Drugs Approved by the FDA to Treat Alcohol Dependence The toxic element in alcohol is ethanol (Nutt, 2006). The five major neurotransmitter systems in the brain that are affected by alcohol are the glutamate, gamma-amino-butyric acid (GABA), dopamine, serotonin, and opioid systems (Chastain, 2006; Prince & Turpin, 2008). Intoxication, memory impairment, reinforcement and addiction are some of the effects produced by the modification of neural functions by ethanol (Chastain, 2006). The pleasurable effects of alcohol are partly due to the increased central inhibition caused by the agonist effect that ethanol has on GABA-A as well as the antagonistic effect that ethanol has on NMDA glutamate receptors resulting in reduced central arousal (Nutt, 2006; Weaver, Jewell, & Tomlinson, 2009). Pleasurable effects may also be linked to interactions between alcohol and endogenous opioids, dopamine, and serotonin (Chastain, 2006; Nutt, 2006). The rewarding effects of alcohol can contribute to alcohol dependence. When alcohol is used frequently over a long period of time, inhibitory processes in the brain are reduced and excitatory processes are enhanced, and when alcohol is not present alcohol withdrawal symptoms may occur (Barrons & Roberts, 2010; Prince & Turpin, 2008; Weaver et al., 2009). Consuming alcohol can alleviate these symptoms which could also contribute to alcohol dependence. Furthermore, genetic, psychosocial, and environmental factors can contribute to whether or not an individual is at greater risk of developing alcohol dependence (Angelini & Brahmbhatt, 2007). Approximately 20% of hospital admissions are related to alcohol dependence (Barrons & Roberts, 2010; Muzyk, Leung, Nelson, Embury & Jones, 2013). The m...... half the paper ......l ingested by those who continue to drink while taking drugs (Angelini & Brahmbhatt, 2007; Lingford-Hughes et al., 2004). It is suggested that naltrexone may be more useful than acamprosate or disulfiram for those who are still drinking alcohol but have a desire to stop (Lingford-Hughes et al., 2004). Acamprosate can also continue to be used if someone starts drinking again as it has also been shown to reduce the amount of alcohol ingested (Lingford-Hughes et al., 2004). According to Lingford-Hughes et al. (2004), neither naltrexone nor acamprosate have proven to be more effective than the others in the treatment of alcohol dependence. There is no consistent evidence regarding which types of patients will respond best to acamprosate or naltrexone, so both should be considered equally as options for those wishing to abstain from alcohol (Lingford-Hughes et al., 2004).