Long-term effects of pharmacotherapy on relapse prevention in alcohol dependence.

Abstract

BACKGROUND:

There is growing evidence that pharmacological treatment with two of the best validated anticraving drugs, acamprosate and naltrexone, is efficacious in promoting abstinence in recently detoxified alcohol-dependent subjects.

OBJECTIVE:

The stability of effects after termination of treatment remains to be answered, especially when combining both the drugs.

METHOD:

After detoxification, 160 alcohol-dependent subjects participated in a randomized, double-blind, placebo-controlled trial. Patients received naltrexone or acamprosate or a combination of naltrexone and acamprosate or placebo for 12 weeks. Patients were assessed weekly by interview, self-report, questionnaires and laboratory screening. Additionally, follow-up evaluation based on telephone interview of participants, general practitioners and relatives was conducted 12 weeks after terminating the medication.

RESULTS:

At week 12, the proportion of subjects relapsing to heavy drinking was significantly lower in the group with combined medication compared with both placebo and acamprosate (P < 0.05). No difference was detectable between acamprosate and naltrexone, both of which were superior to placebo (P < 0.05). Relapse rates were 28% (combined medication), 35% (naltrexone), 50% (acamprosate) and 75% (placebo). After follow-up (week 24), combined medication led to relapse rates significantly lower than placebo, but not lower than acamprosate. Again, both naltrexone and acamprosate were superior to placebo. Relapse rates were 80% (placebo), 54% (acamprosate), 53% (naltrexone) and 34% (combined medication).

CONCLUSIONS:

The results of this study highlight the stability of effects of pharmacotherapy on relapse prevention in alcohol dependence.

• Authors: F Kiefer, F Andersohn, C Otte, K Wolf, H Jahn, K Wiedemann
• Journal: Acta neuropsychiatrica (Acta Neuropsychiatr) Vol. 16 Issue 5 Pg. 233-8 (Oct 2004) ISSN: 0924-2708 [Print] England
• PMID: 26984435 (Publication Type: Journal Article)