Alcohol Medication

The most commonly used medications for alcohol problems are Librium, Antabuse, Benzodiazepine, Chlordiazepoxide & Naltroxone. The majority of people are not drinking enough to warrant using such medication and so have no other help available. Critics also point out that the side effects of the following medications are often worse than those caused by drinking and so many people are reluctant to start taking them.

Librium
Librium is habit-forming and you can become dependent on it. Librium is used in the treatment of anxiety disorders. It is also prescribed for short-term relief of the symptoms of anxiety, symptoms of withdrawal in acute alcoholism, and anxiety and apprehension before surgery. It belongs to a class of drugs known as benzodiazepines. You could experience withdrawal symptoms if you stop taking it abruptly. You should not discontinue the drug or change your dose without your doctor's approval.

Side Effects:

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Librium.

• More common side effects may include:
  Confusion, constipation, drowsiness, fainting, increased or decreased sex drive, liver problems, lack of muscle coordination, minor menstrual irregularities, nausea, skin rash or eruptions, swelling due to fluid retention, yellow eyes and skin

• Side effects due to rapid decrease or abrupt withdrawal from Librium may include:
  Abdominal and muscle cramps, convulsions, exaggerated feeling of depression, sleeplessness, sweating, tremors, vomiting

If you are severely depressed or have suffered from severe depression, consult with your doctor before taking this medication.

Antabuse
Antabuse inhibits an enzyme which assists in the breakdown of alcohol in the body. A build-up of a substance called acetaldehyde results. If alcohol is consumed when a patient has received Antabuse the so called "aldehyde reaction" may occur.

The "aldehyde reaction", which may occur if you take Antabuse and alcohol together starts with a flushing from the head downwards involving the face, arms and chest. This is accompanied by a feeling of heat, sweating, palpitations, fast heart beat, shortness of breath, hyperventilation and headache. There is a feeling of constriction and irritation in the throat resulting in spasms and coughing. Chest pains may occur. Restlessness or a sense of uneasiness and fear of dying may develop. These symptoms are accompanied by a steep rise in blood pressure which may be followed by a drop in blood pressure.

Flushing is then replaced by the patient becoming pale, weak, feeling dizzy and sick which turns into violent vomiting and stomach cramps. Other symptoms may include thirst, dizziness, blurred vision, numbness of the hands and feet and the inability to sleep. Severe reactions may affect the heart, and there may be fits, loss of consciousness and death. The reaction usually lasts 2-4 hours and up to several hours in more severe cases. Confusion, drowsiness and sleep usually follow. The intensity of the reaction varies with each individual, but generally depends on the amount of Antabuse and alcohol consumed.

Side Effects:

All medicines have side effects. Often they are not serious but sometimes they can be. You may need medical treatment if you get some of the side effects.

• Tell your doctor immediately if you notice any of the following:
• numbness, tingling, pain or weakness in hands or feet;
• change in vision or eye tenderness or pain;
• mood changes or abnormal thoughts;
• yellowing of the skin or eyes (jaundice) or abdominal pain

You may have some of the following effects for the first two weeks of treatment. If any of them worry you or continue please tell your doctor as soon as possible:

• Headache
• Weakness
• Acne or skin rash
• Stomach upset
• Impotence in men
• Metallic or garlic-like after taste

Do not hesitate to report any other side effects to your doctor or pharmacist.

Benzodiazepine
This group of drugs are also known as tranquillisers and sedatives. The best known are probably diazepam (brand name Valium) and nitrazepam (Mogadon). Benzodiazepines basically fall into two groups - the anxiolytics (for treating anxiety) and the hypnotics (for treating insomnia). Benzodiazepines are drugs for treating a number of conditions but, because of their Side effects and the risk of dependency (see below), they are not suitable as routine 'sleeping tablets', nor are they an effective treatment for depression.

Benzodiazepines work by depressing the part of the brain, called the reticular activating system, that regulates how active the brain is. They do this by increasing the action of a substance called gamma-aminobutyric acid (GABA), a chemical involved in slowing down the transmission of nerve signals in the brain.

Side Effects:

The main problem with benzodiazepines is that a course taken for more than a few weeks can cause physical and psychological dependence. This means that you may need to take more of the drug for it to have the same effect (known as tolerance) and also that you may find it difficult to stop taking the drug (become addicted). This is known as the 'benzodiazepine withdrawal syndrome'. Symptoms of this syndrome, can occur in people who stop taking the drug after a period of as little as 2-4 weeks. They include confusion, insomnia, anxiety, loss of appetite and so weight, shaking, sweating, and ringing in the ears. Because of this, the Government's advisory group (the Committee on Safety of Medicines) advises doctors that benzodiazepines should not be routinely taken for more than 2-4 weeks for anxiety, and even then should only be used to treat severe, distressing and disabling anxiety or insomnia.

Chlordiazepoxide
Belongs to a group of medicines called benzodiazepines. It acts on receptors in the brain (GABA receptors) causing the release of a chemical called GABA (gamma amino butyric acid). GABA is a major inhibitory chemical in the brain involved in inducing sleepiness and control of anxiety and fits. Chlordiazepoxide acts by increasing the activity of GABA, thereby reducing the functioning of certain areas of the brain. This results in sleepiness, a decrease in anxiety and relaxation of muscles.

Chlordiazepoxide is most commonly used to treat insomnia. It decreases the time taken to fall asleep and nocturnal awakenings, as well as increasing the total amount of time spent sleeping. As chloriazepoxide remains active in the body for many hours, drowsiness may occur the next day. Chlordiazepoxide is also used to relieve anxiety in serious anxiety related conditions including alcohol withdrawal. It is not recommended for the long-term treatment of anxiety due to the development of dependence.

Side Effects:

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

• Headache
• Loss of memory (amnesia)
• Shaky movements and unsteady walk (ataxia)
• Unexpected increase in aggression (paradoxical aggression)
• Drowsiness and lightheadedness the next day
• Rash
• Blurred vision
• Confusion

The side effects listed above may not include all of the side effects reported by the drug's manufacturer.

Naltroxone
Naltrexone is an opioid receptor antagonist used primarily in the management of alcohol dependence and opioid addiction. Naltrexone hydrochloride is sold as the brand name Revia and Depade. An extended-release form of Naltrexone is marketed under the trade name Vivitrol.

For people who have stopped drinking, Naltrexone reduces the craving for alcohol which many alcohol dependent people experience when they quit drinking. It is not fully understood how Naltrexone works to reduce the craving for alcohol, but some scientists believe it works by affecting the neural pathways in the brain where the neurotransmitter dopamine is found.

Side Effects:

For some patients, Naltrexone can cause upset stomach, nervousness, anxiety or muscle and joint pain. Usually these symptoms are mild and temporary, but for some they can be more severe and longer lasting.

In rare cases, Naltrexone can cause more severe side effects including confusion, drowsiness, hallucinations, vomiting, stomach pain, skin rash, diarrhea or blurred vision. Anyone experiencing any of these symptoms should notify their healthcare provider immediately.

Large doses of naltrexone can cause liver failure. Patients should stop taking Naltrexone immediately if they experience any of the following symptoms: excessive tiredness, unusual bleeding or bruising, loss of appetite, pain in the upper right part of the stomach, dark urine, or yellowing of the skin or eyes, according to the warning published on the Naltrexone packaging.

Some alcohol treatment centres also use the above medication in conjunction with the 12 step program.