Pharmacological means of reducing human drug dependence: a selective and narrative review of the clinical literature


  • Shih-Ku Lin

    Corresponding author
    1. Department of Psychiatry, Taipei City Hospital and Psychiatric Center, Taipei, Taiwan
    2. Department of Psychiatry, School of Medicine, Taipei Medical University, Taipei, Taiwan
    • Correspondence

      Dr Shih-Ku Lin MD, Department of Psychiatry, Taipei City Hospital and Psychiatric Centre, 309 SongDe Road, Taipei 110, Taiwan.

      Tel.: +8862 2726 3141

      Fax: +8862 2728 5059


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Substance abuse or addictive disorder is a global problem. A greater understanding of the associated changes in brain pathophysiology supports the notion that pharmacological treatments are part of the necessary treatment options. Craving is a core symptom of addictive disorder. It refers to a strong desire to use drugs again either to re-experience positive effects or to diminish negative experiences. Currently there are a number of medicines that are effective in the treatment of addictive disorders. These medications can either be for substitution (same pharmacological effect as the abused substance) or anticraving (decrease the craving of the abused substance). In this MEDLNE based review, specific compounds (naltrexone, acamprosate, topiramate, disulfiram, baclofen, N-acetylcysteine and bupropion) were selected that are known to diminish desire to use (anticraving effect) and that have been trialled for a number of different substance addictive disorders. Their therapeutic potential in clinical practice is discussed in light of their efficacy.