Rainer Spanagel & Karl F. Mann 
Drugs for Relapse Prevention of Alcoholism 

Alcoholism is a pathological behavioural syndrome, characterised by comp- sive alcohol use, craving and relapses, even recurring after many years of abstinence. It is suggested that chronic alcohol abuse leads to persistent changes within several neurochemical pathways in the brain and furthermore that an imprinted drug and addiction memory may scarcely be extinguished. Hence, the question arises as to whether there ought to be a reasonable hope that pharmacological drugs will be developed that interfere with an addiction memory, and as a result, finally lead to a cure? In this book, leading preclinical and clinical experts in the field of alcohol relapse prevention strive to furnish an answer to this question. None of the researchers or clinicians believes in a magic bullet that will be of help to all alcoholic patients in overcoming this disease. However, there is now convi- ing evidence demonstrating that specific subpopulations of alcoholic patients experience satisfactory benefit from currently available treatments. Today we have two medications for relapse prevention on the market – acamprosate and naltrexone. Although, currently, only a minority of alcoholic patients benefit from these medications, the approval of these compounds may be considered a hallmark in the field of psychopharmacology, even comparable to the era when the first antidepressant compounds were introduced. In recent years we have been witnessing an enormous growth in the science and knowledge regarding the field of relapse prevention.

Table of Content

History of prevention of relapse.- How to measure relapse in animals.- How to measure relapse in humans.- Disulfiram (Antabuse®): the first medication to stop drinking.- Naltrexone: preclinical data.- Naltrexone: clinical data.- Acamprosate: preclinical data.- Acamprosate: clinical data.- Serotonergic compounds: preclinical data.- Serotonergic compounds: clinical data.- Opioidergic compounds: preclinical data.- Second generation opioidergic compounds: clinical data.- Dopaminergic compounds: preclinical data.- Dopaminergic compounds: clinical data.- Baclofen: preclinical data.- Baclofen: clinical data.- Cannabinoid receptor antagonists: a perspective.- Neuropeptide Y antagonists: a perspective.- Glutamatergic compounds: a perspective.- Future perspectives on relapse prevention.