The treatment of alcoholism in France.

Despite a recent decline in per capita alcohol consumption, alcoholism remains a serious public health problem in France. Pharmacotherapy is used to make withdrawal from alcohol easier and to help maintain abstinence. The recent development of effective pharmacologic treatments for alcoholism has increased interest in this approach to therapy. To determine the most appropriate form of pharmacotherapy for treating alcohol dependence, a meta-analysis of randomized controlled studies published between 1960 and 1993 was performed. We found that several pharmacotherapeutic agents had demonstrated safety and efficacy on different periods of follow-up, including acamprosate (long term), naltrexone (intermediate term), fluoxetine and citalopram (short term). Studies of zimeldine, nialamide, L-dopa, viloxazine, and tetrabamate failed to demonstrate efficacy for these agents in the treatment of alcoholism. Results were ambiguous or mixed for lithium, phenytoin, bromocriptine, apomorphine, and buspirone. Continued research is needed to identify the most appropriate patients to receive treatment with specific forms of pharmacotherapy.