Alcohol Use Disorder

Anticraving Therapy

top tier choices

1. Naltrexone
   1. monitor liver enzymes
   2. able to drink/be non-abstinent
   3. can't be on opioids at the same time
   4. hepatically cleared
   5. NNT ~5-6
   6. needs a taper
2. Acamprosate
   1. evidence is best for abstinence maintenance, but you can still drink with this
   2. renally cleared
   3. no dose taper required
3. Gabapentin
   1. not much literature in chronic anticraving therapy
   2. can be used as adjuvant for acute withdrawal (but limited evidence), and reduces benzodiazepine requirement
   3. abuse potential

low-tier options

1. Topiramate
2. Baclofen