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14 - Pharmacotherapy of alcohol misuse, dependence and withdrawal

from Part III - Specific treatments

Published online by Cambridge University Press:  12 May 2010

By
George A. Kenna ,
Kostas Agath  and
Robert Swift
Edited by
Peter Tyrer  and
Kenneth R. Silk
George A. Kenna
Affiliation:
Center for Alcohol and Addiction Studies Brown University Providence, RI USA
Kostas Agath
Affiliation:
Westminster Substance Misuse Services London UK
Robert Swift
Affiliation:
Center for Alcohol and Addiction Studies Brown University Medical School Providence, RI USA
Peter Tyrer
Affiliation:
Imperial College of Science, Technology and Medicine, London
Kenneth R. Silk
Affiliation:
University of Michigan, Ann Arbor
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Summary

Editor's note

While there is a large volume of research on alcohol misuse, dependence and withdrawal, the pharmacologic solutions are not as directly evident as this amount may suggest. There are widespread cultural determinants as to what constitutes alcohol misuse though the definitions for dependence are much clearer. Yet we do not have good solid pharmacologic treatments to prevent or decrease alcohol usage in the alcohol-dependent individual, though results from the recent COMBINE study suggest a more prominent and effective role for naltrexone in conjunction with medical management. Acamprosate did not fare as well in this trial even though it has been approved for alcohol dependence, and questions of heterogeneity among patient populations might explain conflicting findings. The effectiveness of disulfiram appears to rely heavily upon the patient's determination to remain abstinent. Anticonvulsants may have a role here, but more data is needed. Benzodiazepines remain the gold standard for treatment of symptoms of alcohol withdrawal, while a number of studies also support the use of some anticonvulsant drugs in assisting with withdrawal, especially in cases of mild-to-moderate severity.

Introduction

There is a large volume of research on the pharmacological treatments for alcohol misuse, dependence and withdrawal. Part of that research is marred by methodological difficulties (Moncrieff & Drummond 1997), necessitating increasingly sophisticated means of grading the available evidence to allow generalizability of findings (Mayo-Smith, 1997, Garbutt et al., 1999, Scottish Intercollegiate Guidelines Network –SIGN, 2003, Lingford-Hughes et al., 2004).

Type
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Information
Cambridge Textbook of Effective Treatments in Psychiatry , pp. 289 - 313
Publisher: Cambridge University Press
Print publication year: 2008

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References

Abbott, P. J., Quinn, D. & Knox, L. (1995). Ambulatory medical detoxification for alcohol. American Journal of Drug and Alcohol Abuse, 21, 549–63.Google Scholar
Adinoff, B. (1994). Double-blind study of alprazolam, diazepam, clonidine, and placebo in the alcohol withdrawal syndrome: preliminary findings. Alcoholism: Clinical and Experimental Research, 18, 873–8.Google Scholar
Albanese, M. J., Khantzian, E. J.et al. (1994). Decreased substance use in chronically psychotic patients treated with clozapine. American Journal of Psychiatry, 151, 780–1.Google Scholar
American Psychiatric Association (2000). DSM-IV-TR: Diagnostic and Statistical Manual of Mental Disorders, 4th edn. Text Revision. Washington DC: APA.
Anton, R. F., Moak, D. H, Latham, P.et al. (2005). Naltrexone combined with either cognitive behavioral or motivational enhancement therapy for alcohol dependence. Journal of Clinical Psychopharmacology, 25, 349–57.Google Scholar
Anton, R. F., O'Malley, S. S., Ciraulo, D. A.et al. (2006). Combined pharmacotherapies and behavioral interventions for alcohol dependence. The COMBINE study: a randomized controlled trial. Journal of the American Medical Association, 295, 2003–17.Google Scholar
Asplund, C. A., Aaronson, J. W. & Aaronson, H. E. (2004). 3 regimens for alcohol withdrawal and detoxification. Journal of Family Practice, 53, 545–54.Google Scholar
Babor, T. F. (1992). Substance-related problems in the context of international classificatory systems. In The Nature of Alcohol and Drug Related Problems, ed. Lader, M., Edwards, G. & Drummond, D. C., pp. 83–98. Oxford: Oxford University Press.
Baumgartner, G. R. & Rowen, R. C. (1987). Clonidine vs. chlordiazepoxide in the management of acute alcohol withdrawal syndrome. Archives of Internal Medicine, 147, 1223–6.Google Scholar
Bayard, M., McIntyre, J., Hill, K. R. & Woodside, J. Jr. (2004). Alcohol withdrawal syndrome. American Family Physician, 69, 1443–50.Google Scholar
Benjamin, D., Grant, E. R. & Pohorecky, L. A. (1993). Naltrexone reverses ethanol-induced dopamine release in the nucleus accumbens in awake, freely moving rats. Brain Research, 621, 137–40.Google Scholar
Berglund, M. (2003). Pharmacotherapy for alcohol dependence. In Treating Alcohol and Drug Abuse: An Evidence Based Review, ed. Berglund, M., Thelander, S. & Jonsson, E.. Wiley-VCH GmbH & Co.
Besson, J., Aeby, F., Kasas, A., Lehert, P. & Potgieter, A. (1998). Combined efficacy of acamprosate and disulfiram in the treatment of alcoholism: a controlled study. Alcoholism: Clinical and Experimental Research, 22, 573–9.Google Scholar
Bonnet, M. H., Banger, M., Leweke, F. M.et al. (2003). Treatment of acute alcohol withdrawal with gabapentin: results from a controlled two-center trial. Journal of Clinical Psychopharmacology, 23, 514–19.Google Scholar
Book, S. W. & Myrick, H. (2005). Novel anticonvulsants in the treatment of alcoholism. Expert Opinion on Investigational Drugs, 14, 371–6.Google Scholar
Bouza, C., Angeles, M., Munoz, A. & Amate, J. M. (2004). Efficacy and safety of naltrexone and acamprosate in the treatment of alcohol dependence: a systematic review. Addiction, 99(7), 811–28.Google Scholar
Brady, K. T., Myrick, H., Henderson, S. & Coffey, S. F. (2002). The use of divalproex in alcohol relapse prevention: a pilot study. Drug and Alcohol Dependence, 67, 323–30.Google Scholar
Brewer, C. (1993). Recent developments in disulfiram treatment. Alcohol and Alcoholism, 28, 383–95.Google Scholar
British National Formulary (BNF) (2004). British Medical Association and Royal Pharmaceutical Society of Great Britain. No. 50 (Sept 2005).
Bruno, F. (1989). Buspirone in the treatment of alcoholic patients. Psychopathology, 22 (Suppl. 1), 49–59.Google Scholar
Caputo, F., Vignoli, T., Lorenzini, F.et al. (2005). Suppression of craving for gamma-hydroxybutyric acid by naltrexone administration: three case reports. Clinical Neuropharmacology, 28, 87–9.Google Scholar
Carmen, B., Angeles, M., Ana, M. & Maria, A. J. (2004). Efficacy and safety of naltrexone and acamprosate in the treatment of alcohol dependence: a systematic review. Addiction, 99, 811–28.Google Scholar
Carroll, K. M., Fenton, L. R., Ball, S. A.et al. (2004). Efficacy of disulfiram and cognitive behavior therapy in cocaine-dependent outpatients: a randomized placebo-controlled trial. Archives of General Psychiatry, 61, 264–72.Google Scholar
Chan, A. W. (1985). Alcoholism and epilepsy. Epilepsia, 26, 323–33.Google Scholar
Chick, J. (1999). Safety issues concerning the use of disulfiram in treating alcohol dependence. Drug Safety, 20, 427–35.Google Scholar
Chick, J., Anton, R., Checinski, K.et al. (2000). A multicentre, randomized, double-blind, placebo-controlled trial of naltrexone in the treatment of alcohol dependence or abuse. Alcohol and Alcoholism, 35, 587–93.Google Scholar
Chick, J., Gough, K., Falkowski, W.et al. (1992). Disulfiram treatment of alcoholism. British Journal of Psychiatry, 161, 84–9.Google Scholar
Chick, J., Howlett, H., Morgan, M. Y. & Ritson, B. (2000). United Kingdom Multicentre Acamprosate Study (UKMAS): a 6-month prospective study of acamprosate versus placebo in preventing relapse after withdrawal from alcohol. Alcohol and Alcoholism, 35, 176–87.Google Scholar
Ciccocioppo, R. (1999). The role of serotonin in craving: from basic research to human studies. Alcohol, 34, 244–53.Google Scholar
Ciraulo, D. A., Shader, R. I., Greenblatt, D. J. & Creelman, W. (2006). Drug Interactions in Psychiatry, 3rd edn. Philadelphia PA.: Lippincott, Williams & Wilkins.
COMBINE Study Research Group (2003). Testing combined pharmacotherapies and behavioral interventions for alcohol dependence (the COMBINE) study): a pilot feasibility study. Alcoholism: Clinical and Experimental Research, 27, 1123–31.
Cook, C. C. H., Hallwood, P. M., & Thomson, A. D. (1998). B-vitamin deficiency and neuro-psychiatric syndromes in alcohol misuse. Alcohol and Alcoholism, 33, 317–36.Google Scholar
Cornelius, J. R., Salloum, I. M., Ehler, J. G.et al. (1997). Fluoxetine in depressed alcoholics. A double-blind placebo controlled trial. Archives of General Psychiatry, 23, 193–203.Google Scholar
Croop, R. S., Faulkner, E. B., Labriola, D. F.et al. (1997). The safety profile of naltrexone in the treatment of alcoholism. Results from a multicenter usage study. Archives of General Psychiatry, 54, 1130–5.Google Scholar
Daeppen, J., Gache, P., Landry, U.et al. (2002). Symptom-triggered vs fixed-schedule doses of benzodiazepine for alcohol withdrawal. Archives of Internal Medicine, 162, 1117–21.Google Scholar
Daniel, D. G., Swallows, A. & Wolff, F. (1987). Capgras delusion and seizures in association with therapeutic dosages of disulfiram. Southern Medical Journal, 80, 1577–9.Google Scholar
Daoust, M., Legrand, E., Gewiss, M.et al. (1992). Acamprosate modulates synaptosomal GABA transmission in chronically alcoholised rats. Pharmacology Biochemistry and Behavior, 41, 669–74.Google Scholar
Davidson, D, Palfai, T., Bird, C.et al. (1999). Effects of naltrexone on alcohol self-administration in heavy drinkers. Alcoholism: Clinical and Experimental Research, 23, 193–203.Google Scholar
Davidson, D., Saha, C., Scifres, S., Fyffe, J., O'Connor, S. & Selzer, C. (2004). Naltrexone and brief counseling to reduce heavy drinking in hazardous drinkers. Addictive Behaviors, 29, 1253–8.Google Scholar
Dawson, D. A. (1994). Heavy drinking and the risk of occupational injury. Accident Analysis and Prevention, 26, 655–65.Google Scholar
Sousa, A. & Sousa, A. (2004). A one-year pragmatic trial of naltrexone vs disulfiram in the treatment of alcohol dependence. Alcohol and Alcoholism, 39, 528–31.Google Scholar
Department of Health, The Scottish Office Department of Health, Welsh Office, Department of Health and Social Services, Northern Ireland (1999). Drug Misuse and Dependence – Guidelines on Clinical Management. London: The Stationery Office.
Dilts, S. L. & Dilts, S. L. Jr. (1996). Assessing liver function before initiating disulfiram therapy. American Journal of Psychiatry, 153, 1504–5.Google Scholar
Drake, R. E., Xie, H., McHugo, G. J.et al. (2000). The effects of clozapine on alcohol and drug use disorders among patients with schizophrenia. Schizophrenia Bulletin, 26, 441–9.Google Scholar
Dundon, W., Lynch, K. G., Pettinati, H. M. & Lipkin, C. (2004). Treatment outcomes in type A and B alcohol dependence 6 months after serotonergic pharmacotherapy. Alcoholism: Clinical and Experimental Research, 28(7), 1065–73.Google Scholar
Fawcett, J., Kravitz, H. M., McGuire, M.et al. (2000). Pharmacological treatments for alcoholism: revisiting lithium and considering buspirone. Alcoholism: Clinical and Experimental Research, 24, 666–74.Google Scholar
Feinn, R., Nellissery, M. & Kranzler, H. R. (2005). Meta-analysis of the association of a functional serotonin transporter promoter polymorphism with alcohol dependence. American Journal of Medical Genetics, Part B Neuropsychiatric Genetics, 133, 79–84.Google Scholar
Finn, D. A. & Crabbe, J. C. (1997). Exploring alcohol withdrawal syndrome. Alcohol Health and Research World, 21, 149–56.Google Scholar
Forest Laboratories, (2004). Acamprosate product information, Forest Pharmaceuticals, St Louis MO, April.
Franck, J. (2003). Pharmacotherapy for alcohol withdrawal syndrome. In Treating Alcohol and Drug Abuse; Evidence Based Review, ed. Berglund, M., Thelander, S. & Jonsson, E.. Wiley-VCH GmbH & Co. KgaA
Fuller, R. K., Branchey, L., Brightwell, D. R.et al. (1986). Disulfiram treatment of alcoholism. A Veterans Administration cooperative study. Journal of the American Medical Association, 256, 1449–55.Google Scholar
Fuller, R. K. & Gordis, E. (2004). Does disulfiram have a role in alcoholism treatment today? Addiction, 99, 21–34.Google Scholar
Galloway, G. P., Koch, M., Cello, R., & Smith, D. E. (2005). Pharmacokinetics, safety, and tolerability of a depot formulation of naltrexone in alcoholics: an open-label trial. BioMed Central Psychiatry, 5, 18.Google Scholar
Garbutt, J. C., West, S. L., Carey, T. S.et al. (1999). Pharmacological treatment of alcohol dependence: a review of the evidence. Journal of the American Medical Association, 281, 1318–25.Google Scholar
Garbutt, J. C., Kranzler, H. R., O'Malley, S. S.et al. (2005). Efficacy and tolerability of long-acting injectable naltrexone for alcohol dependence: a randomized controlled trial. Journal of the American Medical Association, 293, 1617–25.Google Scholar
Gastpar, M., Bonnet, U., Boning, J.et al. (2002). Lack of efficacy of naltrexone in the prevention of alcohol relapse: results from a German multicenter study. Journal of Clinical Psychopharmacology, 22, 592–8.Google Scholar
George, D. T., Rawlings, R., Eckardt, M. J., Phillips, M. J., Shoaf, S. E. & Linnoila, M. (1999). Buspirone treatment of alcoholism: age of onset, and cerebrospinal fluid 5-hydroxyindolacetic acid and homovanillic acid concentrations, but not medication treatment, predict return to drinking. Alcoholism: Clinical and Experimental Research, 23, 272–8.Google Scholar
Gerasimov, M. R., Schiffer, W. K., Gardner, E. L.et al. (2001). GABAergic blockade of cocaine-associated cue-induced increases in nucleus accumbens dopamine. European Journal of Pharmacology, 414, 205–9.Google Scholar
Gmel, G. & Rehm, J. (2003). Harmful Alcohol Use. http://www.niaaa.nih.gov/publications/arh 27–1/52–62.htm (accessed 8/13/04).
Gorelick, D. A. & Paredes, A. (1992). Effect of fluoxetine on alcohol consumption in male alcoholics. Alcoholism: Clinical and Experimental Research, 16, 261–5.Google Scholar
Gossop, M. & Carroll, K. M. (2006). Disulfiram, cocaine, and alcohol: two outcomes for the price of one? Alcohol and Alcoholism, 41(2), 119–20.Google Scholar
Grafenreed, K. M., Lobo, B., Sands, C. & Yates, M. (2004). Development of an alcohol withdrawal delirium prophylaxis protocol in a community teaching hospital. American Journal of Health System Pharmacy, 61, 1151–5.Google Scholar
Green, A. I., Tohen, M. F., Hamer, R. M.et al. (2004). First episode schizophrenia-related psychosis and substance use disorders: acute response to olanzapine and haloperidol. Schizophrenia Research, 66, 125–35.Google Scholar
Gryder, D. S. & Rogawski, M. A. (2003). Selective antagonism of GluR5 kainate-receptor-mediated synaptic currents by topiramate in rat basolateral amygdala neurons. Journal of Neuroscience, 23, 7069–74.Google Scholar
Guardia, J., Segura, L., Gonzalvo, B.et al. (2004). A double-blind, placebo-controlled study of olanzapine in the treatment of alcohol-dependence disorder. Alcoholism: Clinical and Experimental Research, 28, 736–45.Google Scholar
Gual, A. & Lehert, P. (2001). Acamprosate during and after acute alcohol withdrawal: a double-blind placebo-controlled study in Spain. Alcohol, 36, 413–18.Google Scholar
Guirguis, A. B. & Kenna, G. A. (2005). Treatment considerations for alcohol withdrawal syndrome. US Pharmacist, 30, 71–80.Google Scholar
Heinz, A. (2002). Dopaminergic dysfunction in alcoholism and schizophrenia-psychological and behavioral correlates. European Psychiatry, 17, 9–16.Google Scholar
Hernandez-Avila, C. A., Modesto-Lowe, V., Feinn, R. & Kranzler, H. R. (2004). Nefazodone treatment of comorbid alcohol dependence and major depression. Alcoholism: Clinical and Experimental Research, 28, 433–40.Google Scholar
Hillbom, M., Tokola, R., Kuusela, V.et al. (1989). Prevention of alcohol withdrawal seizures with carbamazepine and valproic acid. Alcohol, 6, 223–6.Google Scholar
Hillbom, M., Pieninkeroinen, I. & Leone, M. (2003). Seizures in alcohol-dependent patients: epidemiology, pathophysiology and management. CNS Drugs, 17, 1013–30.Google Scholar
Hodges, B. & Mazur, J. E. (2004). Intravenous ethanol for the treatment of alcohol withdrawal syndrome in critically ill patients. Pharmacotherapy, 24, 1578–85.Google Scholar
Holbrook, A. M, Crowther, R., Lotter, A., Cheng, C. & King, D. (1999). Meta-analysis of benzodiazepine use in the treatment of acute alcohol withdrawal. Journal of the Canadian Medical Association, 160, 649–55.Google Scholar
Horwitz, R. I., Gottlieb, L. D. & Kraus, M. L. (1989). The efficacy of atenolol in the outpatient management of the alcohol withdrawal syndrome. Results of a randomized clinical trial. Archives of Internal Medicine, 149, 1089–93.Google Scholar
Hotson, J. R. & Langston, J. W. (1976). Disulfiram-induced encephalopathy. Archives of Neurology, 33, 141–2.Google Scholar
Hutchison, K. E., Swift, R., Rohsenow, D. J.et al. (2001). Olanzapine reduces urge to drink after drinking cues and a priming dose of alcohol. Psychopharmacology, 155, 27–34.Google Scholar
Hutchison, K. E., Ray, L., Sandman, E.et al. (2006). The effect of olanzapine on craving and alcohol consumption. Neuropsychopharmacology, 31(6), 1310–17.Google Scholar
Jaffe, A. J., Rounsaville, B., Chang, G.et al. (1996). Naltrexone, relapse prevention and supportive therapy with alcoholics: an analysis of patient-treatment matching. Journal of Consulting and Clinical Psychology, 64, 1044–53.Google Scholar
Janiri, L., Gobbi, G., Mannelli, P., Pozzi, G., Serretti, A. & Tempesta, E. (1996). Effects of fluoxetine at antidepressant doses on short-term outcome of detoxified alcoholics. International Journal of Clinical Psychopharmacology, 11, 109–17.Google Scholar
Johnson, B. A. (2003). The role of serotonergic agents as treatments for alcoholism. Drugs Today, 39, 665–72.Google Scholar
Johnson, B. A. & Ait-Dowd, N. (2000). Neuropharmacological treatments for alcoholism: scientific basis and clinical findings. Psychopharmacology, 149, 327–44.Google Scholar
Johnson, B. A., Roache, J., Javors, M. A.et al. (2000). Ondansetron for reduction of drinking among biologically predisposed patients: a randomized controlled trial. Journal of the American Medical Association, 284, 963–71.Google Scholar
Johnson, B. A., Roache, J. D., Ait-Daoud, N., Zanca, N. A. & Velazquez, M. (2002). Ondansetron reduces the craving of biologically predisposed alcoholics. Psychopharmacology, 160, 408–13.Google Scholar
Johnson, B. A., O'Malley, S. S., Ciraulo, D. A.et al. (2003a). Dose-ranging kinetics and behavioral pharmacology of naltrexone and acamprosate, both alone and combined, in alcohol-dependent subjects. Journal of Clinical Psychopharmacology, 23, 281–93.Google Scholar
Johnson, B. A., Ait-Doud, N., Bowden, C. L.et al. (2003b). Oral topiramate for treatment of alcohol dependence: a randomised controlled trial. Lancet, 361, 1677–85.Google Scholar
Kabel, D. I. & Petty, F. (1996). A placebo-controlled, double-blind study of fluoxetine in severe alcohol dependence: adjunctive pharmacotherapy during and after inpatient treatment. Alcoholism: Clinical and Experimental Research, 20, 780–4.Google Scholar
Karan, R. S. & Pandhi, P. (2000). D2 and 5HT2 receptors: relevance to antipsychotic drugs. Indian Journal of Pharmacology, 32, 187–91.Google Scholar
Kiefer, F., Jahn, H., Tarnaske, T.et al. (2003). Comparing and combining naltrexone and acamprosate in relapse prevention of alcoholism: a double-blind, placebo-controlled study. Archives of General Psychiatry, 60, 92–9.Google Scholar
Kenna, G. A. (2003). Rationale for use of aripiprazole for alcohol dependence treatment. Drugs of the Future, 28, 1227–35.Google Scholar
Kiritze-Topor, P., Huas, D., Rosenzweig, C., Comte, S., Paille, F. & Lehert, P. (2004). A pragmatic trial of acamprosate in the treatment of alcohol dependence in primary care. Alcohol and Alcoholism, 39, 520–7.Google Scholar
Knee, S. T. & Razani, J. (1974). Acute organic brain syndrome: a complication of disulfiram therapy. American Journal of Psychiatry, 131, 1281–2.Google Scholar
Koob, G. F. & Moal, M. (2001). Drug addiction, dysregulation of reward, and allostasis, Neuropsychiatry, 24, 97–129.Google Scholar
Kosten, T. R. & O'Connor, P. G. (2003). Management of drug and alcohol withdrawal. New England Journal Medicine, 348, 1786–95.Google Scholar
Kozak, L. J, Hall, M. J & Owings, M. F. (2000). National Hospital Discharge Survey: 2000 annual summary with detailed diagnosis and procedure data. Vital Health Statistics, 153, 1–194.Google Scholar
Kraemer, K. L., Conigliaro, J. & Saitz, R. (1999). Managing alcohol withdrawal in the elderly. Drugs and Aging, 14, 409–25.Google Scholar
Kranzler, H. R. & Kirk, J. (2001). Efficacy of naltrexone and acamprosate for alcoholism treatment: a meta-analysis. Alcoholism: Clinical and Experimental Research, 25, 1335–41.Google Scholar
Kranzler, H. R., Burleson, J. A., Del Boca, F. K.et al. (1994). Buspirone treatment of anxious alcoholics. A placebo-controlled trial. Archives of General Psychiatry, 51, 720–31.Google Scholar
Kranzler, H. R., Burleson, J. A, Korner, P.et al. (1995). Placebo-controlled trial of fluoxetine as an adjunct to relapse prevention in alcoholics. American Journal of Psychiatry, 152, 391–7.Google Scholar
Kranzler, H. R., Burleson, J. A., Brown, J. & Babor, T. F. (1996). Fluoxetine treatment seems to reduce the beneficial effects of cognitive-behavioral therapy in type B alcoholics. Alcoholism: Clinical and Experimental Research, 20, 1534–41.Google Scholar
Kranzler, H. R., Modesto-Lowe, V. & Kirk, J. (2000). Naltrexone vs. nefazodone for treatment of alcohol dependence. A placebo-controlled trial. Neuropsychiatry, 22, 493–503.Google Scholar
Kranzler, H. R., Armeli, S., Tennen, H.et al. (2003). Targeted naltrexone for early problem drinkers. Journal of Clinical Psychopharmacology, 23, 294–304.Google Scholar
Kranzler, H. R., Wesson, D. R. & Billot, L. (2004). Naltrexone depot for treatment of alcohol dependence: a multicenter, randomized, placebo-controlled clinical trial. Alcoholism: Clinical and Experimental Research, 28, 1051–9.Google Scholar
Kranzler, H. R., Mueller, T., Cornelius, J.et al. (2006). Sertraline treatment of co-occurring alcohol dependence and major depression. Journal of Clinical Psychopharmacology, 26, 13–20.Google Scholar
Krystal, J. H., Cramer, J. A., Krol, W. F.et al. (2001). Veterans Affairs Naltrexone Cooperative Study 425 Group. Naltrexone in the treatment of alcohol dependence. New England Journal of Medicine, 345, 1734–9.Google Scholar
Larson, E. W., Olincy, A., Rummans, T. A. & Morse, R. M. (1992). Disulfiram treatment of patients with both alcohol dependence and other psychiatric disorders: a review. Alcoholism: Clinical and Experimental Research, 16, 125–30.Google Scholar
Lejoyeux, M., Solomon, J. & Ades, J. (1998). Benzodiazepine treatment for alcohol-dependent patients. Alcohol and Alcoholism, 33, 563–75.Google Scholar
LeMarquand, D., Pihl, R. O. & Benkelfat, C. (1994). Serotonin and alcohol intake, abuse, and dependence: clinical evidence. Biological Psychiatry, 36, 326–37.Google Scholar
Lidow, M. S. & Goldman-Rakic, P. S. (1997). Differential regulation of D2 and D4 dopamine receptors mRNAs in the primate cerebral cortex vs. neostriatum: effects of chronic treatment with typical and atypical antipsychotic drugs. Journal of Pharmacology and Experimental Therapeutics 283, 939–46.Google Scholar
Lingford-Hughes, A. R., Welch, S. & Nutt, D. J. (2004). Evidence-based guidelines for the pharmacological management of substance misuse, addiction and comorbidity: recommendations from the British Association for Psychopharmacology. Journal of Psychopharmacology, 18, 293–335.Google Scholar
Littleton, J. & Zieglgansberger, W. (2003). Pharmacological mechanisms of naltrexone and acamprosate in the prevention of relapse in alcohol dependence. American Journal on Addictions, 12 (Suppl. 1), S3–11.Google Scholar
Longo, L. P., Campbell, T. & Hubatch, S. (2002). Divalproex sodium (Depakote) for alcohol withdrawal and relapse prevention. Journal of Addictive Diseases, 21, 55–64.Google Scholar
Longoria, J., Brown, E. S., Perantie, D. C., Bobadilla, L. & Nejtek, V. A. (2004). Quetiapine for alcohol use and craving in bipolar disorder. Journal of Clinical Psychopharmacology, 24, 101–2.Google Scholar
Lovinger, D. (1997). Serotonin's role in alcohol's effects on the brain. Alcohol Health and Research World, 21, 114 –20.Google Scholar
Malcolm, R., Anton, R. F., Randall, C. L., Johnston, A., Brady, K. & Thevos, A. (1992). A placebo-controlled trial of buspirone in anxious inpatient alcoholics. Alcoholism: Clinical and Experimental Research, 16, 1007–13.Google Scholar
Malcolm, R, Ballenger, J. C., Sturgis, E. T. & Anton, R. (1989). Double-blind controlled trial comparing carbamazepine to oxazepam treatment of alcohol withdrawal. American Journal of Psychiatry, 146, 617–21.Google Scholar
Malcolm, R., Myrick, H., Brady, K. T. & Ballenger, J. C. (2001). Update on anticonvulsants for the treatment of alcohol withdrawal. American Journal on Addictions, 10 (Suppl.), 16–23.Google Scholar
Malcolm, R., Myrick, H., Roberts, J., Wang, W., Anton, R. F. & Ballenger, J. C. (2002a). The effects of carbamazepine and lorazepam on single versus multiple previous alcohol withdrawals in an outpatient randomized trial. Journal of General Internal Medicine, 17, 349–55.Google Scholar
Malcolm, R., Myrick, H., Roberts, J., Wang, W. & Anton, R. F. (2002b). The differential effects of medication on mood, sleep disturbance, and work ability in outpatient alcohol detoxification. American Journal on Addictions, 11, 141–50.Google Scholar
Malec, E., Malec, T., Gagne, M. A. & Dongier, M. (1996). Buspirone in the treatment of alcohol dependence: a placebo-controlled trial. Alcoholism: Clinical and Experimental Research, 20, 307–12.Google Scholar
Mann, K., Lehert, P. & Morgan, M. Y. (2004). The efficacy of acamprosate in the maintenance of abstinence in alcohol-dependent individuals: results of a meta-analysis. Alcoholism: Clinical Experimental Research, 28, 51–63.Google Scholar
Mark, T. L., Kranzler, H. R., Song, X., Bransberger, P., Poole, V. H. & Crosse, S. (2003a). Physicians' opinions about medications to treat alcoholism. Addiction, 98, 617–26.Google Scholar
Mark, T. L., Kranzler, H. R. & Song, X. (2003b). Understanding US addiction physicians' low rate of naltrexone prescription. Drug and Alcohol Dependence, 71, 219–28.Google Scholar
Mason, B. J. (2003). Acamprosate and naltrexone treatment for alcohol dependence: an evidence-based risk-benefits assessment. European Neuropsychopharmacology, 13, 469–75.Google Scholar
Mason, B. (2005). Individual patient data meta analysis of predictors of outcome including US and European studies in ‘Acamprosate: New preclinical and clinical findings’, Research Society on Alcoholism, Santa Barbara, CA. June 26.
Mason, B. J., Kocsis, J. H., Ritvo, E. C. & Cutler, R. B. (1996). A double-blind, placebo-controlled trial of desipramine for primary alcohol dependence stratified on the presence or absence of major depression. Journal of the American Medical Association, 275, 761–7.Google Scholar
Mason, B. J., Goodman, A. M., Dixon, R. M.et al. (2002). A pharmacokinetic and pharmacodynamic drug interaction study of acamprosate and naltrexone. Neuropsychopharmacology 27, 596–606.Google Scholar
Mason, B. J., Goodman, A. M., Chabac, S. & Lehert, P. (2006). Effect of oral acamprosate on abstinence in patients with alcohol dependence in a double-blind, placebo-controlled trial: the role of patient motivation. Journal of Psychiatric Research 40(5), 383–93.Google Scholar
Mayo-Smith, M. F. (1997). Pharmacological management of alcohol withdrawal. A meta-analysis and evidence-based practice guideline. American Society of Addiction Medicine Working Group on Pharmacological Management of Alcohol Withdrawal. Journal of the American Medical Association, 278, 144–151.Google Scholar
Mayo-Smith, M. F., Beecher, L. H., Fischer, T. L.et al. (2004). Management of alcohol withdrawal delirium. An evidence-based practice guideline. Archives of Internal Medicine, 164, 1405–12.Google Scholar
McCaul, M. E., Wand, G. S., Eissenberg, T., Rohde, C. A. & Cheskin, L. J. (2000). Naltrexone alters subjective and psychomotor responses to alcohol in heavy drinking subjects. Neuropsychopharmacology, 22, 480–92.Google Scholar
McDonough, M., Kennedy, N., Glasper, A. & Bearn, J. (2004). Clinical features and management of gamma-hydroxybutyrate (GHB) withdrawal: a review. Drug and Alcohol Dependence, 75, 3–9.Google Scholar
McGrath, P. J., Nunes, E. V., Stewart, J. W.et al. (1996). Imipramine treatment of alcoholics with primary depression: a placebo-controlled clinical trial. Archives of General Psychiatry, 53, 232–40.Google Scholar
Micromedix (2006a). Acamprosate http://healthcare.micromedex.com/mdxcgi/display.exe?CTL=/u01/mdx/mdxcgi/MEGAT.SYS&SET=80F0170C4116A485DB0D00&SYS=1&T=10&M=266655 accessed 11/18/06.
Micromedix (2006b). Disulfiram. http://healthcare.micromedex.com/mdxcgi/cgidict.exe?SRCHTERM=disulfiram&CTL=%2Fu01%2Fmdx%2Fmdxcgi%2FMEGAT.SYS accessed 11/18/06.
Micromedix (2006c). Naltrexone. http://healthcare.micromedex.com/mdxcgi/display.exe?CTL=/u01/mdx/mdxcgi/MEGAT.SYS &SET=80F0170C411680BA5AB380&SYS=1&T=1389&D=87 accessed 11.18.06.
Miller, W. R. & Wilbourne, P. L. (2002). Mesa Grande: a methodological analysis of clinical trials of treatments for alcohol use disorders. Addiction, 97, 265–77.Google Scholar
Moak, D. H., Anton, R. F., Latham, P. K., Voronin, K. E., Waid, R. L. & Durazo-Arvizu, R. (2003). Sertraline and cognitive behavioral therapy for depressed alcoholics: results of a placebo-controlled trial. Journal of Clinical Psychopharmacology, 23, 553–62.Google Scholar
Modell, J. G., Mountz, J. M., Glaser, F. B.et al. (1993). Effect of haloperidol on measures of craving and impaired control in alcoholic subjects. Alcoholism: Clinical and Experimental Research, 17, 234–40.Google Scholar
Moncrieff, J. & Drummond, D. C. (1997). New drug treatments for alcohol problems: a critical appraisal. Addiction, 92, 939–47.Google Scholar
Monnelly, E. P., Ciraulo, D. A., Knapp, C., LoCastro, J. & Sepulveda, I. (2004). Quetiapine for treatment of alcohol dependence. Journal of Clinical Psychopharmacology, 24, 532–5.Google Scholar
Monti, P. M., Rohsenow, D. J., Swift, R. M.et al. (2001). Naltrexone and cue exposure with coping and communication skills training for alcoholics: treatment process and 1-year outcomes. Alcoholism: Clinical and Experimental Research, 25, 1634–47.Google Scholar
Monti, P., Rohsenow, D., Hutchison, K. E.et al. (1999). Naltrexone's effect on cue-elicited craving among alcoholics in treatment. Alcoholism: Clinical and Experimental Research, 23, 1386–94.Google Scholar
Morgan, M. Y. (1995). The management of alcohol withdrawal using chlormethiazole. Alcohol and Alcoholism, 30, 771–4.Google Scholar
Mueller, T. I., Stout, R. L., Rudden, S.et al. (1997). A double-blind, placebo-controlled pilot study of carbamazepine for the treatment of alcohol dependence. Alcoholism: Clinical and Experimental Research, 21, 86–92.Google Scholar
Mueser, K. T., Noordsy, D. L., Fox, L. & Wolfe, R. (2003). Disulfiram treatment for alcoholism in severe mental illness. American Journal on Addictions, 12, 242–52.Google Scholar
Myers, R. D. & Martin, G. E. (1973). The role of cerebral serotonin in the ethanol preference of animals. Annals of the New York Academy of Sciences, 215, 135–44.Google Scholar
Myrick, H., Brady, K. T. & Malcolm, R (2000). Divalproex in the treatment of alcohol withdrawal. American Journal of Drug and Alcohol Abuse, 26, 155–60.Google Scholar
Myrick, H., Malcolm, R. & Brady, K. T. (1998). Gabapentin treatment of alcohol withdrawal. American Journal of Psychiatry, 155, 1632.Google Scholar
Namkoong, K., Lee, B. O., Lee, P. G., Choi, M. J. & Lee, E. (2003). Acamprosate in Korean alcohol-dependent patients: a multi-centre, randomized, double-blind, placebo-controlled study. Alcohol and Alcoholism, 38, 135–41.Google Scholar
Naranjo, C. A. & Bremner, K. E. (1994). Serotonin-altering medications and desire, consumption and effects of alcohol-treatment implications. EXS, 71, 209–19.Google Scholar
Naranjo, C. A., Bremner, K. E. & Lanctot, K. L. (1995). Effects of citalopram and a brief psycho-social intervention on alcohol intake, dependence and problems. Addiction, 90, 87–99.Google Scholar
National Institute on Alcohol Abuse and Alcoholism (2000). Tenth Special Report to the US Congress on Alcohol and Health, 2000, Washington, DC: US Department of Health and Human Services.
National Treatment Agency (NTA) for Substance Misuse (NTA) (2002). Models of care for treatment of adult drug misusers: framework for developing local systems of effective drug misuse treatment in England; Part 2: Full reference report. December 2002.
Nellissery, M., Feinn, R. S., Covault, J.et al. (2003). Alleles of a functional serotonin transporter promoter polymorphism are associated with major depression in alcoholics. Alcoholism: Clinical and Experimental Research, 27, 1402–8.Google Scholar
Nimmerrichter, A. A., Walter, H., Gutierrez-Lobos, K. E. & Lesch, O. M. (2002). Double-blind controlled trial of gamma-hydroxybutyrate and clomethiazole in the treatment of alcohol withdrawal. Alcohol and Alcoholism, 37, 67–73.Google Scholar
Nunes, E. V. & Levin, F. R. (2004). Treatment of depression in patients with alcohol or other drug dependence: a meta-analysis. Journal of the American Medical Association, 291, 1887–96.Google Scholar
Office of Applied Studies (2004). Results from the 2003 National Survey on Drug Use and Health: National Findings (DHHS Publication No. SMA 04–3964, NSDUH Series H–25). Rockville, MD: Substance Abuse and Mental Health Services Administration.
O'Malley, S., Jaffe, A. J., Chang, G.et al. (1992). Naltrexone and coping skills therapy for alcohol dependence. Archives of General Psychiatry, 49, 881–7.Google Scholar
Ortho-McNeil Pharmaceutical Inc. (2003). Topamax® package Insert. Raritan, NJ, Revised December.
Petrakis, I. L., Poling, J., Levinson, C., Nich, C., Carroll, K. & Rounsaville, B. (2005). Naltrexone and disulfiram in patients with alcohol dependence and comorbid psychiatric disorders. Biological Psychiatry, 57, 1128–37.Google Scholar
Pettinati, H. M. (1996). Use of serotonin selective pharmacotherapy in the treatment of alcohol dependence. Alcoholism: Clinical and Experimental Research, 20 (Suppl. 7), 23A–9A.Google Scholar
Pettinati, H. M. (2004). Antidepressant treatment of co-occurring depression and alcohol dependence. Biological Psychiatry, 56, 785–92.Google Scholar
Pettinati, H., Volpicelli, J., Kranzler, H.et al. (2000). Sertraline treatment for alcohol dependence. Interactive effects of medication and alcoholic subtype. Alcoholism: Clinical and Experimental Research, 24, 1041–9.Google Scholar
Pettinati, H. M., Dundon, W. & Lipkin, C. (2004). Gender differences in response to sertraline pharmacotherapy in Type A alcohol dependence. American Journal on Addictions, 13, 236–47.Google Scholar
Poldrugo, F. (1997). Acamprosate treatment in a long-term community-based alcohol rehabilitation programme. Addiction, 92, 1537–46.Google Scholar
Powell, B. J., Campbell, J. L., Landon, J. F.et al. (1995). A double-blind, placebo-controlled study of nortriptyline and bromo-criptine in male alcoholics subtyped by comorbid psychiatric disorders. Alcohol Clinical and Experimental Research, 19(2), 462–8.Google Scholar
Regier, D. A, Farmer, M. E, Rae, D. S.et al. (1990). Comorbidity of mental disorders with alcohol and other drug abuse, Journal of the American Medical Association, 264, 2511–18.Google Scholar
Reoux, J. P., Saxon, A. J., Malte, C. A., Baer, J. S. & Sloan, K. L. (2001). Divalproex sodium in alcohol withdrawal: a randomized double-blind placebo-controlled clinical trial. Alcoholism: Clinical and Experimental Research, 25, 1324–9.Google Scholar
Ritson, B. & Chick, J. (1986). Comparison of two benzodiazepines in the treatment of alcohol withdrawal: effects on symptoms and cognitive recovery. Drug and Alcohol Dependence, 18, 329–34.Google Scholar
Rohsenow, D. J. (2004). What place does naltrexone have in the treatment of alcoholism? CNS Drugs, 18, 547–60.Google Scholar
Roy-Byrne, P. P., Pages, K. P., Russo, J. E. (2000). Nefazodone treatment of major depression in alcohol-dependent patients: a double-blind, placebo-controlled trial. Journal of Clinical Psychopharmacology, 20, 129–36.Google Scholar
Royal College of Physicians (2001). Alcohol – can the NHS afford it? Recommendations for a coherent alcohol strategy for hospitals. A report of the Working Party of the Royal College of Physicians. London: Royal College of Physicians of London.
Roussaux, J. P., Hers, D. & Ferauge, M. (1996). Does acamprosate diminish the appetite for alcohol in weaned alcoholics? Journal de Pharmacie de Belgique, 51, 65–8.Google Scholar
Rubio, G., Jimenez-Arriero, M. A., Ponce, G. & Palomo, T. (2001). Naltrexone versus acamprosate: one year follow-up of alcohol dependence treatment. Alcohol and Alcoholism, 36, 419–25.Google Scholar
Rubio, G., Manzanares, J., Lopez-Munoz, F.et al. (2002). Naltrexone improves outcome of a controlled drinking program. Journal of Substance Abuse Treatment, 23, 361–6.Google Scholar
Rubio, G., Ponce, G., Rodriguez-Jimenez, R., Jimenez-Arriero, M. A., Hoenicka, J. & Palomo, T. (2005). Clinical predictors of response to naltrexone in alcoholic patients: who benefits most from treatment with naltrexone? Alcohol and Alcoholism, 40, 227–33.Google Scholar
Saitz, R., Mayo-Smith, M. F., Roberts, M. S., Redmond, H. A., Bernard, D. R. & Calkins, D. R. (1994). Individualized treatment for alcohol withdrawal: a randomized double-blind controlled trial. Journal of the American Medical Association, 272, 519–23.Google Scholar
Salloum, I. M., Cornelius, J. R., Daley, D. C., Kirisci, L., Himmelhoch, J. M. & Thase, M. E. (2005). Efficacy of valproate maintenance in patients with bipolar disorder and alcoholism: a double-blind placebo-controlled study. Archives of General Psychiatry, 62, 37–45.Google Scholar
Substance Abuse and Mental Health Services Administration (SAMHSA) (1997). National Treatment Improvement Evaluation Study. Center for Substance Abuse Treatment.
Sass, H., Soyka, M., Mann, K.et al. (1996). Relapse prevention by acamprosate. Results from a placebo controlled study on alcohol dependence. Archives of General Psychiatry, 53, 673–80.Google Scholar
Saxon, A. J., Sloan, K. L., Reoux, J. & Haver, V. M. (1998). Disulfiram use in patients with abnormal liver function test results. Journal of Clinical Psychiatry, 59, 313–16.Google Scholar
Schatzberg, A. F., Cole, J. O. & DeBattista, C. (2005). Manual of Clinical Psychopharmacology, 5th edn. New York: American Psychiatric Publishing, Inc.
Scottish Intercollegiate Guidelines Network (SIGN) (2003). The management of harmful drinking and alcohol dependence in primary care: a national clinical guideline. Edinburgh: Scottish Intercollegiate Guidelines Network, September.
Sellers, E. M., Zilm, D. H. & Degani, N. C. (1977). Comparative efficacy of propranolol and chlordiazepoxide in alcohol withdrawal. Journal of Studies on Alcohol, 38, 2096–108.Google Scholar
Sellers, E. M., Toneatto, T., Romach, M. K., Somer, G. R., Sobell, L. C. & Sobell, M. B. (1994). Clinical efficacy of the 5-HT3 antagonist ondansetron in alcohol abuse and dependence. Alcoholism: Clinical Experimental Research, 18, 879–85.Google Scholar
Slattery, J., Chick, J., Cochrane, M., et al. (2003). Prevention of relapse in alcohol dependence. Health Technology Assessment Report 3. Glasgow: Health Technology Board for Scotland.
Srisurapanont, M. & Jarusuraisin, N. (2003). Opioid antagonists for alcohol dependence. In The Cochrane Library. Chichester: John Wiley & Sons Ltd.
Stuppaeck, C. H., Pycha, R., Miller, C., Whitworth, A. B., Oberbauer, H. & Fleischhacker, W. W. (1992). Carbamazepine versus oxazepam in the treatment of alcohol withdrawal: a double-blind study. Alcohol and Alcoholism, 27, 153–8.Google Scholar
Sullivan, J. T., Sykora, K., Schneiderman, J., Naranjo, C. A. & Sellers, E. M. (1989). Assessment of alcohol withdrawal: the revised clinical institute withdrawal assessment for alcohol scale (CIWA-Ar). British Journal of Addiction, 84, 1353–7.Google Scholar
Sullivan, J. T, Swift, R. M. & Lewis, DC. (1991). Benzodiazepine requirements during alcohol withdrawal syndrome: clinical implications of using a standardized withdrawal scale. Journal of Clinical Psychopharmacology, 11, 291–5.Google Scholar
Swift, R. M. (2003). Topiramate for the treatment of alcohol dependence: initiating abstinence. Lancet, 361, 1666–7.Google Scholar
Thanos, P. K., Volkow, N. D., Freimuth, P.et al. (2001). Overexpression of dopamine D2 receptors reduces alcohol self-administration, Journal of Neurochemistry, 78, 1094–103.Google Scholar
Thomson, A. D. (2000). Mechanisms of vitamin deficiency in chronic alcohol misusers and the development of the Wernicke–Korsakoff Syndrome. Alcohol and Alcoholism, 35 (Suppl. 1), 2–7.Google Scholar
Tiihonen, J., Ryynanen, O. P., Kauhanen, J., Hakola, H. P. & Salaspuro, M. (1996). Citalopram in the treatment of alcoholism: a double-blind placebo-controlled study. Pharmacopsychiatry, 29, 27–9.Google Scholar
Tollefson, G. D., Montague-Clouse, J. & Tollefson, S. L. (1992). Treatment of comorbid generalized anxiety in a recently detoxified alcoholic population with a selective serotonergic drug (buspirone). Journal of Clinical Psychopharmacology, 12, 19–26.Google Scholar
Torrens, M., Fonseca, F., Mateu, G. & Farre, M. (2005). Efficacy of antidepressants in substance use disorders with and without comorbid depression. A systematic review and meta-analysis. Drug and Alcohol Dependence, 78, 1–22.Google Scholar
Trevisan, L. A., Boutros, N., Petrakas, I. L.et al. (1998). Complications of alcohol withdrawal: pathophysiologic insights. Alcohol Health and Research World, 22, 61–6.Google Scholar
Verheul, R., Lehert, P., Geerlings, P. J., Koeter, M. W. & Brink, W. (2005). Predictors of acamprosate efficacy: results from a pooled analysis of seven European trials including 1485 alcohol-dependent patients. Psychopharmacology, 178, 167–73.Google Scholar
Volpicelli, J. R., Alterman, A. I., Hayashida, M.et al. (1992). Naltrexone in the treatment of alcoholism. Results from a multicenter usage study. The Naltrexone Usage Study Group. Archives of General Psychiatry, 49, 876–80.Google Scholar
Volpicelli, J. R., Rhines, K. C., Rhines, J. S.et al. (1997). Naltrexone and alcohol dependence. Role of subject compliance. Archives of General Psychiatry, 54, 737–42.Google Scholar
Voris, J., Smith, N. L., Rao, S. M., Thorne, D. L. & Flowers, Q. J. (2003). Gabapentin for the treatment of ethanol withdrawal. Substance Abuse, 24, 129–32.Google Scholar
Warsi, M., Sattar, S. P., Bhatia, S. C. & Petty, F. (2005). Aripiprazole reduces alcohol use. Canadian Journal of Psychiatry, 50, 244.Google Scholar
Wetzel, H., Szegedi, A., Scheurich, A.et al. (2004). Combination treatment with nefazodone and cognitive-behavioral therapy for relapse prevention in alcohol-dependent men: a randomized controlled study. Journal of Clinical Psychiatry, 65, 1406–13.Google Scholar
White, H. S., Brown, S. D., Woodhead, J. H.et al. (2000). Topiramate modulates GABA-evoked currents in murine cortical neurons by nonbenzodiazepine mechanism. Epilepsia, 41(S 1), S25–9.Google Scholar
Whitworth, A. B., Fischer, F., Lesch, O. M.et al. (1996). Comparison of acamprosate and placebo in long-term treatment of alcohol dependence. Lancet, 347, 1438–42.Google Scholar
Willenbring, M. L., Kivlahan, D., Kenny, M., Grillo, M., Hagedorn, H. & Postier, A. (2004). Beliefs about evidence-based practices in addiction treatment: a survey of Veterans Administration program leaders. Journal of Substance Abuse Treatment, 26, 79–85.Google Scholar
Williams, D. & McBride, A. J. (1998). The drug treatment of alcohol withdrawal symptoms: a systematic review. Alcohol, 33, 103–15.Google Scholar
World Health Organization (1992). The ICD-10 Classification of Mental and Behavioural Disorders. Geneva: World Health Organization.
Wright, C., Vafier, J. A. & Lake, C. R. (1988). Disulfiram-induced fulminating hepatitis: guidelines for liver-panel monitoring. Journal of Clinical Psychiatry, 49, 430–4.Google Scholar
Wright, C., Moore, R. D., Grodin, D. M., Spyker, D. A. & Gill, E. V. (1993). Screening for disulfiram-induced liver test dysfunction in an inpatient alcoholism program. Alcoholism: Clinical and Experimental Research, 17, 184–6.Google Scholar
Zeise, M. L., Kasparov, S., Capogna, M. & Zieglgansberger, W. (1993). Acamprosate (calcium acetylhomotaurinate) decreases postsynaptic potentials in the rat neocortex: possible involvement of excitatory amino acid receptors. European Journal of Pharmacology, 26(231), 47–52.Google Scholar
Zullino, D. F., Khazaal, Y., Hattenschwiler, J., Borgeat, F. & Besson, J. (2004). Anticonvulsant drugs in the treatment of substance withdrawal. Drugs Today (Barc.), 40(7), 603–19.Google Scholar
Zwerling, C., Sprince, N. L., Wallace, R. B., Davis, C. S., Whitten, P. S. & Heeringa, S. G. (1996). Alcohol and occupational injuries among older workers. Accident Analysis and Prevention, 28, 371–6.Google Scholar

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