Table 1.

Drugs approved or under investigation for the treatment of alcohol dependence, mechanisms of action, most common side effects, and possible liver toxicity.

Drug	Mechanism of action	Most common Side effects	Liver toxicity
Disulfiram	ADH inhibition	hypotension, flushing, nausea and vomiting.	hepatotoxicity and liver failure
Naltrexone	opioid receptor antagonist	Nausea	hepatotoxicity, in particular in patients with significant liver problems
Acamprosate	Glutamatergic antagonist and GABA agonist	Diarrhea	Contraindicated in Child C Cirrhosis
Gamma Hydroxybutyric Acid (GHB)	Alcohol mimetic with an endogenous receptor, GABA-B receptor agonist	anterograde amnesia, risk of abuse (GHB is a controlled substance in many countries)	Not reported
Topiramate	GABAA receptor agonist (non-BDZ site) glutamate receptors antagonist	Dizziness, sedation, Anorexia, metabolic acidosis, hyperammoniemia	Not reported
Baclofen	GABAB receptor agonist	sedation weakness	Not reported
Ondansetron	5-HT3 receptor antagonist	QT prolongation	Not reported
Metadoxine	increases the activity of acetaldehyde dehydrogenase	Reversible peripheral neuropathy	Not reported

ADH: acetaldehyde dehydrogenase; BDZ: benzodiazepine, 5-HT3: serotonin