Research suggests that some medications may be more effective for certain types of alcoholics. For example, when ondansetron (Zofran®) was combined with psychotherapy, alcoholics who had begun drinking heavily before age 25 (i.e., early-onset alcoholics) decreased their alcohol consumption and increased their number of abstinent days, but later onset alcoholics did not (37). Sertraline (Zoloft®), in contrast, appears to reduce drinking in late-onset, but not early-onset, alcoholics (38). However, fluoxetine (Prozac®), a medication related to sertraline, has not been found to be effective in late-onset alcoholism (39).
In conclusion, research supports the concept of using medications as an adjunct to the psychosocial therapy of alcohol abuse and alcoholism. However, additional clinical trials are required to identify those patients most likely to benefit from such an approach, to determine the most appropriate medications for different patient types, to establish optimal dosages, and to develop strategies for enhancing patient compliance with medication regimens.