What factors into your choice to use craving-related medications (e.g., baclofen, naltrexone, acamprosate, etc.) in the management of alcohol use disorder?

When I discuss starting medications of alcohol use disorder (MAUD), we discuss reducing alcohol cravings, thereby reducing overall intake with the ultimate goal of abstinence with adjunctive psychotherapy if necessary. The options currently available in the market are naltrexone oral and intramuscul...

I favor naltrexone over ease of use, especially if the patient has cravings. If the patient has anxiety that seems to be driving their alcohol use, I choose gabapentin 300 mg BID. If they don’t have anxiety or have a contraindication to naltrexone, I would go with acamprosate. If the patient doesn’t...