Which medication serves as a deterrent for alcohol use disorder?

Which medication serves as a deterrent for alcohol use disorder?

• A. Disulfiram
• B. Gabapentin
• C. Topiramate
• D. Naltrexone

Answer: (A)

Deterrent pharmacotherapy works by making drinking itself unpleasant, so the patient is discouraged from consuming alcohol. Disulfiram does exactly this: it inhibits aldehyde dehydrogenase, so if alcohol is ingested, acetaldehyde rapidly accumulates. That buildup triggers a cluster of unpleasant effects—facial flushing, tachycardia, flushing, sweating, nausea, vomiting, dizziness, and can include hypotension or chest tightness. The reaction is a learned signal that drinking will bring misery, which helps motivate abstinence, especially in someone who is adherent and motivated. This approach depends on taking the medication consistently and avoiding alcohol in any form, including hidden sources like cough syrups, mouthwash, or certain foods. Disulfiram isn’t a cure by itself; its effectiveness hinges on patient commitment and proper supervision, and it’s not suitable for everyone—particularly those with significant liver disease or other contraindications. Other medications listed don’t provide this aversive deterrent. Naltrexone blocks the rewarding effects of alcohol, helping reduce cravings and the likelihood of relapse. Gabapentin and topiramate can ease withdrawal symptoms and lower consumption, but they don’t induce the adverse reaction if alcohol is used.

Deterrent pharmacotherapy works by making drinking itself unpleasant, so the patient is discouraged from consuming alcohol. Disulfiram does exactly this: it inhibits aldehyde dehydrogenase, so if alcohol is ingested, acetaldehyde rapidly accumulates. That buildup triggers a cluster of unpleasant effects—facial flushing, tachycardia, flushing, sweating, nausea, vomiting, dizziness, and can include hypotension or chest tightness. The reaction is a learned signal that drinking will bring misery, which helps motivate abstinence, especially in someone who is adherent and motivated.

This approach depends on taking the medication consistently and avoiding alcohol in any form, including hidden sources like cough syrups, mouthwash, or certain foods. Disulfiram isn’t a cure by itself; its effectiveness hinges on patient commitment and proper supervision, and it’s not suitable for everyone—particularly those with significant liver disease or other contraindications.

Other medications listed don’t provide this aversive deterrent. Naltrexone blocks the rewarding effects of alcohol, helping reduce cravings and the likelihood of relapse. Gabapentin and topiramate can ease withdrawal symptoms and lower consumption, but they don’t induce the adverse reaction if alcohol is used.