Anti-craving agents for alcohol dependence are all, EXCEPT:
Correct Answer: Lorazepam
Description: Lorazepam is used for the management of acute intoxication of alcohol. It should be used with caution as it can worsen the vitals because of CNS depression. It is not used as an anti-craving agent. Other drugs in the choices are used for anti-craving. Good to know: Naltrexone is chemically related to the highly selective opioid-receptor antagonist naloxone but has higher oral bioavailability and a longer duration of action. Naltrexone helps to maintain abstinence by reducing the urge to drink and increasing control when a "slip" occurs. It is not a "cure" for alcoholism and does not prevent relapse in all patients. Naltrexone works best when used in conjunction with some form of psychosocial therapy, such as cognitive behavioral therapy. It typically is administered after detoxification and given at a dose of 50 mg/day for several months. Acamprosate is an analogue of GABA. A number of double-blind, placebo-controlled studies have demonstrated that acamprosate (1.3-2 g/day) decreases drinking frequency and reduces relapse drinking in abstinent alcoholics and appears to have efficacy similar to that of naltrexone. Acamprosate generally is well tolerated by patients, with diarrhea being the main side effect. Topiramate, a drug used for treating seizure disorders, appears useful for treating alcohol dependence. Compared with the placebo group, patients taking topiramate achieved more abstinent days and a lower craving for alcohol. Ref: Schuckit M.A. (2011). Chapter 23. Ethanol and Methanol. In L.L. Brunton, B.A. Chabner, B.C. Knollmann (Eds), Goodman & Gilman's The Pharmacological Basis of Therapeutics, 12e.
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