Alcohol use disorder

Chronic disorder with loss of control over alcohol intake, withdrawal syndrome on cessation and continued use despite harm to health and social function.

ICD-10 F10.22 drugs

Also known as: Alcoholism, Alcohol dependence, Alcohol craving

Drugs used for this condition

BDisulfiramSecond line · Drug for alcohol use disorder, aldehyde dehydrogenase inhibitorDisulfiram is used in chronic alcohol use disorder as a second-line drug after naltrexone and acamprosate. Prescribed for motivated patients ready for full abstinence, usually combined with psychotherapy and a support group. SOCIDROGALCOHOL stresses mandatory patient education about the alcohol reaction and supervised dosing (often by a family member).

Marketing claims without evidence base

The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.

DL-threonine + pyridoxine (Biotredin)Not recommended · Combined metabolic preparations (local classification). Russian development.In Russia, Biotredin (L-threonine + pyridoxine) is registered in the state drug register (GRLS) for relief of alcohol withdrawal and reduction of alcohol craving as part of combination therapy. PubMed holds no clinical trials of this combination for that use; the supporting data are limited to a few uncontrolled, non-indexed observations. The EMA guideline on medicines for alcohol dependence and the Socidrogalcohol clinical guideline do not list threonine with pyridoxine among treatments with demonstrated efficacy, where the recognised options are naltrexone, acamprosate, nalmefene and disulfiram. A critical review of off-label and investigational drugs for alcohol use disorder (Fischler et al., 2022) likewise does not mention it. No harm has been documented at the registered doses, so the rating is D: benefit is unproven and current data show no net negative.

How to read tiers A–F

Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.

AStrong evidence – first or second line in international guidelines
BRecommended in selected cases
CStudy data contradict each other
DBenefit not proven, no documented harm
FDocumented harm, or risk without benefit