UZH-Logo

Maintenance Infos

Aktueller Stand der pharmakologischen Rückfallprophylaxe der Alkoholabhängigkeit


Pape, E; Herdener, M; Rösner, S; Grosshans, M; Mutschler, J (2013). Aktueller Stand der pharmakologischen Rückfallprophylaxe der Alkoholabhängigkeit. Suchttherapie, 14(04):170-177.

Abstract

This review with practical clinical focus offers an overview of available medication in Germany and current knowledge of treatment outcomes. Further, potential strategies of optimizing individual treatment of alcohol dependence are discussed.
Acamprosate, naltrexone and most recently nalmefene are approved in Germany for pharmacologic relapse prevention in alcohol dependent patients. In April 2011, disulfiram though being the most effective of the authorized substances lost its approval because the manufacturer no longer produces the drug due to “technological pro­blems”. However, disulfiram still remains rather easily obtainable via international pharmacies.
Available evidence of relapse prevention for acamprosate if administered to a heterogeneous patient population is controversial. It has been suggested that only a specific group of patients might respond to acamprosate treatment. Its future therapeutic relevance will therefore depend on identifying this group of patients.
Current data for efficacy of naltrexone seem to be slightly more favorable showing some reduction on relapse probability to heavy drinking while effects on return to any drinking missed statistical significance in a recent meta-analysis. The opiate antagonist nalmefene is the first medication explicitly authorized for reduction of alcohol consumption and will shortly be introduced to the German market. The substance might embrace a wider patient population that has not yet been reached by abstinence oriented treatment strategies.
Finally, treatment options administered in off-label-use (like baclofen, topiramat) are briefly introduced as well as substances which are currently under development using novel pharmacological mechanisms of action.

Abstract

This review with practical clinical focus offers an overview of available medication in Germany and current knowledge of treatment outcomes. Further, potential strategies of optimizing individual treatment of alcohol dependence are discussed.
Acamprosate, naltrexone and most recently nalmefene are approved in Germany for pharmacologic relapse prevention in alcohol dependent patients. In April 2011, disulfiram though being the most effective of the authorized substances lost its approval because the manufacturer no longer produces the drug due to “technological pro­blems”. However, disulfiram still remains rather easily obtainable via international pharmacies.
Available evidence of relapse prevention for acamprosate if administered to a heterogeneous patient population is controversial. It has been suggested that only a specific group of patients might respond to acamprosate treatment. Its future therapeutic relevance will therefore depend on identifying this group of patients.
Current data for efficacy of naltrexone seem to be slightly more favorable showing some reduction on relapse probability to heavy drinking while effects on return to any drinking missed statistical significance in a recent meta-analysis. The opiate antagonist nalmefene is the first medication explicitly authorized for reduction of alcohol consumption and will shortly be introduced to the German market. The substance might embrace a wider patient population that has not yet been reached by abstinence oriented treatment strategies.
Finally, treatment options administered in off-label-use (like baclofen, topiramat) are briefly introduced as well as substances which are currently under development using novel pharmacological mechanisms of action.

Altmetrics

Additional indexing

Item Type:Journal Article, not refereed, original work
Communities & Collections:04 Faculty of Medicine > Psychiatric University Hospital Zurich > Clinic for Psychiatry, Psychotherapy, and Psychosomatics
Dewey Decimal Classification:610 Medicine & health
Language:German
Date:2013
Deposited On:17 Feb 2014 10:36
Last Modified:05 Apr 2016 17:34
Publisher:Georg Thieme Verlag
ISSN:1439-9903
Publisher DOI:https://doi.org/10.1055/s-0033-1355362

Download

Full text not available from this repository.
View at publisher

TrendTerms

TrendTerms displays relevant terms of the abstract of this publication and related documents on a map. The terms and their relations were extracted from ZORA using word statistics. Their timelines are taken from ZORA as well. The bubble size of a term is proportional to the number of documents where the term occurs. Red, orange, yellow and green colors are used for terms that occur in the current document; red indicates high interlinkedness of a term with other terms, orange, yellow and green decreasing interlinkedness. Blue is used for terms that have a relation with the terms in this document, but occur in other documents.
You can navigate and zoom the map. Mouse-hovering a term displays its timeline, clicking it yields the associated documents.

Author Collaborations