woman taking natrexone or antabuse for alcoholism

What is the Difference Between Naltrexone and Antabuse?

Use of pharmacotherapies along with psychological modalities to treat alcohol addiction has proven to be beneficial in preventing relapse.  Naltrexone and Antabuse (Disulfiram) are two drugs currently used to treat alcohol addiction.  A common question we receive is “which is better for treating alcohol addiction, Naltrexone or Antabuse”?  First thing to know is that these medications are quite different in their approach to treating alcohol addiction.

How Naltrexone works to treat alcoholism.

Naltrexone was originally developed to treat opioid addiction and can only be administered if the person is off all opioids.  The reason for this is because Naltrexone actually will push out any opioids in your system and cause precipitated withdrawals if taken too early.  This type of withdrawal although not usually fatal, is very uncomfortable and can last a few hours.  A person will experience considerable sweating, vomiting, bowel problems, irritability, and restlessness to name a few.  If you are not on any opioid’s Naltrexone can be administered immediately.  Naltrexone decreases the “reward” experienced in a person’s brain when they consume alcohol.  In addition, Naltrexone has been proven to reduce cravings and dependence on alcohol.  In many cases people use this drug to taper off or reduce the amount of alcohol they consume.

How Antabuse works to treat alcoholism.

Antabuse came into use during WW II for treating alcohol addiction and remains in the top two of choice to this day.  When taking Antabuse, a person will experience symptoms of sickness when they drink any kind of alcohol.  Many people describe the effects similar to a hangover.  The reason for this is that Antabuse blocks the metabolism of alcohol causing a build up of acetaldehyde.  The effects can be felt when a person drinks as soon as an hour of taking the medication.  It is important to know that Antabuse can remain in the system for up to two weeks.  Thus, even if you stop taking the pill or miss a day, you can experience hangover symptoms if you consume any alcohol during this time.  This type of treatment is meant for people who have already quit drinking or are planning to quit drinking completely.

Common side effects of Naltrexone include cramps, headaches, anxiety, nausea and fatigue.  Common side effects of Antabuse can include drowsiness, low energy, and headaches.  So, which is more beneficial to treating alcohol addiction?  Recent studies have Naltrexone and Antabuse equally effective in treating alcohol addiction.  Although these results do not really give a clear winner, one really needs to ask themselves what their goal is around drinking alcohol.  In my experience many people who are struggling with alcohol have already tried to limit their drinking or control and enjoy it with very little success.  Therefore, they realized that they needed to completely abstain from alcohol in order to obtain their desired goal in their alcohol addiction recovery.  Along with addiction counselling, an individualized alcohol rehab treatment plan, and the administration of Antabuse, many clients have been able to abstain from alcohol.  In turn, they have experienced an increase in overall well being, along with rebuilding their relationships with loved ones.  Although it always comes down to a personal choice, in our experience, we have found that those who have chosen Antabuse as an extra layer of protection against relapsing tend to have longer term sobriety.  No matter your choice of medication assisted treatment (MAT), it is recommended that a continued recovery plan be in place to assist you with this life style change.


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