Alcohol use disorder - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

Alcohol use disorder (AUD) is a problematic pattern of alcohol use leading to significant impairment or distress. Unhealthy alcohol use includes the spectrum of at-risk drinking and alcohol use disorders.
Unhealthy alcohol use is defined by more than 3 drinks per day or 7 per week for women and more than 4 drinks per day or 14 per week for men. To differentiate between at-risk drinking and alcohol use disorder, the DSM-5-TR criteria should be used.
Unhealthy alcohol use is underdiagnosed and undertreated.
Treatments should be driven by a patient's alcohol-related goals and the evidence behind them. Treatments include psychosocial therapies, medication, or both. Medications used include naltrexone, acamprosate, disulfiram, gabapentin, and topiramate.

Quick Reference

History & Exam
- Key Factors
- Other Factors
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Diagnostics Tests
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Treatment Options
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Definition

Epidemiology

Etiology

Pathophysiology

Images

Treatment overview
FRAMES method for brief intervention
Nonpharmacologic approaches can be useful for many patients with alcohol use disorder, as they provide strategies to help patients avoid returning to alcohol use, enhance self-efficacy, and reduce the impact of stressors that can precipitate return to use
Summary of medications, their mechanism of action, and the number needed to treat to reduce heavy drinking and to achieve abstinence

Citations

Key Articles

American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed., text revision (DSM-5-TR). Washington, DC: American Psychiatric Publishing; 2022.
Reus VI, Fochtmann LJ, Bukstein O, et al. The American Psychiatric Association practice guideline for the pharmacological treatment of patients with alcohol use disorder. Am J Psychiatry. 2018 Jan 1;175(1):86-90.[Abstract][Full Text]
Lingford-Hughes AR, Welch S, Peter L, et al. BAP updated guidelines: evidence-based guidelines for the pharmacological management of substance abuse, harmful use, addiction, and comorbidity: recommendations from BAP. J Psychopharmacol. 2012 Jul;26(7):899-952.[Abstract]
Anton RF, O'Malley SS, Ciraulo DA, et al. Combined pharmacotherapies and behavioral interventions for alcohol dependence: the COMBINE study: a randomized controlled trial. JAMA. 2006 May 3;295(17):2003-17.[Abstract][Full Text]

Other Online Resources

Clinical Institute Withdrawal Assessment of Alcohol Scale, revised (CIWA- Ar)
Alcoholics Anonymous
National Institute on Alcohol Abuse and Alcoholism (NIAAA)

Referenced Articles

1. National Institute on Alcohol Abuse and Alcoholism. Drinking levels defined [internet publication].[Full Text]
2. Kelly JF, Westerhoff CM. Does it matter how we refer to individuals with substance-related conditions? A randomized study of two commonly used terms. Int J Drug Policy. 2010 May;21(3):202-7.[Abstract]
3. American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed., text revision (DSM-5-TR). Washington, DC: American Psychiatric Publishing; 2022.
4. World Health Organization. International classification of diseases 11th revision (ICD-11). Jan 2022 [internet publication].[Full Text]
5. Allen JP. Use of biomarkers of heavy drinking in health care practice. Mil Med. 2003 May;168(5):364-7.[Abstract]
6. World Health Organization. Global status report on alcohol and health 2018. September 2018 [internet publication].[Full Text]
7. Grant BF, Goldstein RB, Saha TD, et al. Epidemiology of DSM-5 alcohol use disorder: results from the national epidemiologic survey on alcohol and related conditions III. JAMA Psychiatry. 2015 Aug;72(8):757-66.[Abstract][Full Text]
8. Kanny D, Naimi TS, Liu Y, et al. Annual total binge drinks consumed by US Adults, 2015. Am J Prev Med. 2018 Apr;54(4):486-96.[Abstract]
9. Spillane S, Shiels MS, Best AF, et al. Trends in alcohol-induced deaths in the United States, 2000-2016. JAMA Netw Open. 2020 Feb 5;3(2):e1921451.[Abstract][Full Text]
10. Pollard MS, Tucker JS, Green HD Jr. Changes in adult alcohol use and consequences during the COVID-19 pandemic in the US. JAMA Netw Open. 2020 Sep 1;3(9):e2022942.[Abstract][Full Text]
11. GBD 2016 Alcohol Collaborators. Alcohol use and burden for 195 countries and territories, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2018 Sep 22;392(10152):1015-35.[Abstract][Full Text]
12. Swift RM. Drug therapy for alcohol dependence. N Engl J Med. 1999 May 13;340(19):1482-90.[Abstract]
13. Addolorato G, Leggio L, Abenavoli L, et al. Neurobiochemical and clinical aspects of craving in alcohol addiction: a review. Addict Behav. 2005 Jul;30(6):1209-24.[Abstract]
14. Tawa EA, Hall SD, Lohoff FW. Overview of the genetics of alcohol use disorder. Alcohol Alcohol. 2016 Sep;51(5):507-14.[Abstract][Full Text]
15. Koob GF, Volkow ND. Neurobiology of addiction: a neurocircuitry analysis. Lancet Psychiatry. 2016 Aug;3(8):760-73.[Abstract]
16. Plunk AD, Syed-Mohammed H, Cavazos-Rehg P, et al. Alcohol consumption, heavy drinking, and mortality: rethinking the j-shaped curve. Alcohol Clin Exp Res. 2014 Feb;38(2):471-8.[Abstract]
17. Leggio L, Kenna GA, Swift RM. New developments for the pharmacological treatment of alcohol withdrawal syndrome: a focus on non-benzodiazepine GABAergic medications. Prog Neuropsychopharmacol Biol Psychiatry. 2008 Jul 1;32(5):1106-17.[Abstract]
18. Malcolm RJ. GABA systems, benzodiazepines, and substance dependence. J Clin Psychiatry. 2003;64(suppl 3):36-40.[Abstract]
19. Gordis E. Alcohol research: at the cutting edge. Arch Gen Psychiatry. 1996 Mar;53(3):199-201.[Abstract]
20. Cloninger CR, Bohman M, Sigvardsson S. Inheritance of alcohol abuse: cross-fostering analysis of adopted men. Arch Gen Psychiatry. 1981 Aug;38(8):861-8.[Abstract]
21. Babor TF, Dolinsky ZS, Meyer RE, et al. Types of alcoholics: concurrent and predictive validity of some common classification schemes. Br J Addict. 1992 Oct;87(10):1415-31.[Abstract]
22. Leggio L, Addolorato G. Serotonin transporter (SERT) brain density and neurobiological cloninger subtypes model: a lesson by human autoradiography studies. Alcohol Alcohol. 2008 Mar-Apr;43(2):148-50.[Abstract]
23. Poikolainen K. Risk factors for alcohol dependence: a case-control study. Alcohol Alcohol. 2000 Mar-Apr;35(2):190-6.[Abstract]
24. Ward RJ, McPherson AJS, Chow C, et al. Identification and characterization of alcohol-induced flushing in Caucasian subjects. Alcohol Alcohol. 1994 Jul;29(4):433-8.[Abstract]
25. Schuckit MA, Hesselbrock V, Tipp J, et al. A comparison of DSM-III-R, DSM-IV and ICD-10 substance use disorders diagnoses in 1922 men and women subjects in the COGA study. Addiction. 1994 Dec;89(12):1629-38.[Abstract]
26. Svensson PA, Anveden Å, Romeo S, et al. Alcohol consumption and alcohol problems after bariatric surgery in the Swedish obese subjects study. Obesity (Silver Spring). 2013 Dec;21(12):2444-51.[Abstract][Full Text]
27. Toomey TL, Wagenaar AC. Policy options for prevention: the case of alcohol. J Public Health Policy. 1999;20(2):192-213.[Abstract]
28. Anderson P, Chisholm D, Fuhr DC. Effectiveness and cost-effectiveness of policies and programmes to reduce the harm caused by alcohol. Lancet. 2009 Jun 27;373(9682):2234-46.[Abstract]
29. Smit E, Verdurmen J, Monshouwer K, et al. Family interventions and their effect on adolescent alcohol use in general populations; a meta-analysis of randomized controlled trials. Drug Alcohol Depend. 2008 Oct 1;97(3):195-206.[Abstract]
30. Donoghue K, Patton R, Phillips T, et al. The effectiveness of electronic screening and brief intervention for reducing levels of alcohol consumption: a systematic review and meta-analysis. J Med Internet Res. 2014 Jun 2;16(6):e142.[Abstract][Full Text]
31. Kypri K, Langley JD, Saunders JB, et al. Randomized controlled trial of web-based alcohol screening and brief intervention in primary care. Arch Intern Med. 2008 Mar 10;168(5):530-6.[Abstract]
32. Désy PM, Howard PK, Perhats C, et al. Alcohol screening, brief intervention, and referral to treatment conducted by emergency nurses: an impact evaluation. J Emerg Nurs. 2010 Nov;36(6):538-45.[Abstract]
33. Callon W, Beach MC, Saha S, et al. Assessing problematic substance use in HIV care: which questions elicit accurate patient disclosures? J Gen Intern Med. 2016 Oct;31(10):1141-7.[Abstract][Full Text]
34. Babor TF, Higgins-Biddle JC, Saunders JB, et al. The Alcohol Use Disorders Identification Test (AUDIT). Guidelines for use in primary care, second edition. Geneva: World Health Organization; 2001.[Full Text]
35. Agabio R, Nioi M, Serra C, et al. Alcohol use disorders in primary care patients in Cagliari, Italy. Alcohol Alcohol. 2006 May-Jun;41(3):341-4.[Abstract][Full Text]
36. Berner MM, Kriston L, Bentele M, et al. The alcohol use disorders identification test for detecting at-risk drinking: a systematic review and meta-analysis. J Stud Alcohol Drugs. 2007 May;68(3):461-73.[Abstract]
37. First MB, Spitzer RL, Gibbon M, et al. Structured clinical interview for DSM-IV axis I disorders, clinician version (SCID-CV). Washington, DC: American Psychiatric Press; 1996.[Full Text]
38. Sullivan JT, Swift RM, Lewis DC. Benzodiazepines requirements during alcohol withdrawal syndrome: clinical implications of using standardized withdrawal scale. J Clin Psychopharmacol. 1991 Oct;11(5):291-5.[Abstract]
39. Swift RM. Direct measurement of alcohol and its metabolites. Addiction. 2003 Dec;98(suppl 2):73-80.[Abstract]
40. Reus VI, Fochtmann LJ, Bukstein O, et al. The American Psychiatric Association practice guideline for the pharmacological treatment of patients with alcohol use disorder. Am J Psychiatry. 2018 Jan 1;175(1):86-90.[Abstract][Full Text]
41. Bilban M, Vrhovec S, Karlovsek MZ. Blood biomarkers of alcohol abuse. Arh Hig Rada Toksikol. 2003 Dec;54(4):253-9.[Abstract]
42. Tilg H, Day CP. Management strategies in alcoholic liver disease. Nat Clin Pract Gastroenterol Hepatol. 2007 Jan;4(1):24-34.[Abstract]
43. Stein MD, Friedmann PD. Disturbed sleep and its relationship to alcohol use. Subst Abus. 2005 Mar;26(1):1-13.[Abstract]
44. Arackal BS, Benegal V. Prevalence of sexual dysfunction in male subjects with alcohol dependence. Indian J Psychiatry. 2007 Apr;49(2):109-12.[Abstract][Full Text]
45. Grucza RA, Bierut LJ. Co-occurring risk factors for alcohol dependence and habitual smoking: update on findings from the Collaborative Study on the Genetics of Alcoholism. Alcohol Res Health. 2006;29(3):172-8.[Abstract]
46. US Preventive Services Task Force, Krist AH, Davidson KW, et al. Interventions for tobacco smoking cessation in adults, including pregnant persons: US Preventive Services Task Force recommendation statement. JAMA. 2021 Jan 19;325(3):265-79.[Abstract][Full Text]
47. Reding KW, Cain KC, Jarrett ME, et al. Relationship between patterns of alcohol consumption and gastrointestinal symptoms among patients with irritable bowel syndrome. Am J Gastroenterol. 2013 Feb;108(2):270-6.[Abstract][Full Text]
48. Chick J, Kemppainen E. Estimating alcohol consumption. Pancreatology. 2007;7(2-3):157-61.[Abstract]
49. Klatsky AL, Friedman GD, Armstrong MA. The relationships between alcoholic beverage use and other traits to blood pressure: a new Kaiser Permanente study. Circulation. 1986 Apr;73(4):628-36.[Abstract][Full Text]
50. Addolorato G, Capristo E, Greco AV, et al. Influence of chronic alcohol abuse on body weight and energy metabolism: is excess ethanol consumption a risk factor for obesity or malnutrition? J Intern Med. 1998 Nov;244(5):387-95.[Abstract][Full Text]
51. Addolorato G, Capristo E, Greco AV, et al. Three months of abstinence from alcohol normalizes energy expenditure and substrate oxidation in alcoholics: a longitudinal study. Am J Gastroenterol. 1998 Dec;93(12):2476-81.[Abstract]
52. Addolorato G, Leggio L, Ojetti V, et al. Effects of short-term moderate alcohol administration on oxidative stress and nutritional status in healthy males. Appetite. 2008 Jan;50(1):50-6.[Abstract]
53. Addolorato G, Capristo E, Leggio L, et al. Relationship between ghrelin levels, alcohol craving, and nutritional status in current alcoholic patients. Alcohol Clin Exp Res. 2006 Nov;30(11):1933-7.[Abstract]
54. Leggio L, Ferrulli A, Malandrino N, et al. Insulin but not insulin growth factor-1 correlates with craving in currently drinking alcohol-dependent patients. Alcohol Clin Exp Res. 2008 Mar;32(3):450-8.[Abstract]
55. Lingford-Hughes AR, Welch S, Peter L, et al. BAP updated guidelines: evidence-based guidelines for the pharmacological management of substance abuse, harmful use, addiction, and comorbidity: recommendations from BAP. J Psychopharmacol. 2012 Jul;26(7):899-952.[Abstract]
56. American College of Surgeons. Best practices guidelines: screening and intervention for mental health disorders and substance use and misuse in the acute trauma patient. Dec 2022 [internet publication].[Full Text]
57. US Preventive Services Task Force, Curry SJ, Krist AH, et al. Screening and behavioral counseling interventions to reduce unhealthy alcohol use in adolescents and adults: US Preventive Services Task Force recommendation statement. JAMA. 2018 Nov 13;320(18):1899-09.[Abstract][Full Text]
58. Seale JP, Johnson JA, Clark DC, et al. A Multisite Initiative to Increase the Use of Alcohol Screening and Brief Intervention Through Resident Training and Clinic Systems Changes. Acad Med. 2015 Dec;90(12):1707-12.[Abstract][Full Text]
59. Bush K, Kivlahan DR, McDonell MB, et al. The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Ambulatory Care Quality Improvement Project (ACQUIP). Alcohol Use Disorders Identification Test. Arch Intern Med. 1998 Sep 14;158(16):1789-95.[Abstract][Full Text]
60. National Institute for Health and Care Excellence. Alcohol-use disorders: diagnosis, assessment and management of harmful drinking and alcohol dependence. February 2011 [internet publication].[Full Text]
61. Ray LA, Meredith LR, Kiluk BD, et al. Combined pharmacotherapy and cognitive behavioral therapy for adults with alcohol or substance use disorders: a systematic review and meta-analysis. JAMA Netw Open. 2020 Jun 1;3(6):e208279.[Abstract][Full Text]
62. Kranzler HR, Soyka M. Diagnosis and pharmacotherapy of alcohol use disorder: a review. JAMA. 2018 Aug 28;320(8):815-24.[Abstract]
63. Sullivan JT, Sykora K, Schneiderman J, et al. Assessment of alcohol withdrawal: the revised Clinical Institute Withdrawal Assessment for Alcohol scale (CIWA-Ar). Br J Addiction. 1989;84:1353-1357.[Abstract]
64. Bertholet N, Daeppen JB, Wietlisbach V, et al. Reduction of alcohol consumption by brief alcohol intervention in primary care: systematic review and meta-analysis. Arch Intern Med. 2005 May 9;165(9):986-95.[Abstract][Full Text]
65. Álvarez-Bueno C, Rodríguez-Martín B, García-Ortiz L, et al. Effectiveness of brief interventions in primary health care settings to decrease alcohol consumption by adult non-dependent drinkers: a systematic review of systematic reviews. Prev Med. 2015 Jul;76(suppl):S33-8.[Abstract]
66. Field C, Walters S, Marti CN, et al. A multisite randomized controlled trial of brief intervention to reduce drinking in the trauma care setting: how brief is brief? Ann Surg. 2014 May;259(5):873-80.[Abstract][Full Text]
67. Kaner EF, Beyer FR, Muirhead C, et al. Effectiveness of brief alcohol interventions in primary care populations. Cochrane Database Syst Rev. 2018 Feb 24;(2):CD004148.[Abstract][Full Text]
68. Miller WR, Rollnick S. Motivational interviewing: preparing people to change addictive behavior. New York, NY: Guilford Press; 1991.
69. Wendt DC, Gone JP. Group therapy for substance use disorders: a survey of clinician practices. J Groups Addict Recover. 2017;12(4):243-59.[Abstract]
70. Powers MB, Vedel E, Emmelkamp PM. Behavioral couples therapy (BCT) for alcohol and drug use disorders: a meta-analysis. Clin Psychol Rev. 2008 Jul;28(6):952-62.[Abstract]
71. Swift R. Emerging approaches to managing alcohol dependence. Am J Health Syst Pharm. 2007 Mar 1;64(5 suppl 3):S12-22.[Abstract]
72. Agosti V, Nunes EV, O'Shea D. Do manualized psychosocial interventions help reduce relapse among alcohol-dependent adults treated with naltrexone or placebo? A meta-analysis. Am J Addict. 2012 Nov-Dec;21(6):501-7.[Abstract]
73. Kelly JF, Hoeppner B, Stout RL, et al. Determining the relative importance of the mechanisms of behavior change within Alcoholics Anonymous: a multiple mediator analysis. Addiction. 2012 Feb;107(2):289-99.[Abstract][Full Text]
74. Soyka M, Rösner S. Opioid antagonists for pharmacological treatment of alcohol dependence - a critical review. Curr Drug Abuse Rev. 2008 Nov;1(3):280-91.[Abstract]
75. Antonelli M, Ferrulli A, Sestito L, et al. Alcohol addiction - the safety of available approved treatment options. Expert Opin Drug Saf. 2018 Feb;17(2):169-77.[Abstract]
76. Ciraulo DA, Dong Q, Silverman BL, et al. Early treatment response in alcohol dependence with extended-release naltrexone. J Clin Psychiatry. 2008 Feb;69(2):190-5.[Abstract]
77. Lucey MR, Silverman BL, Illeperuma A, et al. Hepatic safety of once-monthly injectable extended-release naltrexone administered to actively drinking alcoholics. Alcohol Clin Exp Res. 2008 Mar;32(3):498-504.[Abstract]
78. Anton RF, O'Malley SS, Ciraulo DA, et al. Combined pharmacotherapies and behavioral interventions for alcohol dependence: the COMBINE study: a randomized controlled trial. JAMA. 2006 May 3;295(17):2003-17.[Abstract][Full Text]
79. Jonas DE, Amick HR, Feltner C, et al. Pharmacotherapy for adults with alcohol use disorders in outpatient settings: a systematic review and meta-analysis. JAMA. 2014 May 14;311(18):1889-900.[Abstract][Full Text]
80. Pettinati HM, Silverman BL, Battisti JJ, et al. Efficacy of extended-release naltrexone in patients with relatively higher severity of alcohol dependence. Alcohol Clin Exp Res. 2011 Oct;35(10):1804-11.[Abstract]
81. Anton RF, Latham P, Voronin K, et al. Efficacy of gabapentin for the treatment of alcohol use disorder in patients with alcohol withdrawal symptoms: a randomized clinical trial. JAMA Intern Med. 2020 May 1;180(5):728-36.[Abstract][Full Text]
82. Anton RF, Myrick H, Wright TM, et al. Gabapentin combined with naltrexone for the treatment of alcohol dependence. Am J Psychiatry. 2011 Jul;168(7):709-17.[Abstract][Full Text]
83. Johnson BA, Ait-Daoud N, Bowden CL, et al. Oral topiramate for treatment of alcohol dependence: a randomised controlled trial. Lancet. 2003 May 17;361(9370):1677-85.[Abstract]
84. Johnson BA, Rosenthal N, Capece JA, et al. Topiramate for treating alcohol dependence: a randomized controlled trial. JAMA. 2007 Oct 10;298(14):1641-51.[Abstract][Full Text]
85. Johnson BA, Rosenthal N, Capece JA, et al. Improvement of physical health and quality of life of alcohol-dependent individuals with topiramate treatment: US multisite randomized controlled trial. Arch Intern Med. 2008 Jun 9;168(11):1188-99.[Abstract]
86. Shinn AK, Greenfield SF. Topiramate in the treatment of substance-related disorders: a critical review of the literature. J Clin Psychiatry. 2010 May;71(5):634-48.[Abstract][Full Text]
87. Kenna GA, Lomastro TL, Schiesl A, et al. Review of topiramate: an antiepileptic for the treatment of alcohol dependence. Curr Drug Abuse Rev. 2009 May;2(2):135-42.[Abstract]
88. Arbaizar B, Diersen-Sotos T, Gómez-Acebo I, et al. Topiramate in the treatment of alcohol dependence: a meta-analysis. Actas Esp Psiquiatr. 2010 Jan-Feb;38(1):8-12.[Abstract][Full Text]
89. Swift RM. Topiramate for the treatment of alcohol dependence: initiating abstinence. Lancet. 2003 May 17;361(9370):1666-7.[Abstract]
90. Kranzler HR, Covault J, Feinn R, et al. Topiramate treatment for heavy drinkers: moderation by a GRIK1 polymorphism. Am J Psychiatry. 2014 Apr;171(4):445-52.[Abstract][Full Text]
91. Rösner S, Hackl-Herrwerth A, Leucht S, et al. Acamprosate for alcohol dependence. Cochrane Database Syst Rev. 2010 Sep 8;(9):CD004332.[Abstract][Full Text]
92. Mason BJ, Lehert P. Acamprosate for alcohol dependence: a sex-specific meta-analysis based on individual patient data. Alcohol Clin Exp Res. 2012 Mar;36(3):497-508.[Abstract][Full Text]
93. Skinner MD, Lahmek P, Pham H, et al. Disulfiram efficacy in the treatment of alcohol dependence: a meta-analysis. PLoS One. 2014;9(2):e87366.[Abstract][Full Text]
94. AshaRani PV, Karuvetil MZ, Brian TYW, et al. Prevalence and correlates of physical comorbidities in alcohol use disorder (AUD): a pilot study in treatment-seeking population. Int J Ment Health Addict. 2022 Jan 23;1-18.[Abstract][Full Text]
95. Saitz R, Cheng DM, Winter M, et al. Chronic care management for dependence on alcohol and other drugs: the AHEAD randomized trial.JAMA. 2013 Sep 18;310(11):1156-67.[Abstract][Full Text]
96. Ujhelyi Gomez K, Goodwin L, Jackson L, et al. Are psychosocial interventions effective in reducing alcohol consumption during pregnancy and motherhood? A systematic review and meta-analysis. Addiction. 2021 Jul;116(7):1638-63.[Abstract]
97. Smith EJ, Lui S, Terplan M. Pharmacologic interventions for pregnant women enrolled in alcohol treatment. Cochrane Database Syst Rev. 2009 Jul 8;(3):CD007361.[Abstract][Full Text]
98. Towers CV, Katz E, Weitz B, et al. Use of naltrexone in treating opioid use disorder in pregnancy. Am J Obstet Gynecol. 2020 Jan;222(1):83.e1-83.e8.[Abstract]
99. DeVido J, Bogunovic O, Weiss RD. Alcohol use disorders in pregnancy. Harv Rev Psychiatry. 2015 Mar-Apr;23(2):112-21.[Abstract]
100. Medicines and Healthcare products Regulatory Agency. Topiramate (Topamax): introduction of new safety measures, including a pregnancy prevention programme. Jun 2024 [internet publication].[Full Text]
101. Bjørk MH, Zoega H, Leinonen MK, et al. Association of prenatal exposure to antiseizure medication with risk of autism and intellectual disability. JAMA Neurol. 2022 Jul 1;79(7):672-81.[Abstract][Full Text]
102. European Medicines Agency. PRAC recommends new measures to avoid topiramate exposure in pregnancy. Sep 2023 [internet publication].[Full Text]
103. Tripodi SJ, Bender K, Litschge C, et al. Interventions for reducing adolescent alcohol abuse: a meta-analytic review. Arch Pediatr Adolesc Med. 2010 Jan;164(1):85-91.[Abstract][Full Text]
104. Engle B, Macgowan MJ. A critical review of adolescent substance abuse group treatments. J Evid Based Soc Work. 2009 Jul;6(3):217-43.[Abstract]
105. Clark DB. Pharmacotherapy for adolescent alcohol use disorder. CNS Drugs. 2012 Jul 1;26(7):559-69.[Abstract]
106. O'Malley SS, Carroll KM. Psychotherapeutic considerations in pharmacological trials: alcoholism, clinical and experimental research. Alcohol Clin Exp Res. 1996 Oct;20(7 suppl):17A-22A.[Abstract]
107. Pettinati HM, Volpicelli JR, Pierce JD, et al. Improving naltrexone response: an intervention for medical practitioners to enhance medication compliance in alcohol dependent patients. J Addict Dis. 2000;19(1):71-83.[Abstract]
108. Modesto-Lowe V, Barron GC, Aronow B, et al. Gabapentin for alcohol use disorder: a good option, or cause for concern? Cleve Clin J Med. 2019 Dec;86(12):815-23.[Abstract][Full Text]
109. Hobbs JD, Kushner MG, Lee SS, et al. Meta-analysis of supplemental treatment for depressive and anxiety disorders in patients being treated for alcohol dependence. Am J Addict. 2011 Jul-Aug;20(4):319-29.[Abstract][Full Text]
110. Pettinati HM, Volpicelli JR, Kranzler HR, et al. Sertraline treatment for alcohol dependence: interactive effects of medication and alcoholic subtype. Alcohol Clin Exp Res. 2000 Jul;24(7):1041-9.[Abstract]
111. Kranzler HR, Burleson JA, Brown J, et al. Fluoxetine treatment seems to reduce the beneficial effects of cognitive-behavioral therapy in type B alcoholics. Alcohol Clin Exp Res. 1996 Dec;20(9):1534-41.[Abstract]
112. Cornelius JR, Bukstein OG, Wood DS, et al. Double-blind placebo-controlled trial of fluoxetine in adolescents with comorbid major depression and an alcohol use disorder. Addict Behav. 2009 Oct;34(10):905-9.[Abstract][Full Text]
113. Heilig M, Egli M. Pharmacological treatment of alcohol dependence: target symptoms and target mechanisms. Pharmacol Ther. 2006 Sep;111(3):855-76.[Abstract]
114. Johnson BA, Roache JD, Javors MA, et al. Ondansetron for reduction of drinking among biologically predisposed alcoholic patients: a randomized controlled trial. JAMA. 2000 Aug 23-30;284(8):963-71.[Abstract][Full Text]
115. Addolorato G, Abenavoli L, Leggio L, et al. How many cravings? Pharmacological aspects of craving treatment in alcohol addiction: a review. Neuropsychobiology. 2005;51(2):59-66.[Abstract]
116. Johnson BA, Ait-Daoud N, Seneviratne C, et al. Pharmacogenetic approach at the serotonin transporter gene as a method of reducing the severity of alcohol drinking. Am J Psychiatry. 2011 Mar;168(3):265-75.[Abstract][Full Text]
117. Tait RJ, Christensen H. Internet-based interventions for young people with problematic substance use: a systematic review. Med J Aust. 2010 Jun 7;192(11 suppl):S15-21.[Abstract]
118. Carey KB, Scott-Sheldon LA, Elliott JC, et al. Computer-delivered interventions to reduce college student drinking: a meta-analysis. Addiction. 2009 Nov;104(11):1807-19.[Abstract][Full Text]
119. Gainsbury S, Blaszczynski A. A systematic review of internet-based therapy for the treatment of addictions. Clin Psychol Rev. 2011 Apr;31(3):490-8.[Abstract]
120. Carey KB, Scott-Sheldon LA, Elliott JC, et al. Face-to-face versus computer-delivered alcohol interventions for college drinkers: a meta-analytic review, 1998 to 2010. Clin Psychol Rev. 2012 Dec;32(8):690-703.[Abstract][Full Text]
121. Bingham CR, Barretto AI, Walton MA, et al. Efficacy of a web-based, tailored, alcohol prevention/intervention program for college students: initial findings. J Am Coll Health. 2010 Jan-Feb;58(4):349-56.[Abstract]
122. Carey KB, Carey MP, Henson JM, et al. Brief alcohol interventions for mandated college students: comparison of face-to-face counseling and computer-delivered interventions. Addiction. 2011 Mar;106(3):528-37.[Abstract][Full Text]
123. World Health Organization. Global strategy to reduce the harmful use of alcohol. May 2010 [internet publication].[Full Text]
124. Grant BF. Prevalence and correlates of alcohol use and DSM-IV alcohol dependence in the United States: results of the National Longitudinal Alcohol Epidemiological Survey. J Stud Alcohol. 1997 Sep;58(5):464-73.[Abstract]
125. Finney JW, Hahn AC, Moos RH. The effectiveness of inpatient and outpatient treatment for alcohol abuse: the need to focus on mediators and moderators of setting effects. Addiction. 1996 Dec;91(12):1773-96.[Abstract]
126. Williams SH. Medications for treating alcohol dependence. Am Fam Physician. 2005 Nov 1;72(9):1775-80.[Abstract][Full Text]
127. Mayo-Smith MF, Beecher LH, Fischer TL, et al. Management of alcohol withdrawal delirium: an evidence-based practice guideline. Arch Intern Med. 2004 Jul 12;164(13):1405-12.[Abstract][Full Text]
128. Rathlev NK, Ulrich AS, Delanty N, et al. Alcohol-related seizures. J Emerg Med. 2006 Aug;31(2):157-63.[Abstract]
129. Shield KD, Parry C, Rehm J. Chronic diseases and conditions related to alcohol use. Alcohol Res. 2013;35(2):155-73.[Abstract]
130. Agabio R. Thiamine administration in alcohol-dependent patients. Alcohol Alcohol. 2005 Mar-Apr;40(2):155-6.[Abstract]
131. Thomson AD. Mechanisms of vitamin deficiency in chronic alcohol misusers and development of the Wernicke-Korsakoff syndrome. Alcohol Alcohol Suppl. 2000 May-Jun;35(1):2-7.[Abstract]
132. Dwivedi M, Misra SP. Mallory-Weiss syndrome: clinical features and management. J Assoc Physicians India. 1999 Apr;47(4):397-9.[Abstract]
133. Zhang X, Li SY, Brown RA, et al. Ethanol and acetaldehyde in alcoholic cardiomyopathy: from bad to ugly en route to oxidative stress. Alcohol. 2004 Apr;32(3):175-86.[Abstract]
134. Topiwala A, Allan CL, Valkanova V, et al. Moderate alcohol consumption as risk factor for adverse brain outcomes and cognitive decline: longitudinal cohort study. BMJ. 2017 Jun 6;357:j2353.[Abstract][Full Text]
135. Kobayashi M, Pilishvili T, Farrar JL, et al. Pneumococcal vaccine for adults aged ≥19 years: recommendations of the Advisory Committee on Immunization Practices, United States, 2023. MMWR Recomm Rep 2023;72(No. RR-3):1-39.[Full Text]