Pharmacotherapy for alcohol dependence
József Nagy
Gedeon Richter Plc., Budapest, Hungary
Suicidal Behavior in Alcohol and Drug Abuse and Dependence. Hauppauge, New York: Nova Science Publishers, 2010, 540 pages.
Alcohol use disorders represent an extensive public health problem all over the world affecting more than 2 billion alcohol users worldwide. According to the recent facts reported by the WHO, alcohol causes 1.8 million deaths (3.2% of total) and 58.3 million (4% of total) of Disability-Adjusted Life Years (DALYs) and estimated to cause about 20-30% of oesophageal or liver cancer, liver cirrhosis, epilepsy, accidents, homicide and suicide.
Given the harmful effects of alcohol on the concerned individuals as well as the society as a whole, there is an increasing urge for efficient therapies. Due to the extensive research on the machinery causal for the actions of ethanol in the central nervous system that has been ongoing for more than a century, by now there is increasing amount of information available about the mechanisms by which alcohol exerts its effects. In recent years, scientists discovered evidence that alcohol acts on several neurotransmitter systems in the brain to create its tempting effects. Besides altering the release of neurotransmitters like dopamine, ethanol alters the function of a number of neurotransmitter receptors and transporters as well. When ethanol is consumed in larger amounts and used for a longer period of time, changes in these specific neurotransmitter functions may occur possibly leading to the development of alcohol dependence. Therefore, modulators of these targets of ethanol can be used as pharmacotherapeutic approaches for the treatment of alcohol related disorders.
This chapter focuses on the pharmacotherapies used for the treatment of alcohol dependence and summarizes the pharmacologically most relevant targets and agents currently available or would be accessible in the near future.