Table 2.
Therapeutic potential of selected alcohol metabolism modulators in AUD.
| Therapeutic | Mechanism | FDA-Approved? | PROS | CONS |
|---|---|---|---|---|
| Disulfiram | ALDH inhibitor | Yes | Improves alcohol avoidance | Off-target effects High levels of AcH |
| ANS-6637 | ALDH2 inhibitor | No | Decreases alcohol liking Specific and reversible inhibition |
ANS-6637 withdrawn due to liver toxicity |
| DCR-AUD (Dicerna) | ALDH2 mRNA inhibitor | No | Uses RNAi to specifically target ALDH2 | Still in clinical trial phase Only targets the liver |
| Isoflavones/Kudzu (puerarin, daidzin, daidzein) | ALDH inhibitor | Yes (puerarin–heart disease) |
Potential to utilize dietary intervention | Higher blood alcohol level |
| Alda-1 | ALDH2 activator | No | Enhances clearance of AcH and other toxic aldehydes | Could reverse protective effect of ADH1/ALDH2 polymorphisms on AUD |
| Fomepizole | ADH inhibitor | Yes (methanol/ ethylene glycol poisoning) |
Approved for use in ethylene glycol and methanol toxicity | Increase in ethanol concentration |
| Metadoxine | Increases alcohol clearance | No (approved in certain European countries) |
Decreases intoxication Potentially beneficial for treating ALD |
Mechanism not entirely clear |