Gabapentin is Effective in Alcohol Use Disorder in Patients with Alcohol Withdrawal Symptoms
Researcher Raymond F. Anton and colleagues reported in the journal JAMA Internal Medicine that compared with placebo, the anticonvulsant medication gabapentin helped people with alcohol use disorders reduce their drinking or abstain from drinking, especially those who had more withdrawal symptoms before treatment.
Ninety-six participants were randomized to receive either placebo or 1200mg/day of gabapentin for 16 weeks.
In the study, 27% of participants who took gabapentin had no heavy drinking days (compared to 9% among those who took placebo) and 18% achieved total abstinence (compared to 4% among those who took placebo). Gabapentin was most effective in those with a history of alcohol withdrawal symptoms. An impressive 41% of participants with high alcohol withdrawal symptoms who took gabapentin achieved total abstinence compared with 1% of participants in the placebo group.
Gabapentin, which is used to treat epilepsy, influences GABA and glutamate transmitters and inhibits the alpha 2gamma-1 voltage sensitive calcium channel, which is upregulated in chronic alcohol exposure.
NAC Reduces Alcohol Cravings, If Not Use
The antioxidant N-acetylcysteine (NAC) has been found to reduce many types of habitual behavior, from gambling to drug use to compulsive hair-pulling. A recent study by researcher Gihyun Yoon and colleagues, which was presented at a 2015 scientific meeting, found that while NAC and placebo reduced days of heavy drinking by about the same rates, NAC significantly reduced alcohol cravings and quality of life compared to placebo among participants with alcohol dependence.
In the 8-week study, 44 participants aged 18â65 received either 3600mg/day of NAC or a placebo. This dose of NAC was higher than the 600mgâ2400mg doses that have typically been used in research settings, and there were few side effects, confirming that NAC is a safe treatment.
The authors are not sure how NAC produces this effect, but it may be by regulating the neurotransmitter glutamate.
