Pharmacotherapy for Adults With Alcohol Use Disorders in Outpatient Settings
A Systematic Review and Meta-analysis
JAMA. May 14, 2014;311(18):1889-1900.
Daniel E. Jonas, MD, MPH, et al.
Importance: Alcohol use disorders cause substantial morbidity and early mortality yet remain greatly undertreated. Medications are considerably underused.
Most assessed acamprosate, naltrexone, or both.
The NNT to prevent return to any drinking for acamprosate was 12
Among medications used off-label, moderate evidence supports an association with improvement in some consumption outcomes for nalmefene and topiramate.
Conclusions and Relevance: Both acamprosate and oral naltrexone were associated with reduction in return to drinking.
When directly compared with one another, no significant differences were found between acamprosate and naltrexone for controlling alcohol consumption.
Factors such as dosing frequency, potential adverse events, and availability of treatments may guide medication choice.