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This article aims to synthesize the GPR<\/jats:styled-content>s focused on the pharmacotherapy of alcohol dependence.<\/jats:p><\/jats:sec>Methods<\/jats:title>A four\u2010member European steering committee defined the questions that were addressed to an 18\u2010member multiprofessional working group (WG<\/jats:styled-content>). The WG<\/jats:styled-content> developed the GPR<\/jats:styled-content>s based on a systematic, hierarchical, and structured literature search and submitted the document to two review processes involving 37 French members from multiple disciplines and 5 non\u2010French EUFAS<\/jats:styled-content> members. The final GPR<\/jats:styled-content>s were graded A, B, or C, or expert consensus (EC<\/jats:styled-content>) using a reference recommendation grading system.<\/jats:p><\/jats:sec>Results<\/jats:title>The treatment of alcohol dependence consists of either alcohol detoxification or abstinence maintenance programs or drinking reduction programs. The therapeutic objective is the result of a decision made jointly by the physician and the patient.<\/jats:p>For alcohol detoxification, benzodiazepines (BZD<\/jats:styled-content>s) are recommended in first\u2010line (grade A). BZD<\/jats:styled-content> dosing should be guided by regular clinical monitoring (grade B). Residential detoxification is more appropriate for patients with a history of seizures, delirium tremens, unstable psychiatric comorbidity, or another associated substance use disorder (grade B). BZD<\/jats:styled-content>s are only justified beyond a 1\u2010week period in the case of persistent withdrawal symptoms, withdrawal events or associated BZD<\/jats:styled-content> dependence (grade B). BZD<\/jats:styled-content>s should not be continued for more than 4\u00a0weeks (grade C). The dosing and duration of thiamine (vitamin B1) during detoxification should be adapted to nutritional status (EC<\/jats:styled-content>).<\/jats:p>For relapse prevention, acamprosate and naltrexone are recommended as first\u2010line medications (grade A). Disulfiram can be proposed as second\u2010line option in patients with sufficient information and supervision (EC<\/jats:styled-content>). For reducing alcohol consumption, nalmefene is indicated in first line (grade A). The second\u2010line prescription of baclofen, up to 300\u00a0mg\/day, to prevent relapse or reduce drinking should be carried out according to the \u201ctemporary recommendation for use\u201d measure issued by the French Health Agency (EC<\/jats:styled-content>).<\/jats:p>During pregnancy, abstinence is recommended (EC<\/jats:styled-content>). If alcohol detoxification is conducted during pregnancy, BZD<\/jats:styled-content> use is recommended (grade B). No medication other than those for alcohol detoxification should be initiated in pregnant or breastfeeding women (EC<\/jats:styled-content>). In a stabilized pregnant patient taking medication to support abstinence, the continuation of the drug should be considered on a case\u2010by\u2010case basis, weighing the benefit\/risk ratio. Only disulfiram should be always stopped, given the unknown risks of the antabuse effect on the fetus (EC<\/jats:styled-content>).<\/jats:p>First\u2010line treatments to help maintain abstinence or reduce drinking are off\u2010label for people under 18\u00a0years of age and should thus be considered on a case\u2010by\u2010case basis after the repeated failure of psychosocial measures alone (EC<\/jats:styled-content>). Short half\u2010life BZD<\/jats:styled-content>s should be preferred for the detoxification of elderly patients (grade B). The initial doses of BZD<\/jats:styled-content>s should be reduced by 30 to 50% in elderly patients (EC<\/jats:styled-content>). In patients with chronic alcohol\u2010related physical disorders, abstinence is recommended (EC<\/jats:styled-content>). Any antidepressant or anxiolytic medication should be introduced after a psychiatric reassessment after 2\u20134\u00a0weeks of alcohol abstinence or low\u2010risk use (grade B). A smoking cessation program should be offered to any smokers involved in an alcohol treatment program (grade B).<\/jats:p><\/jats:sec>","DOI":"10.1111\/cns.12489","type":"journal-article","created":{"date-parts":[[2015,12,21]],"date-time":"2015-12-21T19:44:50Z","timestamp":1450727090000},"page":"25-37","source":"Crossref","is-referenced-by-count":108,"title":["Pharmacotherapy for Alcohol Dependence: The 2015 Recommendations of the French Alcohol Society, Issued in Partnership with the European Federation of Addiction Societies"],"prefix":"10.1111","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8666-3635","authenticated-orcid":false,"given":"Benjamin","family":"Rolland","sequence":"first","affiliation":[{"name":"Soci\u00e9t\u00e9 Fran\u00e7aise d'Alcoologie Issy\u2010les\u2010Moulineaux France"},{"name":"Service d'Addictologie CHRU de Lille INSERM U1171 Univ Lille Lille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7ois","family":"Paille","sequence":"additional","affiliation":[{"name":"Soci\u00e9t\u00e9 Fran\u00e7aise d'Alcoologie Issy\u2010les\u2010Moulineaux France"},{"name":"Service d'Addictologie CHU de Nancy Vand\u0153uvre\u2010l\u00e8s\u2010Nancy Nancy France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudine","family":"Gillet","sequence":"additional","affiliation":[{"name":"Soci\u00e9t\u00e9 Fran\u00e7aise d'Alcoologie Issy\u2010les\u2010Moulineaux France"},{"name":"Centre d'Addictologie H\u00f4pital Villemin Nancy France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alain","family":"Rigaud","sequence":"additional","affiliation":[{"name":"Soci\u00e9t\u00e9 Fran\u00e7aise d'Alcoologie Issy\u2010les\u2010Moulineaux France"},{"name":"P\u00f4le d'addictologie EPSM Marne Ch\u00e2lons\u2010en\u2010Champagne et Reims Reims France"},{"name":"Association Nationale de Pr\u00e9vention en Alcoologie et Addictologue (ANPAA) Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romain","family":"Moirand","sequence":"additional","affiliation":[{"name":"Soci\u00e9t\u00e9 Fran\u00e7aise d'Alcoologie Issy\u2010les\u2010Moulineaux France"},{"name":"CHU de Rennes Unit\u00e9 d'Addictologie Rennes France"},{"name":"INSERM UMR 991 Rennes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corine","family":"Dano","sequence":"additional","affiliation":[{"name":"Soci\u00e9t\u00e9 Fran\u00e7aise d'Alcoologie Issy\u2010les\u2010Moulineaux France"},{"name":"Service d'Addictologie CHU d'Angers Angers France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurice","family":"Dematteis","sequence":"additional","affiliation":[{"name":"Soci\u00e9t\u00e9 Fran\u00e7aise d'Alcoologie Issy\u2010les\u2010Moulineaux France"},{"name":"Clinique d'Addictologie CHU de Grenoble Universit\u00e9 Grenoble Alpes Grenoble France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl","family":"Mann","sequence":"additional","affiliation":[{"name":"Central Institute of Mental Health Medical Faculty Mannheim University of Heidelberg Mannheim Germany"},{"name":"EUFAS Scientific Secretariat Professor Antoni Gual (MD; 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