Pharmacology in Alcohol Use Disorder: Naltrexone, Acamprosate, and Disulfiram

The Psychopharmacology Institute is an online platform offering unbiased, practical psychopharmacology updates for healthcare providers, with content updated monthly. It also presents opportunities to earn CME and SA credits.
This video discusses medications for alcohol use disorder, such as naltrexone, acamprosate, and disulfiram. It explains their clinical effects, the goals and benefits of treatment, side effects, liver function monitoring, precautions, contraindications, and dosing. Finally, it emphasizes the patient factors to consider when choosing a treatment.
This is an excerpt from a video lecture. Find the transcript here: tinsy.me/sA33MD
If you become a member, you can earn CME credits for this activity. Want to know more? Take a look at the 2023-24 Psychopharmacology Update here: tinsy.me/FpAidg
#AlcoholUseDisorder #Disulfiram #Naltrexone #CMEs

[@ChristIsRisen33]

Acamprosate is saving my life right now. 🙏

[@richardfrancis5406]

Really great stuff....I am going to give Naltrexone a try...thank you so much!

[@Michael-tr7uq]

To use Naltrexone with the most effectiveness, watch the documentary called One Little Pill on the Sinclair Method. Alcohol changes our brain by learning is all. TSM will help you change it back. Tons of info on KZbin.

[@richardfrancis5406]

@@Michael-tr7uq Thank you...I appreciate the advice...at that stage I know I have to do something...

[@gazzleroakley2053]

Perfect info👍

[@zakirzak1494]

Thank you 🙏 well explained

[@0HolyFudge0]

Great content

[@arielcepero3719]

Hi Dr. Suzuki! Can you please explain how does Naltrexone decreases GABA inhibition? I understand that it is a Mu receptor antagonist and that it ultimately blocks dopamine release. So, I guess my question is, wouldn't decreasing GABA inhibition cause the membrane to be able to fire an action potential? and if so, how does this decrease in GABA inhibition leads to the ultimate block of Dopamine release? Thank you in advance!

[@nieuweabnormaal5869]

I am using Naltrexone by the Sinclair method. So i take a Naltrexone pill an hour before drinking. On days that i do not drink, i do not take Naltrexone. My drinking behavior collapsed in 4 months. I used to drink more or less a lot every day. But by the Sinclair method I rarely drink. So what he is describing is not completely good. You do not take a pill during a day that you do not drink.

[@larryc7209]

that is correct for TSM. However, naltrexone or vivitrol are used extensively in treatment programs where abstinence is the immediate and long term goal. Naltrexone is given daily and vivitrol a monthly injection

[@devisissy1]

I tried an hour before and found it completely ineffective. I am having a little more luck 4-5 hours before drinking.

[@nieuweabnormaal5869]

@@devisissy1 I am talking about longer term effects. Waiting 4-5 hours is too long. It may look ineffective an hour before, but maybe you are doing this only for a short time. I used it about 6 months with one hour before the pill. Now i already do not drink anything for 3 months. From my coach who has many patients, she said to me that more than 1.5 hours is not good. So you just have to repeat everyt time with the 1 hour period before drinking. It is not a quick fix, do not trust your observations if you only using a short time.

[@devisissy1]

@@nieuweabnormaal5869 Its been a few months. I tried an hour before but found it had no effect. At my last check up I told my doctor about this and he suggested at noon or 1pm since I start my drinking after work. That has had more results for me. Like last night I couldn't even finish my last beer. It tasted like pond water. I'm on 100mg a day. Maybe it's not a one size fits all. In the end whatever helps us.

[@stevecooper6515]

@Larry C Taking Naltrexone daily regardless of whether you drink or not was found to be very ineffective in Project Combine 2006. The medication has to be used in the specific targeted dosage regime of TSM in order to be effective, whilst the patient continues to drink. The Vivitrol injection cannot be used to facilitate Pharmacological Extinction.

[@atriptoserenity5335]

Thanks for your video, i have a question, i m sober now for 19 days but i struggle is it better to start Natrexone some days before starting to drink again or the same day of the first drink? 🙏

[@FuryForceFive]

How long should a patient be maintained on a medication like naltrexone IM? The closest I have found is that the benefits VS placebo end after 1 to 3 months AFTER the end of treatment.

[@Maris0L0L]

from what i learned they can be on it for life if they deem it necessaruy for them to be sober. some ppl wean off after a year and do not relapse.

[@Michael-tr7uq]

No naltrexone on alcohol-free days. No naltrexone if you ultimately choose abstinence at the end of Sinclair Method treatment. Only 1 hr before drinking always. If you drink only on Fridays, 1 pill a week will keep you unaddicted and cravings free at the end of TSM treatment.

[@alexsadeghi6535]

who is running you after? why are you presenting so fast?

[@macfrichtel1]

Reminder: for a true alcoholic there is no moderate drinking or cutting back. Complete abstinence is the only treatment although meds may help get you started. God bless

[@Michael-tr7uq]

Not true since 2004 ... watch the documentary called One Little Pill on the Sinclair Method. Alcohol changes our brain by learning is all. TSM will help you change it back. Tons of info on KZbin.

[@stevecooper6515]

Complete outdated and debunked nonsense. That outdated concept is actually incorrect. Science and the understanding of Alcohol Use Disorder has progressed. Please research "The Sinclair Method" and the book "The Cure for Alcoholism" by Dr Roy Eskapa. Alcohol Use Disorder is now completely treatable and effectively curable. Abstinence in NOT the only way. You might want to also research the Alcohol Deprivation Effect, which accounts for why forced abstinence has such a miserablely poor long term success rate.

[@brucefranken4615]

Meds naltrexone + acamprosate are as or more effective than any other treatment (including A.A.) at producing abstinence. However if you want sobriety (abstinence + psychological well-being), than I believe a spiritual program (e.g. A.A.) must be included.

[@stevecooper6515]

Completely incorrect. Science has moved on since the "Abstinence is the only way" doctrine enforced by AA. AUD is completely treatable and effectively curable today using The Sinclair Method.

[@prodipdebnath3029]

TAB 1/2/3 যে কোন 1টা

[@AltraxX]

Disulfiram seems like a punishment

[@stevecooper6515]

It is a punishment or fear based medication, that's why it's so ineffective.

[@benjaminhesford5178]

That's what attracts me too it