Which medication is noted for being first-line in addressing alcohol use disorder?

Naltrexone is recognized as a first-line medication for addressing alcohol use disorder because it works by blocking the rewarding effects of alcohol, helping to reduce cravings and the likelihood of relapse. It is an opioid receptor antagonist that decreases alcohol consumption by inhibiting the release of dopamine in the brain that is typically stimulated by alcohol consumption, thus reducing the pleasure associated with drinking. This mechanism supports individuals in maintaining abstinence or reducing their alcohol intake effectively.

Naltrexone has been well-studied and demonstrated efficacy in several clinical trials, making it a preferred choice for many clinicians. It is often prescribed as part of a comprehensive treatment plan that includes behavioral therapies and support groups, reflecting an integrated approach to treatment. With a favorable safety profile and oral administration option, it is often chosen as an initial pharmacological therapy for patients with alcohol use disorder.

While other medications like acamprosate, disulfiram, and citalopram can also be utilized in the context of treating alcohol use disorder, they have different mechanisms of action and are generally used in specific situations or for patients who may not respond to or tolerate naltrexone. Acamprosate aids in maintaining abstinence, disulfiram discourages drinking by causing unpleasant reactions when alcohol