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

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Kiefer F, Andersohn F, Otte C, Wolf K, Jahn H, Wiedemann K. Long-term effects of pharmacotherapy on relapse prevention in alcohol dependence. 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.

Keywords: Abstinence; Acamprosate; Alcoholism; Craving; Naltrexone; Treatment; Trial

Document Type: Research Article

DOI: http://dx.doi.org/10.1111/j.0924-2708.2004.00093.x

Affiliations: Department of Psychiatry and Psychotherapy, University Hospital of Hamburg, Hamburg, Germany

Publication date: October 1, 2004

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