Gabapentin for Alcohol Use Disorder: A Promising Outlook

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Alexander Kantorovich, PharmD, BCPS
Alexander Kantorovich, PharmD, BCPS
Alexander Kantorovich, PharmD, BCPS, is a Clinical Assistant Professor of Pharmacy Practice at Chicago State University College of Pharmacy and Clinical Pharmacy Specialist in the area of Internal Medicine at Advocate Christ Medical Center in Oak Lawn, Illinois. Dr. Kantorovich earned his Associate of Science degree with an emphasis in chemistry from William Rainey Harper College in 2008 and received his Doctor of Pharmacy degree in 2012 from the University of Illinois at Chicago College of Pharmacy. He went on to complete a 2-year pharmacotherapy residency with an emphasis in cardiology and critical care at the Cleveland Clinic and earned board certification in pharmacotherapy in 2014. His research interests center around cardiovascular pharmacotherapy, anticoagulation, and anticoagulation reversal.
Gabapentin for Alcohol Use Disorder: A Promising Outlook
AUGUST 23, 2016
This article was collaboratively written with Festus Durugo, a fourth-year PharmD candidate at Chicago State University College of Pharmacy.

Alcohol use disorder (AUD) is characterized by a problematic pattern of alcohol use leading to clinically significant impairment or distress, manifested in multiple psychosocial, behavioral, or physiological features.1

Excessive alcohol use led to approximately 88,000 deaths and 2.5 million years of potential life lost annually in the United States between 2006 and 2010. In addition, 1 in 10 deaths among working adults 20 to 64 years were attributed to excessive alcohol use.2

Currently, there are 3 FDA-approved medications for AUD: naltrexone, acamprosate, and disulfiram.

Naltrexone is considered first-line AUD treatment, though its use is limited in patients taking opioids because it acts on mu-opioid receptor, and it’s contraindicated in hepatitis or liver failure.3 Naltrexone is particularly beneficial in those with genetic susceptibility.
Acamprosate enhances glutamate neurotransmission at the metabotropic-5 glutamate receptors. Lower doses are required in patients who weigh <60 kg and in renal impairment. Acamprosate hasn’t been proven effective in individuals who are heavy drinkers.
Disulfiram is a second-line agent that works by causing unpleasant physiologic reactions (eg, vomiting, sweating, headaches) when alcohol is consumed, thereby deterring motivation to drink.

For years, benzodiazepines have been the gold standard treatment for alcohol withdrawal due to their well-documented efficacy.4 Because of their abuse potential, drug interactions with alcohol, and significant cognitive and psychomotor side effects, however, there has been growing interest in alternative therapies for this indication.

http://www.pharmacytimes.com/contributor/alexander-kantorovich-pharmd-bcps/2016/08/gabapentin-for-alcohol-use-disorder-a-promising-outlook

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