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Selincro (nalmefene)

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Nalmefene is prescribed for use as-needed for people who want to decrease their drinking without necessarily abstaining completely. One pill is taken one to two hours before the first drink. 

The research is limited as to the effectiveness of nalmefene, particularly in comparison to other medications for the treatment of alcohol use disorders (AUDs). It is, however, the first medication to be developed and marketed specifically for AUDs in thirteen years. 

It has been found to be most effective for very heavy drinkers to help them reduce their alcohol intake and the number of heavy drinking days.

"It is hypothesized that the blockade of opioid receptors interferes with the reinforcing effects of alcohol, in turn reducing alcohol cravings." 2

"The appraisal committee concluded that nalmefene in conjunction with psychosocial support was a cost effective use of NHS resources compared with psychosocial support alone for treating people with alcohol dependence drinking at a high risk level, without physical withdrawal symptoms and not requiring immedicate assisted withdrawal from alcohol"3

  • Nalmefene is non-addictive
  • It can be taken while the patient is still drinking and is meant to be taken 1-2 hours before drinking.
  • There is "evidence for the long-term safety and efficacy of nalmefene as-needed in alcohol-dependent patients who continue to drink heavily, following a brief intervention."4
  • Side effects are reportedly mild and tolerable. 

This information has been taken from the book A Prescription for Alcoholics - Medications for Alcoholism by Linda Burlison, Kindle Locations 7644-11720 and pages 379-400 in the book. A much more comprehensive understanding can be found there. It can be purchased at: http://www.amazon.com/gp/product/B01A1E8YKW?keywords=a%20prescription%20for%20alcoholics&qid=1458427110&ref_=sr_1_1&sr=8-1

Website: http://www.aprescriptionforalcoholics.com/

1. van den Brink W, Sørensen P, Torup L, Mann K, Gual A. Long-term efficacy, tolerability and safety of nalmefene as-needed in patients with alcohol dependence: A 1-year, randomised controlled study. J Psychopharmacol. 2014. doi: 10.1177/ 0269881114527362.

2. Wackernah RC, Minnick MJ, Clapp P. Alcohol use disorder: pathophysiology, effects, and pharmacologic options for treatment. Subst Abuse Rehabil. 2014;5: 1-12. doi: 10.2147/ SAR.S37907.

3. van den Brink W, Sørensen P, Torup L, Mann K, Gual A. Long-term efficacy, tolerability and safety of nalmefene as-needed in patients with alcohol dependence: A 1-year, randomised controlled study. J Psychopharmacol. 2014. doi: 10.1177/ 0269881114527362.

4. van den Brink W, Strang J, Gual A, Sørensen P, Jensen TJ, Mann K. Safety and tolerability of as-needed nalmefene in the treatment of alcohol dependence: results from the Phase III clinical programme. Expert Opin Drug Saf. 2015;14( 4): 495-504. doi: 10.1517/ 14740338.2015.1011619.

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