weeks in conjunction with psychological counseling.

Results showed that the Topiramate group had major improvements in terms of depression, anxiety, and obsessive-compulsive drinking. 4 months into follow-up, Topiramate users had lower relapse rates. They also had longer times to relapse. All in all, those who received Topiramate had an average abstinence duration of 10 weeks. The placebo group, on the other hand, only had 4 weeks.

Topiramate side effects to note include:

  • Headaches
  • Drowsiness
  • Slowed reactions
  • Nervousness
  • Weakness
  • Uncontrollable shaking or eye movements
  • Dry or teary eyes
  • Dry mouth
  • Nosebleeds
  • Burning, tingling, or numbness of the hands or feet
  • Pain
  • Bleeding or bruising
  • Heartburn
  • Constipation
  • Weight loss


Several medications help address alcoholism. Taken orally are Disulfiram, Acamprosate, and Naltrexone. The latter is available as an injectable as well. Other off-label drugs for alcohol use include Gabapentin and Topiramate.

Latest posts by Raychel Ria Agramon, BSN, RN, MPM (see all)