Table 2 FDA-approved medications and other medications tested in clinical research settings (phase 2 or 3 medication trials) for the treatment of alcohol use disorder.

FDA, U.S. Food and Drug Administration; AMPA, α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid; NMDA, N-methyl-d-aspartate; PO, per os (oral); IM, intramuscular; HT, serotonin.

FDA-approved medications for alcohol use disorder
Daily total dosePharmacological mechanism(s) and additional
Acamprosate (PO)1998 mg per dayUnclear—it has been suggested that acamprosate is
a modulator of hyperactive glutamatergic states,
possibly as an NMDA receptor agonist
Disulfiram (PO)250–500 mg per dayInhibition of acetaldehyde dehydrogenase
Naltrexone (PO)50 mg per daym-opioid receptor antagonist
Naltrexone (IM)380 mg once a monthm-opioid receptor antagonist
Not FDA-approved medications tested for alcohol use disorder
Baclofen (PO)30–80 mg per dayGABAB receptor agonist
Approved in France by the National Agency for the
Safety of Medicines and Healthcare Products
Gabapentin (PO)900–1800 mg per dayUnclear—the most likely mechanism is blockade of
voltage-dependent Ca2+ channels. Although it is a
GABA analog, gabapentin does not seem to act on
the GABA receptors
Nalmefene (PO)18 mg per daym- and d-opioid receptor antagonist and k-opioid
receptor partial agonist
Approved in Europe by the European Medicines
Ondansetron (PO)0.5 mg per day (fixed dose) or up to
36 mcg/kg per day
5HT3 antagonist
Prazosin/doxazosin (PO)Up to 16 mg per daya-1 receptor antagonists
Topiramate (PO)Up to 300 mg per dayTopiramate is an anticonvulsant with multiple
targets. It increases GABAA-facilitated neuronal
activity and simultaneously antagonizes AMPA
and kainate glutamate receptors. It also inhibits
l-type calcium channels, limits the activity of
voltage-dependent sodium channels and
facilitates potassium conductance. Furthermore, it
is a weak inhibition of the carbonic anhydrase
isoenzymes, CA-II and CA-IV
Varenicline (PO)2 mg per dayNicotinic acetylcholine receptor partial agonist