How do alcoholism drugs work

Treating alcohol addiction »Medication

Medicines are only useful for short-term support

Some medications - such as Campral® and Antabus® - reduce the desire to drink by making alcohol consumption unattractive. However, they also have severe side effects, and Antabus® can be fatal if taken with alcohol at the same time. These so-called 'anti-craving' substances can therefore only be used under certain circumstances and for a limited period of time.

In any case, the administration of medication must be accompanied by psychotherapeutic treatment, because alcoholism is never just a purely 'physical' problem. Without changing addiction-promoting lifestyle habits, the best drugs are of no use - on the contrary, they represent an additional heavy burden on the organism. In addition, new dependencies or a shift in addiction can occur.

Studies have shown that the pure desire for the 'substance' plays a much smaller role in triggering relapses than, for example, interpersonal tensions and other stressful life circumstances. You can also read our article on relapse. Medicines against the 'drinking pressure' are therefore particularly suitable as a support for people with a stable social environment. In the case of socially isolated sufferers, however, the risk of renewed alcohol consumption is much higher, and treatment with Antabus® poses a major health risk.

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Anti-craving drugs

+++ Campral® - suppresses the desire to drink

The active ingredient acamprosate dampens the over-excitability of the nerve cells, which is triggered by the messenger substance glutamate, and thus reduces the desire for alcohol during withdrawal. It has a direct effect on the neurotransmitters in the brain involved in the addiction and thus relieves the desire to drink. It is therefore an effective means of preventing relapses after withdrawal. Unfortunately, however, the expensive active ingredient does not seem to work for all alcoholics.

Common side effects are: diarrhea, abdominal pain, nausea and vomiting, gas, itching, rash, decreased libido, impotence and frigidity. Occasionally the libido increases. Confusion and trouble sleeping can also occur.

Like all anti-craving medications, acamprosate should only be used in conjunction with other therapies that can support long-term abstinence without the use of medication.


+++ Antabus® - makes drinking uncomfortable


The active ingredient disulfiram reduces alcohol tolerance. If alcohol is drunk during or up to a week after taking Antabus®, symptoms of intoxication such as nausea, circulatory disorders, anxiety, reddened skin, headaches and a feeling of cold in the extremities occur. These symptoms occur because Antabus® interferes with the breakdown of acetaldehyde, which is responsible for the hangover after drinking. The simultaneous or delayed consumption of alcohol and Antabus® produces a particularly aggressive hangover and can even lead to life-threatening conditions. Antabus® must never be administered to the patient without their knowledge and consent!

All foods that could contain traces of alcohol (such as in non-alcoholic 'free' beer) must be avoided at all costs! This also applies to creams, gels, lipsticks, perfumes, cough syrups and mouthwashes with alcohol. Even mustard, vinegar, and canned products can be a problem. Even without alcohol consumption, Antabus® initially has side effects such as constant tiredness and permanent nausea - but anyone who seriously wants to quit should accept this in consultation with the treating doctor, because the drug can be of great help, especially in the initial phase of abstinence .

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As a rule, Antabus® is only used at the beginning of abstinence during controlled withdrawal in order to prevent relapses. Drinking under Antabus® is no longer fun and makes it easier to quit. However, the drug itself is not suitable for curing alcohol addiction; After a short time, other ways and means must be found together with the alcohol addict to prevent drinking again. Antabus® only serves to support a multi-pronged therapy of alcoholism with other means and should under no circumstances be taken over a longer period of time (about several months), because the liver and other organs are severely affected by this. There are interactions with many drugs. For example, the effect of benzodiazepines (sedatives, especially diazepam and chlordiazepoxide) is increased, and psychoses may occur in connection with isoniazid and metronidazole (antibiotics).

The following requirements should be met in order to start an Antabus® treatment:

* the patient has an intact social environment
(Partner, friends, work ...),

* regular intake is guaranteed (good 'compliance'),

* there are no suicidal or self-destructive tendencies
(Risk of suicide with the help of Antabus® due to shortness of breath and heart failure!) And

* the person concerned is not taking any other medication that may interfere with disulfiram.


Medication for the symptoms of withdrawal

+++ Distraneurin® - works against withdrawal symptoms

The active ingredient clomethiazole - like the benzodiazepines - has a calming, anxiety-relieving and sleep-promoting effect. It also relieves cramps. The drug is used in the acute phase of detoxification (in severe states of excitement) and for the treatment of delirium tremens. Since Distraneurin® is very addictive, it should ONLY be used under inpatient supervision and not for longer than 2 weeks in decreasing doses. Self-medication 'at home' can be life-threatening.

When taken orally, nausea, vomiting, the urge to sneeze, allergic reactions and a slight drop in blood pressure are not uncommon. Intravenous administration should only be carried out under intensive medical supervision, as this can lead to a massive drop in blood pressure, respiratory depression up to apnea and excessive saliva and bronchial secretion.

We strongly advise against taking painkillers, sleeping pills and other substances that affect the brain at the same time. The effect of certain cardiovascular drugs is reduced. There is a danger to life when taking Distraneurin® with alcohol!

Clomethiazole is contraindicated in existing respiratory insufficiency and obstructive airway diseases as well as in severe liver or kidney damage.

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+++ Haldol® - dampens withdrawal symptoms and delirium

If someone is already dependent on Distraneurin®, the neuroleptic and butyrophenone derivative haloperidol (e.g. in Haldol®) are often used. It is an effective antipsychotic and - like Distraneurin® - is used to relieve withdrawal symptoms and delirium. It combats the psychoses and nausea caused by alcohol abuse.

Haloperidol has strong side effects such as drowsiness, convulsions, tremors, restlessness, tiredness, hypotension and movement disorders and can damage the liver and blood. The sedative promethazine (ATOSIL®) is used as an alternative, but there are side effects here too.

+++ Catapresan®, Paracefan® and Haemiton®

The active ingredient clonidine is another means of dampening withdrawal symptoms.


+++ Tegretal® or Timonil® - help with seizures

The anti-epileptic carbamazepine is used for seizures during alcohol detoxification. Since it inhibits the conduction of excitation in the nerve cells, it can be used not only in acute phases, but also to prevent seizures. The side effects of the drug include: tiredness, blurred vision, nausea, dizziness, rash, mood swings and a decrease in white blood cells.

Caution: The effect of the birth control pill is canceled out by carbamazepine, and in pregnancy a malformation of the embryo cannot be ruled out!

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+++ Tiapridex® - effective in the acute phase of withdrawal

The effectiveness of tiapride in combination with carbamazepine in withdrawal treatment has been proven by studies. Tiapride is not addictive, is well tolerated and can also be used if there is still a small amount of alcohol in the blood.

Link to external article »

Tiaprid is one of the nerve-suppressing agents (neuroleptics) from the benzamide group. The dopamine receptor antagonist inhibits the release and effect of dopamine in certain brain regions. This can alleviate withdrawal symptoms such as movement disorders (e.g. tics and dyskinesia), excitement, tremors, rise in blood pressure, high pulse rate and sweating.


Drug addiction

Many drugs have harmful effects on the organism in connection with alcohol and with existing alcohol-related pre-existing illnesses. Alcohol sufferers should therefore only take drugs after consulting their doctor or, if possible, not take them at all. In any case, the attending physician should be informed about the alcohol dependence (also and especially in the case of unexpected inpatient admissions, accidents, etc.!)

Especially sedatives, sleeping pills and painkillers quickly lead to the next addiction. The use of drugs with addictive potential should only be considered in an emergency and then kept to a minimum.

PLEASE SEE WHAT YOUR DOCTOR PRESCRIBES FOR YOURSELF! Remain critical - prescription addiction is preventable.

It is not uncommon for alcoholic people to switch to medication during abstinence because they are used to intoxicants helping them through all kinds of unpleasant conditions. This leads to a shift in addiction and multiple addictions, which are even more difficult to treat than alcoholism itself.

Withdrawal from medication is more difficult and lengthy than alcohol withdrawal. It should definitely be done under medical supervision. The heel symptoms (fears, restlessness, depression, insomnia, etc.) can persist long after the detoxification. Unfortunately, they cannot always be clearly distinguished from the symptoms that led to the use of medication. Since the withdrawal symptoms cannot be treated with medication, the active ingredients are often 'tapered off', that is, the medication is slowly and slowly dosed.

Which drugs are addictive?

* Sleeping pills and sedatives

(e.g. tranquilizers, benzodiazepines, barbiturates, beta blockers, some antidepressants, certain antiallergics; e.g. Distraneurin®, Valium®, Tavor® ...)

* Pain tablets (analgesics), opiates

* Stimulants and stimulants, appetite suppressants


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