What medications can you take to stop drinking?
FDA-approved medications for alcohol use disorder include naltrexone, acamprosate, and disulfiram. Other medications may be discussed by clinicians in some situations, but medication choice depends on health history, goals, current drinking pattern, and clinical supervision.
If you have reached the point of asking what you could take to help you stop drinking, here is the most useful thing to know first: the FDA has approved three medications for alcohol use disorder — naltrexone, acamprosate, and disulfiram — and the evidence does not crown one of them the winner for everyone. They share a goal and a regulator's stamp, but they do genuinely different jobs. The better question is which trade-offs fit your health history, your goal, and your daily life, and that is a call to make with a clinician rather than a search results page.
The short version
- Naltrexone dampens the pleasant lift a drink gives, which is why it comes up both for stopping and for drinking less.
- Acamprosate is a stay-stopped medicine: it helps steady brain chemistry that can remain off-balance for months after you quit.
- Disulfiram makes drinking physically unpleasant — a deterrent, built for someone fully committed to not drinking at all.
- None of the three treats withdrawal, and each carries its own caution a clinician has to check before anything is prescribed.
Meet the three on equal footing
Each option below answers the same questions in the same order, so you can compare like with like. As one peer-reviewed overview of the three medications lays out, they act on entirely different systems in the body — three tools, three jobs.
Naltrexone
How it is thought to work. Alcohol triggers a release of endorphins, the brain's own feel-good chemicals. SAMHSA describes naltrexone as attaching to the receptors those endorphins would normally use and blocking them, which blunts the rewarding feel of alcohol and, in SAMHSA's account, reduces craving and the amount people drink.
What it is FDA-approved for. The FDA label on DailyMed lists naltrexone tablets as indicated for treating alcohol dependence — the older clinical name for alcohol use disorder.
How you take it. A daily oral tablet. A monthly injectable form also exists; naltrexone vs. Vivitrol walks through that split.
The key caution. Because it blocks opioid receptors, naltrexone cannot be combined with opioid pain medicines and is ruled out for anyone currently dependent on opioids. The same label is blunt on one more point: naltrexone has not been shown to help except as part of a broader plan for the drinking itself.
Acamprosate
How it is thought to work. Years of heavy drinking push the brain to rebalance itself around alcohol's constant "quiet down" signal. Take the alcohol away and the "go" side of that chemistry is left over-revved — part of why early sobriety can feel so restless. In the pharmacology literature, acamprosate is described as acting on that over-active system (glutamate, the brain's main excitatory messenger) to help it settle back toward normal.
What it is FDA-approved for. Maintaining abstinence in people who have already stopped drinking. It is a stay-stopped medicine, not a cut-down one.
How you take it. Oral tablets.
The key caution. Acamprosate leaves the body through the kidneys rather than the liver, so kidney function gets reviewed first. That same trait, though, is part of why it comes up for people whose liver is already strained by drinking.
Disulfiram
How it is thought to work. Your body breaks alcohol down in two steps, and the middle product — acetaldehyde — is harsh stuff. Per the Antabuse label, disulfiram blocks the second step, so drinking while on it makes acetaldehyde pile up: flushing, a throbbing head, nausea, a pounding chest. It is a tripwire you set for yourself, not a craving medicine.
What it is FDA-approved for. The label frames it as an aid for people who want to remain in what it calls "enforced sobriety" — and states plainly that it is not a cure.
How you take it. A daily oral tablet, started only after you have completely stopped drinking.
The key caution. The unpleasant reaction is the whole mechanism, so disulfiram demands total avoidance of alcohol — including the hidden kind in cooking sauces, mouthwash, and some liquid medicines — and a clear understanding, before you start, of what happens if you slip.
Side by side
| Naltrexone | Acamprosate | Disulfiram | |
|---|---|---|---|
| How it works, in a phrase | Blocks the receptors that carry alcohol's pleasant lift | Helps re-steady brain chemistry after quitting | Blocks alcohol's breakdown so drinking causes a reaction |
| FDA-approved for | Alcohol dependence | Staying abstinent after stopping | Supporting abstinence in people committed to not drinking |
| How it is taken | Daily tablet (monthly injection also exists) | Oral tablets | Daily tablet |
| If you drink on it | No built-in reaction; the drink is just less rewarding | No reaction | Flushing, nausea, pounding heart |
| Often discussed for | Cutting back or stopping | Staying stopped | A firm no-alcohol commitment |
Where the evidence is stronger — and where honesty means saying less
AHRQ's systematic review of outpatient medication treatment found moderate-strength evidence that oral naltrexone and acamprosate each help reduce a return to drinking, while the evidence for disulfiram against placebo was judged inadequate. The American Academy of Family Physicians draws a similar line, grouping naltrexone and acamprosate as the better-supported options and recommending that any of them be paired with counseling or other behavioral support rather than used alone.
That difference is worth knowing, but it is not a ranking. "Better studied" is not the same as "right for you," and disulfiram's deterrent logic matters to some people precisely because it does something the other two never attempt.
The question behind the question: cutting back, or stopping entirely?
This is the biggest practical fork, and it is worth settling before the medication conversation starts. Naltrexone is the one often discussed when the goal is drinking less, since nothing dramatic happens if you drink while taking it — the drink simply lands flatter. Acamprosate and disulfiram, on the other hand, both assume you have already stopped: one steadies the aftermath, the other guards the exit.
There is a safety layer under that fork. If you drink heavily every day, stopping abruptly can be dangerous on its own — and none of these three medications treats withdrawal. Shaking, sweating, or a racing heart when you go without alcohol is a sign to involve a clinician in how you stop, not just what you take afterward. Confusion, hallucinations, or a seizure during withdrawal is an emergency: call 911 or go to an emergency room.
What about the other names in your search results?
You may have run into topiramate or gabapentin. The AAFP review notes such off-label alternatives exist and can be reasonable in specific situations, but they sit a step further into individual clinical judgment — worth raising with a clinician, not worth deciding from a search page.
The scale of the underlying problem is larger than most people guess. NIAAA estimates that 27.9 million people ages 12 and older in the United States had past-year alcohol use disorder in 2024 — about 9.7% of that age group.
Yet NIAAA's treatment figures show only about 2.1 million of them — roughly 7.6% — received any alcohol-use treatment that year, and the AAFP notes most people with alcohol use disorder are never offered medication at all. That gap says nothing about whether the medicines work; it says the conversation rarely happens. Reading a comparison like this one already puts you ahead of it.
Questions worth bringing to a clinician
- Given my goal — cutting back or stopping — which of these is worth discussing first?
- Does anything in my history rule one out: opioid painkillers, kidney or liver concerns, past withdrawal symptoms?
- If I have not fully stopped yet, what is the safe way to get there before a stay-stopped medicine makes sense?
- What support goes alongside the prescription, and what do we try next if the first option is a poor fit?
If you are weighing all of this without a clinician to ask — the spot where many people quietly stall — Clero can connect you with a licensed clinician by telehealth to go through your history and which of these options, if any, is worth pursuing.
No winner, on purpose
Each of these three medications earns its place for a different reason: one turns down the reward, one steadies the recovery, one raises the cost of a slip. Each has real drawbacks, and none is the answer for everyone — the honest close is the same as the honest open. What decides it is your goal, your health history, and a clinician who knows both.
For more depth on each option, see naltrexone for alcohol, acamprosate (Campral), and disulfiram (Antabuse).
This article is general education, not medical advice or a prescribing guide; medication decisions belong with a licensed clinician who knows your history. If stopping drinking brings on confusion, hallucinations, or a seizure, call 911 or go to an emergency room; if you have thoughts of harming yourself, call or text 988; for confidential treatment referrals, SAMHSA's helpline is 1-800-662-HELP (4357).
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