Naltrexone for 3 or 12 months did not reduce drinking in alcohol dependence.

نویسنده

  • Jonathan Chick
چکیده

In patients with alcohol dependence and a recent history of drinking to intoxication, is treatment with naltrexone for 3 or 12 months in addition to standardized psy-chosocial treatment more effective than placebo for reducing alcohol consumption? Randomized {allocation concealed*} †, blinded (participants and health care providers),* controlled trial with 52-week follow-up. 15 Veterans Affairs medical centers in the United States. P a t i e n t s 627 outpatients (mean age 49 y, 98% men) who had a diagnosis of alcohol dependence according to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) criteria; who had not drunk for ≥ 5 days; and who had a recent history of drinking to intoxication (≥ 6 drinks for men and ≥ 4 drinks for women at least twice during a 1-week period in the 30 d before screening). Exclusion criteria included previous use of naltrexone and other substance abuse or dependence. Follow-up was 90% and 93% at 13 and 52 weeks, respectively. 209 patients each were allocated to naltrex-one, 50 mg once daily, for 3 months (short-term group); naltrexone, 50 mg once daily, for 12 months (long-term group); or placebo. All patients received individual 12-step facilitation counseling for 13 months and were encouraged to attend Alcoholics Anonymous meetings. Visits were weekly for 16 weeks, every 2 weeks during weeks 17 to 36, and monthly during weeks 37 to 56. M a i n o u t c o m e m e a s u r e s Time to relapse (d from randomization to first d of heavy drinking) during the first 3 months, percentage of drinking days (PDD), and number of drinks per drinking day (NDPDD) for a 12-month period. Analysis was by intention to treat. At 13 weeks, the combined short-and long-term naltrexone groups did not differ from the placebo group for time to relapse (Table). At 52 weeks, the short and long-term naltrexone groups did not differ from the placebo group for PDD or NDPDD (NDPDD evaluated for the 66% of patients who consumed alcohol during follow-up) (Table). In patients with alcohol dependence and a recent history of drinking to intoxication, treatment with naltrexone for 3 or 12 months in addition to standardized psychosocial treatment was no more effective than placebo for reducing alcohol consumption. C o m m e n t a r y 2 meta-analyses have supported the effectiveness of naltrexone in reating …

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Naltrexone for 3 or 12 months in addition to psychosocial counselling did not reduce drinking in alcohol dependence.

Patients 627 outpatients (mean age 49 y, 98% men) who had a diagnosis of alcohol dependence according to DSM-IV criteria, who had not drunk for >5 days, but who had a recent history of drinking to intoxication (heavy drinking at least twice during a 1 week period in the 30 days before screening, where heavy drinking was defined as >6 drinks for men and >4 drinks for women). Exclusion criteria i...

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عنوان ژورنال:
  • ACP journal club

دوره 137 1  شماره 

صفحات  -

تاریخ انتشار 2002