Academic journal article Alcoholism and Psychiatry Research

Past Research and Cognitions of Quetiapine Use in the Treatment of Alcohol Dependence

Academic journal article Alcoholism and Psychiatry Research

Past Research and Cognitions of Quetiapine Use in the Treatment of Alcohol Dependence

Article excerpt


Alcoholism is the most frequent addiction disease. It has appeared in all social and economic groups, in each age group and in both women and men. Research has shown that in countries such as Croatia, USAand England around 15% of women and 25% of men drank alcohol excessively, and alcoholism was diagnosed in 3-5% of women and 10% of men.1 The number of women dependent on alcohol is constantly increasing. In the last few years the ratio of men and women in Croatia has been 3.6:1. The monitoring of drinking habits among young persons from 1995 to 2005 has also shown an increase in drinking among adolescents. When it comes to the share of children who had drunk in the previous year, Croatia was below the European average thirteen years ago (the average was 80%, in Croatia 70%). However, in 2007 Croatia was above the European average (82%, Croatia 84%). 2 This fact is very disturbing since early use of alcohol carries the risk of adopting alcohol drinking as a habit, and those who started drinking earlier have higher chances to become alcoholics as the time passes. Around 30-45% of persons older than 18 have had at least once in their life a problem related to alcohol use, e.g. alcohol amnesia, difficulties at school or at the workplace, or traffic violations. The prevalence of drinking is highest between 21and 34 years of age. In the group of mental disorders and behavior disorders, mental disorders induced by alcohol accounted for 21.4% of all hospitalizations in working population (20-59 years of age) in 2009. 3 Sixty percent of all traffic accidents was caused by alcohol abuse. More than 50% of homicides and 25% of all suicides have been caused by alcohol. In the USA alcohol abuse causes around 100 000 deaths per annum. 4 Alcoholism represents a big public health problem which costs the USA around 185 billion dollars annually.5

A review of pharmacotherapy used in the treatment of alcoholism

Medicines which decrease the desire for alcohol are naltrexon and acamprosate.

Naltrexon is an opioid receptor antagonist which blocks the pleasure of drinking and makes the abstinence possible by cutting the reward cycle. Naltrexon has an aversive activity too, so if alcohol is taken after it, nausea and weakness can occur strengthening the alcohol intoxication. 2 There is also a depot preparation of this drug (Vivitrol), in the dosage of 380 mg, which is injected intramuscularly once a month. If we take into consideration past studies on Naltrexon, some are in favor of Naltrexon intake, while others stress the fact that there is no statistically significant difference between Naltrexon and the placebo.6

Acamprosate (Campral) is used in the treatment of alcoholism combined with other therapeutic programs. It is a derivate of taurine amino acid. It inhibits glutamate excretion and it activates type AGABAreceptors. 2,7 It must not be given to patients suffering from kidney insufficiency, pregnant women and nursing women. Besides supporting the patients' abstinence, some studies suggest that acamprosate protects neurons from damage and death caused by abstinence from alcohol.8

Disulfiram has been used in the alcoholism treatment since 1948. It inhibits the enzyme aldehyde dehydrogenase blocking the metabolism of acetaldehyde, primary metabolite of alcohol. If alcohol is taken after disulfiram, acetaldehyde starts accumulating in blood and unpleasant effects, such as face redness, heart beating, headache, suffocation, weakness, and vomiting occur, and in higher doses of alcohol hypertension, arrhythmia, loss of consciousness and even death. The reaction starts 10-30 minutes prior to drinking and lasts several hours. It is necessary to monitor the course of reaction, and in severe cases vitamin C or antihistaminic should be given intravenously. 2 In this way the patient is conditioned and creates and aversive relationship towards alcohol. Limitations when disulfiram is taken are the patient's compliance, the danger of aversive reactions and the fact that this medication does not decrease the craving for alcohol. …

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