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Can We Take Anti-craving Medication Along With Haloperidol And Neocalm For Alcohol Deaddiction?

Posted on Sat, 27 Jun 2015

Question: my dad taking medication since last 6 weeks for alcohol deaddiction because i motivated him to do so. he had violent behaviour after drinking. that has stopped now. and his drinking quantity also reduced. but he is still drinking regularly even if not in high quantity. medication currently he taking is

haloperidol 0.25mg reduced from 0.5mg

neocalm 25mg

fluoxetine 20mg

clonazepam at night probably 0.5mg

topamax 25mg

so shouldnt we use some anti craving medicine also. or anything you prefer to decrease his quantity in drinking or drinking less frequently.
is dose of topamax is fine or should be increased, if yes then what should be the dose.

or some other drug is more useful than topamax..please suggest dose also.

Answered by Dr. Chintan Solanki (38 minutes later)

Brief Answer:
lorazepam can help, topamax 50 mg will help more

Detailed Answer:
Hello XXXXXXX

Thanks for writing to us.

It is good that behaviour symptoms are controlled and quantity of drinking is reduced.

In my opinion he is taking enough medicines except benzodiazepine in daytime.Lorazepam in low dose at day time can reduce his craving. It acts same like alcohol on brain.Clonazepam at night is ok but I prefer lorazepam as benzo in people with alcohol use as it bypasses liver metabolism.

Specific aversion therapy in form of disufiram or acamprosate can be applied only after 7 days of abstinence from alchol.

If he has no psychotic symptoms like fearfullness, agitation or irrelavant talking no need of neocalm(trifuloperazine+ trihexyphenydyl).

Dose of topamax should be increased up to 50 mg.
Dose of fluoxetine and haloperidol is ok.

I hope that his treatment is going on under psychiatrist's supervision (or some deaddiction specialist).If not so, please consult psychiatrist.

In my opinion the best way to deaddict him is indoor hospital management for at least one week.

Discuss my view with treating doctor and move forward for deaddiction of your dad from alcohol use.

Hope I have answered your query, I will be happy to help further.

Regards,
Dr.Chintan Solanki.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Chintan Solanki (25 minutes later)

right now we have topamax 25mg tablets. so cant we give 2 tablets to make it 50 mg. if yes then how should we give. both at once or at different time?

Answered by Dr. Chintan Solanki (45 minutes later)

Brief Answer:
I prefer morning and evening/night dose

Detailed Answer:
Hi,

Thanks for follow up. Topamax can be given 50 mg at night or in divided dosage. I prefer twice a day 25 mg one in morning and one at evening/ night.
Inform his treating doctor about increasing dose.

Feel free to ask if any query is there.

Note: In case of any other concern or query related to prevention, evaluation, diagnosis, treatment, or the recovery of persons with the any type of addiction or substance use, follow up with our Addiction Medicine Specialist. Click here to book a consultation now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar