Several medications have shown effectiveness in reducing cravings for drugs of abuse and treating substance abuse disorders. Anti-craving drugs are most commonly use in Opioid Use Disorder and Alcohol Use Disorder. [1]
Anti-craving drugs by the substances they counteract
Alcohol
Please note none of the medications listed below are suitable for treating alcohol withdrawal syndrome on their own.
- Naltrexone is FDA approved for alcohol use disorder. It reduces the euphoria caused by alcohol by blocking the opioid receptor. It may also reduce cravings by blocking the effects of dynorphin. Debate exist about if it is best to take every day, or only on drinking days. It has been shown to reduce the number of heavy drinking days and reduce cravings.
- Acamprosate is FDA approved for alcohol use disorder. It seems to reduce cravings in those abstaining from alcohol.
- Disulfiram/Antabuse is FDA approved for alcohol use disorder but is not a true anti-craving drug. It causes violent illness when drinking. It is less favored and is often not effective due to non-compliance.
- Gabapentin is used off label for alcohol use disorder. It may reduce withdrawal symptoms, anxiety and heavy drinking days.
- Baclofen is used off label for alcohol use disorder.
- Topiramate is used off label for alcohol use disorder. It may reduce withdrawal symptoms, anxiety and heavy drinking days. [2]
Opioids
- Buprenorphine
- Naltrexone
- Methadone[3]
- Levacetylmethadol
Stimulants
- Modafinil has been used to treat stimulant addiction but is not FDA approved. [1]
- Methylphenidate has been tried as a form of replacement therapy alone and in combination with Naltrexone. [2]