Abstract
Over the past decade, research into pharmacotherapy for alcohol use disorder (AUD) has significantly expanded. Three medications—naltrexone (including its extended-release (XR formulation, Vivitrol®), acamprosate, and disulfiram—are Food and Drug Administration (FDA) and European Medicines Agency (EMA) approved for alcohol use disorder treatment. In some European regions, baclofen, nalmefene, and sodium oxybate are also approved for alcohol use disorder treatment. Despite their widespread use, variability in clinical outcomes underscores the need for more tailored treatment strategies.
Several emerging medications show promise for treating alcohol use disorder. Among the numerous neurotransmitter systems identified for novel drug development, the most promising compounds modulate the functions of opioids, glutamate (with or without gamma-aminobutyric acid), and serotonin. Other potential therapeutic agents target systems involved in sleep, appetite, stress response, and neuroplasticity. While more research is needed to confirm the efficacy of these agents in larger clinical trials, they represent an exciting new avenue for alcohol use disorder treatment.
In summary, while established treatments for alcohol use disorder remain essential, there is a growing need for more personalized approaches. These strategies should address not only alcohol-related reward mechanisms but also symptoms of withdrawal, cravings, depression, cognitive processing, and sleep disturbances. The exploration of new pharmacotherapies offers hope for improved outcomes, with treatment tailored to each individual’s unique needs.