(Note: Studies assessed in this review typically included psychosocial cointerventions; effect sizes reflect the added benefits of medications beyond those of psychosocial cointerventions.)
| Medication | Outcome | N Studiesa | N Subjects | Finding | Effect Size (95% CI) | NNTb | SOE |
|---|---|---|---|---|---|---|---|
| Acamprosate vs. placebo | Return to any drinking | 16 | 4,847 | Reduced by acamprosate | RD: -0.09 (-0.14 to -0.04) | 12 |
 |
| Return to heavy drinking | 7 | 2,496 | No difference | RD: -0.01 (-0.04 to 0.03) | NA |
| |
| Percentage of drinking days | 13 | 4,485 | Reduced by acamprosate | WMD: -8.8 (-12.8 to -4.8) | NA |
| |
| Disulfiram vs. placebo | Return to any drinking | 2 | 492 | No difference | RD: -0.04 (-0.11 to 0.03) | NA |
 |
| Naltrexone 50 mg oral vs. placebo | Return to any drinking | 16 | 2,347 | Reduced by naltrexone | RD: -0.05 (-0.10 to -0.00) | 20 |
|
| Return to heavy drinking | 19 | 2,875 | Reduced by naltrexone | RD: -0.09 (-0.13 to -0.04) | 12 |
| |
| Percentage of drinking days | 15 | 1,992 | Reduced by naltrexone | WMD: -5.4 (-7.5 to -3.2) | NA |
| |
| Percentage of heavy drinking days | 6 | 521 | Reduced by naltrexone | WMD: -4.1 (-7.6 to -0.61) | NA |
| |
| Naltrexone injection vs. placebo | Return to any drinking | 2 | 939 | No difference | RD: -0.04 (-0.10 to 0.03) | NA |
|
| Return to heavy drinking | 2 | 615 | No difference | RD: -0.01 (-0.14 to 0.13) | NA |
| |
| Percentage of heavy drinking days | 2 | 926 | Reduced by naltrexone | WMD: -4.6 (-8.5 to -0.56) | NA |
| |
| Topiramatec vs. placebo | Percentage of drinking days | 2 | 521 | Reduced by topiramate | WMD: -8.5 (-15.9 to -1.1) | NA |
|
| Percentage of heavy drinking days | 2 | 521 | Reduced by topiramate | WMD: -11.5 (-18.3 to -4.8) | NA |
| |
| Number of drinks per drinking day | 2 | 521 | Reduced by topiramate | WMD: -1.1 (-1.7 to -0.4) | NA |
| |
| Other drugs c | The evidence is insufficient to determine the efficacy of other medications because of inconsistency, imprecision, or lack of sufficient studies in the literature (e.g., amitriptyline, aripiprazole, atomoxetine, baclofen, buspirone, citalopram, desipramine, fluoxetine, fluvoxamine, gabapentin, imipramine, olanzapine, ondansetron, paroxetine, quetiapine, varenicline, viloxazine). | ||||||
CI = confidence interval; N = number; NA = not applicable; NNT = number needed to treat; RD = risk difference; SOE = strength of evidence; WMD = weighted mean difference.
This column only includes studies rated as having a low or medium risk of bias that were included in the main analysis; these numbers do not include studies rated as having a high or unclear risk of bias that were included in sensitivity analyses.
In the NNT column, NA indicates that the risk difference (95-percent confidence interval) was not statistically significant and that an NNT was not calculated or that the effect measure was not one that allows direct calculation of an NNT (e.g., weighted mean difference).
Medications that have not been approved by the FDA for the treatment of alcohol dependence, alcohol abuse, or AUD.
From: Pharmacotherapy for Adults With Alcohol Use Disorder (AUD) in Outpatient Settings
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