Diagnosis and Management of Alcohol Problems

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A variety of effective medications for treating alcoholism will likely become available in the near future.

This Food and Drug Administration has approved naltrexone for the treatment of alcoholism. Naltrexone was the first medication in 40 years (since disulfiram) to be approved specifically for this purpose.

Naltrexone is safe and effective in doses of 50 mg/day for alcoholics without liver disease. In very high doses (300 mg/day) naltrexone causes elevations of liver enzymes. Such doses, therefore, are not used to treat alcoholics. Furthermore, naltrexone has not been studied in patients with alcoholic liver disease, so its safety in such patients is unknown.

Because of the idiosyncratic, potentially fatal, drug-induced hepatitis that can occur with the use of disulfiram, it is not recommended for patients with liver disease.

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