Acamprosate is the first new anticraving agent used prophylactically to prevent relapse in alcohol-dependent patients. This book presents an overview on basic mechanisms in alcohol dependence and craving and all the preclinical and clinical results are available to date on Acamprosate's mechanisms of action and efficacy.
Alcoholism is a pathological behavioural syndrome, characterised by comp- sive alcohol use, craving and relapses, even recurring after many years of abstinence. It is suggested that chronic alcohol abuse leads to persistent changes within several neurochemical pathways in the brain and furthermore that an imprinted drug and addiction memory may scarcely be extinguished. Hence, the question arises as to whether there ought to be a reasonable hope that pharmacological drugs will be developed that interfere with an addiction memory, and as a result, finally lead to a cure? In this book, leading preclinical and clinical experts in the field of alcohol relapse prevention strive to furnish an answer to this question. None of the researchers or clinicians believes in a magic bullet that will be of help to all alcoholic patients in overcoming this disease. However, there is now convi- ing evidence demonstrating that specific subpopulations of alcoholic patients experience satisfactory benefit from currently available treatments. Today we have two medications for relapse prevention on the market – acamprosate and naltrexone. Although, currently, only a minority of alcoholic patients benefit from these medications, the approval of these compounds may be considered a hallmark in the field of psychopharmacology, even comparable to the era when the first antidepressant compounds were introduced. In recent years we have been witnessing an enormous growth in the science and knowledge regarding the field of relapse prevention.
Alcohol use disorder (AUD) is a major public health problem in the United States. The estimated 12-month and lifetime prevalence values for AUD are 13.9% and 29.1%, respectively, with approximately half of individuals with lifetime AUD having a severe disorder. AUD and its sequelae also account for significant excess mortality and cost the United States more than $200 billion annually. Despite its high prevalence and numerous negative consequences, AUD remains undertreated. In fact, fewer than 1 in 10 individuals in the United States with a 12-month diagnosis of AUD receive any treatment. Nevertheless, effective and evidence-based interventions are available, and treatment is associated with reductions in the risk of relapse and AUD-associated mortality. The American Psychiatric Association Practice Guideline for the Pharmacological Treatment of Patients With Alcohol Use Disorder seeks to reduce these substantial psychosocial and public health consequences of AUD for millions of affected individuals. The guideline focuses specifically on evidence-based pharmacological treatments for AUD in outpatient settings and includes additional information on assessment and treatment planning, which are an integral part of using pharmacotherapy to treat AUD. In addition to reviewing the available evidence on the use of AUD pharmacotherapy, the guideline offers clear, concise, and actionable recommendation statements, each of which is given a rating that reflects the level of confidence that potential benefits of an intervention outweigh potential harms. The guideline provides guidance on implementing these recommendations into clinical practice, with the goal of improving quality of care and treatment outcomes of AUD.
About a decade ago, psychologists began exploring the commonalities among alcohol and drug abuse, smoking, and obesity. The term sub stance abuse evolved into the current concept of addictive behaviors, which recognizes similarities with other behaviors that do not involve consummatory responses (e. g. , pathological gambling, compulsions, sexual deviations). Professional societies and journals now have been founded in both Britain and the United States with the purpose of focus ing on research and treatment in the area of addictive behaviors. As the field has evolved, new models have emerged to address the questions and puzzles that face professionals. This volume examines some of these current issues and, in particular, explores common pro cesses of change that seem to cut across the addictive behaviors. The chapters are based on papers presented at the Third International Con ference on Treatment of Addictive Behaviors, which was held at North Berwick, Scotland, in August of 1984. The conference was organized around an integrative model of stages and processes of change that has been useful in organizing new knowledge about how to intervene with addictive behaviors. This model is set forth by its authors, Jim Prochaska and Carlo DiClemente, in Chapter 1. In Chapter 2, Fred Kanfer ex pounds his own model of self-regulation, which overlaps nicely with the Prochaska-DiClemente framework and provides a behavioral-theoretical context.
Written by the foremost authority in the field, this volume is a comprehensive review of the multifaceted phenomenon of hepatotoxicity. Dr. Zimmerman examines the interface between chemicals and the liver; the latest research in experimental hepatotoxicology; the hepatotoxic risks of household, industrial, and environmental chemicals; and the adverse effects of drugs on the liver. This thoroughly revised, updated Second Edition features a greatly expanded section on the wide variety of drugs that can cause liver injury. For quick reference, an appendix lists these medications and their associated hepatic injuries. Also included are in-depth discussions of drug metabolism and factors affecting susceptibility to liver injury.
This manual attempts to provide simple, adequate and evidence-based information to health care professionals in primary health care especially in low- and middle-income countries to be able to provide pharmacological treatment to persons with mental disorders. The manual contains basic principles of prescribing followed by chapters on medicines used in psychotic disorders; depressive disorders; bipolar disorders; generalized anxiety and sleep disorders; obsessive compulsive disorders and panic attacks; and alcohol and opioid dependence. The annexes provide information on evidence retrieval, assessment and synthesis and the peer view process.
This book provides a reference guide describing the current status of medication in all major psychiatric and neurological indications, together with comparisons of pharmacological treatment strategies in clinical settings in Europe, USA, Japan and China. In addition, it highlights herbal medicine as used in China and Japan, as well as complementary medicine and nutritional aspects. This novel approach offers international readers a global approach in a single dedicated publication and is also a valuable resource for anyone interested in comparing treatments for psychiatric disorders in three different cultural areas. There are three volumes devoted to Basic Principles and General Aspects, offering a general overview of psychopharmacotherapy (Vol. 1); Classes, Drugs and Special Aspects covering the role of psychotropic drugs in the field of psychiatry and neurology (Vol. 2) and Applied Psychopharmacotherapy focusing on applied psychopharmacotherapy (Vol. 3). These books are invaluable to psychiatrists, neurologists, neuroscientists, medical practitioners and clinical psychologists.
A fully revised and updated edition of this unique and authoritative reference The award-winning A Guide to Treatments that Work , published in 1998, was the first book to assemble the numerous advances in both clinical psychology and psychiatry into one accessible volume. It immediately established itself as an indispensable reference for all mental health practitioners. Now in a fully updated edition,A Guide to Treatments that Work, Second Edition brings together, once again, a distinguished group of psychiatrists and clinical psychologists to take stock of which treatments and interventions actually work, which don't, and what still remains beyond the scope of our current knowledge. The new edition has been extensively revised to take account of recent drug developments and advances in psychotherapeutic interventions. Incorporating a wealth of new information, these eminent researchers and clinicians thoroughly review all available outcome data and clinical trials and provide detailed specification of methods and procedures to ensure effective treatment for each major DSM-IV disorder. As an interdisciplinary work that integrates information from both clinical psychology and psychiatry, this new edition will continue to serve as an essential volume for practitioners of every kind: psychiatrists, psychologists, clinical social workers, counselors, and mental health consultants.
The Australian Guidelines for the Treatment of Alcohol Problems have been periodically developed over the past 25 years. In 1993, the first version of these guidelines, titled: ‘An outline for the management of alcohol problems: Quality assurance in the treatment of drug dependence project’ was published (Mattick & Jarvis 1993). The Australian Government commissioned an update a decade later (Shand et al. 2003) and a further edition in 2009 to integrate the Guidelines with the Australian Guidelines to Reduce Health Risks from Drinking Alcohol (National Health and Medical Research Council, NHMRC 2009; Haber et al., 2009). The present version of the Guidelines was also commissioned by the Commonwealth of Australia to remain current and integrated with the updated NHMRC consumption guidelines (2020). In order to ensure that guidelines remain relevant, the next set of guidelines should be updated in 2025, consistent with NHMRC recommendation that guidelines be updated every five years. These guidelines aim to provide up-to-date, evidence-based information to clinicians on available treatments for people with alcohol problems and are largely directed towards individual clinicians in practice, such as primary care physicians (general practitioners, nursing staff), specialist medical practitioners, psychologists and other counsellors, and other health professionals. Some chapters highlight service or system level issues that impact on clinicians and their patients. These include recommendations concerning Aboriginal and Torres Strait Islander peoples, culturally and linguistically diverse groups, stigma, and discrimination. Elsewhere, organisation capacity is implied, such as medical resources for withdrawal management where recommendations indicate use of medications. As all forms of treatment will not be readily available or suitable for all populations or settings, these guidelines may require interpretation and adaptation.
Alcohol and nicotine addiction mostly occur together. Over the last ten years therapeutic aspects and motivational strategies have been considerably improved. Hence, groups and subgroups have been defined and can be treated with specific medication and tailor-made psychotherapies, leading in the long term to considerably better and more effective results than the once broadly applied, rigorous abstinence -based therapies. However, alcohol and nicotine addiction still represent major medical and social problems. In this book, new therapeutic approaches are comprehensively described, outlining the different interactions between personality, environment and the effects of the substance. In addition to prevention-based therapies and diagnosis, essential psychological and sociological strategies, as well as medication-based therapies, are also presented in detail. All of these therapies have realistic aims and are of global validity. In addition, the book provides a broad overview of the American and European epidemiology of alcohol and nicotine addictions. The book is written for all those who care for and offer professional therapy for alcohol and nicotine-addicted patients.
