Which medication is used for alcohol use disorder in pregnant women, despite unknown fetal effects?

Naltrexone is a medication that can be used for alcohol use disorder and is often considered when treating pregnant women, despite the lack of definitive research about its effects on the fetus. It is an opioid antagonist that helps reduce cravings and the rewarding effects of alcohol, supporting individuals in maintaining abstinence. The consideration for its use during pregnancy arises from the need to manage alcohol dependence effectively while balancing potential risks to the developing fetus.

Some medications specifically known to be contraindicated during pregnancy due to potential harm include disulfiram and acamprosate, which have more established safety concerns. Disulfiram can cause adverse reactions when alcohol is consumed, which can be problematic during pregnancy. Acamprosate requires careful consideration as it has not been extensively studied in pregnant populations. Thiamine is crucial for preventing Wernicke's encephalopathy in alcohol-dependent patients, particularly during withdrawal, but it does not directly treat alcohol use disorder.

Thus, while the fetal impacts of naltrexone are not well-documented, it is sometimes preferred in clinical practice when assessing the risk-benefit ratio during treatment for alcohol use disorder in pregnant women.