Table 4.
Current FDA-approved pharmacological treatments for SUD
| SUD | Current Status | FDA-Approved Medication | Promising Targets | Reference Nos. |
|---|---|---|---|---|
| Opioids (OUD) | Mu opioid receptor (MOR) drugs with different properties have been approved by the FDA and are recommended as first-line interventions, supported by high-quality evidence. Despite their effectiveness, relapse rates are very high (50% within 6 mo). | Maintenance medications: buprenorphine (partial agonist), methadone (full agonist), naltrexone (antagonist). Reverse opioid overdoses: naloxone. Control opioid withdrawal: lofexidine. | 93, 134, 353 | |
| α-Adrenergic agonists for opioid withdrawal. | ||||
| Nicotine | There are FDA-approved pharmacotherapies for smoking cessation. Despite their effectiveness, relapse rates are very high (75% within 1 yr). | Nicotine replacement therapies: patches, oral and nasal sprays, inhalers, and lozenges. Bupropion, varenicline. | Nortriptyline, clonidine | 131, 265 |
| Alcohol (AUD) | There are three FDA-approved medications for the treatment of AUD, displaying different mechanisms of action. | Disulfiram is an ADH inhibitor that blocks the breakdown of alcohol leading to a buildup of acetaldehyde that results in unpleasant side effects. Naltrexone is a MOR and KOR antagonist that reduces the pleasure a person with AUD can experience while drinking. Acamprosate is an NMDA receptor function booster that appears to reduce or stop severe alcohol withdrawal symptoms during detoxification. | Anticonvulsants: gabapentin, topiramate, and pregabalin. Antipsychotics: quetiapine and aripiprazole. Antidepressants: duloxetine and venlafaxine. Others: baclofen, ondansetron, and nalmefene. | 4 |
| Stimulants | No FDA-approved medications | NMDAR antagonist ketamine, A2AR antagonists, 5-HT2CR agonist lorcaserin, N-acetylcysteine, D3R antagonists, cannabidiol | 14, 71, 163 | |
| Cannabis (CUD) | No FDA-approved medications | CB1R agonists, gabapentin, N-acetylcysteine, FAAH inhibitors | 132, 280 |
Current United States Food and Drug Administration (FDA)-approved pharmacological treatments for substance use disorder (SUD) and other promising medications chosen based on reproducible preclinical findings that interfered with drug consumption, prevented relapse, or inhibited craving and/or on pilot clinical studies showing positive results in interfering with subjective drug reward, drug consumption, reducing craving, or withdrawal.