Which medication is used for relapse prevention in alcohol dependence and can be started during withdrawal?

• A. Naltrexone
• B. Acamprosate
• C. Disulfiram
• D. Methadone

Answer: (A)

Acamprosate is used for relapse prevention in alcohol dependence and is suitable to start during withdrawal. It works by stabilizing glutamatergic neurotransmission that becomes dysregulated with prolonged drinking, which helps reduce protracted withdrawal symptoms and cravings as abstinence is maintained. Its safety profile allows initiation while detox is ongoing, making it a practical option to begin early in recovery and continue long-term to support sustained abstinence.

Naltrexone targets the rewarding effects of alcohol by blocking opioid receptors, which helps with relapse prevention, but it is generally started after detox to avoid issues during withdrawal and if there’s concern about opioids use. Disulfiram acts as an aversive deterrent and is typically started after detox when adherence can be ensured. Methadone is used for opioid dependence, not alcohol.