Abstract. Background: Craving plays an important role in the relapse and management of patients with alcohol dependence. Naltrexone and acamprosate are the current approved drugs of choice for anti-craving. In this article, we compare naltrexone to a novel anti-craving drug. Aim: To follow up on patients diagnosed with alcohol dependence and assess the anti-craving effects of naltrexone and ondansetron. Objectives: 1. To assess and compare the reduction in cravings by ondansetron to naltrexone. 2. To assess the reduction in cravings by ondansetron in early-onset (age < 25 years) and late-onset (age > 25 years) drinkers. 3. To assess the reduction in cravings by ondansetron in patients with and without a family history of alcoholism. Method: A prospective, randomized study in a tertiary care center with 80 participants diagnosed with alcohol dependence was done, who were currently not in withdrawal. These participants are then called for bi-weekly follow-ups to assess their cravings for up to 12 weeks. Results: The study reported a 78% reduction in cravings with naltrexone and a 60.5% reduction in cravings with ondansetron. There was no association found with the age of onset of alcohol consumption and family history of alcoholism with a reduction in cravings by ondansetron. Conclusion: Ondansetron is efficacious anti-craving drug. Based on low cost, availability, and relatively low side effect profile, ondansetron can be considered an appropriate anti-craving medication for alcohol dependence.

Key words: alcohol dependence, naltrexone, ondansetron, cravings

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