A Systematic Review of the Effectiveness of Acamprosate, Naltrexone, Disulfiram and Nalmefene for Reducing Alcohol Consumption and Maintaining Abstinence with Alcohol Dependence,Systematische Literaturübersicht der Wirksamkeit von Acamprosat, Naltrexon, Disulfiram und Nalmefen zur Trinkmengenreduktion und Aufrechterhaltung der Abstinenz bei Alkoholabhängigkeit

The aim of this review is the systematic presentation of relevant literature on the effectiveness of acamprosate, naltrexone, disulfiram and nalmefene for maintaining abstinence or reducing alcohol consumption in alcohol dependent patients. A systematic literature search identified a total of 27 studies which met all inclusion criteria (i.a. RCTs, at least 8 weeks treatment). Mostly indications for the effectiveness of nalmefene were found. Acamprosate was not (additionally) effective. Naltrexon showed an added benefit in combined interventions, but not for the majority of studies. Disulfiram was not effective in providing an additional benefit but was more effective compared to topiramate (anticonvulsive agent). These results differ from the prevailing research, which classifies acamprosate, naltrexone and nalmefene as predominantly effective and safe and disulfiram as moderately effective. Looking into the future, the need for medical interventions in the presence of alcohol-related problems should be considered, so that barriers can be removed and a wide range of treatment is created. Especially harm reduction should be taken into account as a treatment goal in reducing drinking.