The treatment of alcohol dependence.
OBJECTIVE
The present review summarizes current research on the management of alcohol dependence, including pharmacotherapy, psychosocial interventions and treatment of alcohol dependence with comorbid psychiatric disorders.


RESULTS
Among recent studies, naltrexone has demonstrated the most consistent effect in reducing alcohol consumption in the context of behavioral therapy. In contrast to most previous studies, acamprosate did not show significant benefits on treatment outcomes relative to placebo. The combined use of naltrexone and acamprosate appeared to be safe and well tolerated but there was no additional therapeutic benefit. With the exception of topiramate, there are currently no new, effective medications for alcohol dependence. Of the psychosocial interventions, such as social behavior and network therapy, cognitive behavioral therapy, and motivational enhancement therapy, no one appears to be superior to another. Psychiatric comorbidity is common in alcohol-dependent patients; however, there are too few studies to effectively guide treatment practice.


CONCLUSIONS
Progress has been made with pharmacotherapy and psychosocial interventions for alcohol-dependent individuals. More research is needed, however, in developing newer medications and psychosocial interventions in alcohol-dependent populations and in those with comorbid psychiatric conditions, and to improve the strategies to engage patients in continuing care.
Assanangkornchai
Sawitri
S
aDepartment of Psychiatry, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand. savitree.a@psu.ac.th
Srisurapanont
Manit
M
D000427:Alcohol Deterrents / Q000627:therapeutic use; D000436:Alcoholics Anonymous; D000437:Alcoholism / Q000453:epidemiology / Q000534:rehabilitation*; D002986:Clinical Trials as Topic; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D015897:Comorbidity; D006801:Humans; D001523:Mental Disorders / Q000453:epidemiology / Q000534:rehabilitation; D009042:Motivation; D011619:Psychotropic Drugs / Q000627:therapeutic use; D055502:Secondary Prevention
D000427:Alcohol Deterrents; D011619:Psychotropic Drugs