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Key Takeaways
- Naltrexone can help reduce alcohol cravings by blocking certain brain receptors.
- Acamprosate can ease emotional discomfort and may help people who have quit drinking stay sober.
- Other drugs, like Topiramate and Gabapentin, may also help reduce alcohol cravings.
People who have become alcohol-dependent often experience cravings when trying to stop drinking, making it harder to quit. The good news, however, is that there are medications that may help manage the urge for alcohol, which can aid in the recovery from alcohol use disorder (AUD).
Here we provide a list of medicines approved by the U.S. Food and Drug Administration (FDA) for treating AUD that have effects as an alcohol craving medication. We also share other medications that are under investigation for AUD, as well as non-drug alternatives for managing cravings when quitting drinking.
FDA-Approved Alcohol Craving Medications
The FDA has approved three medications for the treatment of AUD, two of which may help manage alcohol cravings: naltrexone and acamprosate.
Vivitrol (Naltrexone)
Naltrexone blocks certain receptors in the brain (opioid receptors), which reduces the pleasure a person experiences from drinking alcohol. This can help eventually reduce alcohol cravings.
Vivitrol is a once-monthly injection brand-name version of naltrexone that works by inhibiting the high that people experience when they drink alcohol. Naltrexone is also available as a tablet in the generic form.
Acamprosate
Acamprosate was previously marketed as Campral and reduces the physical distress and emotional discomfort people can experience when they quit drinking. How it works as an alcohol craving medication is not completely understood, but researchers believe that it helps restore a chemical imbalance in the brain’s reward system that is altered by long-term alcohol abuse.
Acamprosate does not help someone quit drinking. Instead, it is prescribed for those who have already stopped drinking alcohol. Because the side effects are typically mild and well-tolerated, it is usually prescribed for up to 12 months following alcohol abstinence.
The Third FDA-Approved Medication
The third FDA-approved medication for treating AUD is Antabuse (disulfiram). This drug does not target cravings but assists in alcohol recovery by causing a severe adverse reaction when someone taking the medication consumes alcohol.
Other Medications That May Reduce Alcohol Cravings
In addition to FDA-approved medications, other drugs may have positive effects on alcohol cravings. Some are prescribed off-label to treat AUD, some are being studied for this use, and others have been approved to treat alcohol dependence outside of the United States. They include:
- Topamax (Topiramate): Topamax is an anti-epileptic medication that has shown promise for helping to manage alcohol use disorder, especially in people who experience cravings.
- Neurontin (Gabapentin): Neurontin is another anti-epileptic drug that some research has shown may be effective for reducing alcohol cravings.
- Zofran (Ondansetron): A drug used to ease nausea and vomiting in people being treated for cancer, ondansetron has also been found to reduce cravings in people with early-onset AUD—though it can increase cravings in people with late-onset AUD.
- Selincro (Nalmefene): Selincro has been approved for use in Europe to help reduce alcohol cravings, although there is controversy around this approval due to a lack of evidence combined with potential safety risks.
- Baclofen: Baclofen is a muscle relaxant that, when compared to a placebo, has been found to significantly reduce alcohol cravings in several studies. It has been approved to treat AUD in France.
- Bromocriptine (Parlodel). This drug can be prescribed to treat symptoms associated with high levels of prolactin in the body, such as infertility and a lack of menstruation, but also appears to reduce cravings and support alcohol abstinence.
- Selective serotonin reuptake inhibitors (SSRIs): In one small double-blind, placebo-controlled study, a group of 10 people with alcohol dependency who received citalopram had fewer cue-induced cravings for alcohol.
The American Psychiatric Association (APA) does not recommend using antidepressants, which includes SSRIs, in the treatment of AUD unless there is another disorder present that they can help treat.
Alternatives to Alcohol Craving Medications
Medications aren’t the only options for reducing alcohol cravings. The following approaches can also be used, with or without medication.
Cognitive Behavioral Therapy (CBT)
Cognitive behavioral therapy is a form of psychotherapy, or talk therapy, used in the treatment of substance use disorders, including AUD. CBT works to help reframe a person’s thoughts and change their actions. It can be useful in addressing cravings by helping the person develop coping mechanisms for when they occur.
Support Groups
Participating in a mutual-help group like Alcoholics Anonymous (A.A.) or another 12-step program can offer even more support. These types of groups provide access to information that can be helpful for coping with alcohol cravings.
Research has found fewer self-reported cravings in A.A. members who had a “spiritual awakening” and those who prayed after viewing craving-inducing images. However, a 2017 review suggests that A.A.’s benefits primarily come from therapeutic factors that mirror those found in other treatments—such as those that are social, cognitive, and affective in nature.