Pharmacotherapy for Alcohol Craving Reduction: Efficacy of Short-Term Treatments in Alcohol Use Disorder - PubMed

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Alcohol Use Disorder (AUD) significantly contributes to global morbidity, mortality, and socioeconomic burden.
Cravings, intense urges to consume alcohol, are central to relapse and a DSM-5 diagnostic criterion.
Pharmacological strategies targeting cravings may offer short-term relief, complementing long-term approaches.
A systematic review of 26 RCTs evaluated short-term pharmacological treatments for cue-induced alcohol cravings.
Naltrexone consistently reduced cravings, especially when combined with ondansetron.
Varenicline and acamprosate also showed reductions in craving and drinking.
Memantine was effective for craving reduction, but its impact on abstinence was not assessed.
Topiramate was effective, while gabapentin showed limited short-term benefits.
Other agents like citalopram, oxytocin, ondansetron, and quetiapine had mixed results.
58% of trials reported positive anti-craving effects, 23% no difference, and 8% increased craving vs. placebo.
Methodological limitations included small sample sizes and heterogeneous experimental paradigms.
Naltrexone and varenicline are the most consistently supported short-term pharmacotherapies for alcohol craving.

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