[Alcoholism: relapse prevention].

Abstract

Prevention of alcoholism relapse implies an early detection of the problem (abuse or dependence). This can be achieved through clinical interview, biological evaluation, psychological assessment (i.e. "The Drinking Habits"--I. Pelc) or according to the "Alcoholism Decision Tree" (The Plinius Maior Society). In order to prevent alcoholism relapse, strategies to control the clinical symptoms related to the "Post-Detoxification Syndrome" have recently been highlighted. Further are discussed the benefit of various psychotherapeutic modalities as well as psychopharmacological interventions. According to a better knowledge of the neurochemical and neurobiological basis of alcoholism and craving, the contributions of specific psychopharmacological agents active on the dopaminergic, serotoninergic, glutamatergic systems as well as blocking of opiate receptors are discussed. Acamprosate, as a specific modulator of the glutamatergic system, recently marketed in Belgium, appears one of the most promising new pharmacological agent in relapse prevention when the patient benefits of psychosocial support.