Prescribing antidepressants to treat alcohol use disorder can cause cravings: CMAJ
Global News
The advice is comprised of 15 recommendations on early detection of alcohol use disorder, withdrawal management, psychological interventions and community-based programs.
New guidance to help family doctors detect and manage high-risk drinking addresses a crucial gap in knowledge among both patients and doctors, say its authors, who warn that a common practice to prescribe antidepressants can actually induce cravings for alcohol.
The advice is comprised of 15 recommendations on early detection of alcohol use disorder, withdrawal management, psychological interventions and community-based programs.
It urges routine screening for alcohol use and includes tips on what to avoid, such as prescribing antidepressants without ruling out problematic alcohol use first because selective serotonin reuptake inhibitors (SSRIs) can worsen alcoholism symptoms.
“Unfortunately, all the literature is pretty clear that this is not good practice, whereas those medications that are specifically made for the treatment of alcohol use disorder are almost not used.”
Antipsychotic medications should also not be prescribed off-label to treat alcohol addiction and can exacerbate symptoms, Rehm said.
The guideline was published Monday in the Canadian Medical Association Journal, or CMAJ.
It was developed by the Canadian Research Initiative on Substance Misuse (CRISM) and the BC Centre on Substance Use (BCCSU), with input from a committee of 36 members across the country, including clinicians, academics and people who have experienced alcoholism or are struggling with it.
Rehm said committee members hope the guideline will be endorsed by medical associations across the country.
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