Naltrexone in the treatment of alcohol dependence.
Seventy male alcohol-dependent patients participated in a 12-week, double-blind, placebo-controlled trial of naltrexone hydrochloride (50 mg/d) as an adjunct to treatment following alcohol detoxification. Subjects taking naltrexone reported significantly less alcohol craving and days in which any alcohol was consumed. During the 12-week study, only 23% of the naltrexone-treated subjects met the criteria for a relapse, whereas 54.3% of the placebo-treated subjects relapsed. The primary effect of naltrexone was seen in patients who drank any alcohol while attending outpatient treatment. Nineteen (95%) of the 20 placebo-treated patients relapsed after they sampled alcohol, while only eight (50%) of 16 naltrexone-treated patients exposed to alcohol met relapse criteria. Naltrexone was not associated with mood changes or other psychiatric symptoms. Significant side effects (nausea) occurred in two naltrexone-treated subjects, and one naltrexone-treated subject complained of increased pain from arthritis. These results suggest that naltrexone may be a safe and effective adjunct to treatment in alcohol-dependent subjects, particularly in preventing alcohol relapse.
Department of Psychiatry, University of Pennsylvania, Philadelphia.
J R
JR
Volpicelli
A I
AI
Alterman
M
M
Hayashida
C P
CP
O'Brien
D000328:Adult; D000428:Alcohol Drinking / Q000523:psychology; D000437:Alcoholism / Q000188:drug therapy* / Q000523:psychology / Q000628:therapy; D000553:Ambulatory Care; D003131:Combined Modality Therapy; D004311:Double-Blind Method; D006801:Humans; D008297:Male; D009271:Naltrexone / Q000009:adverse effects / Q000627:therapeutic use*; D009325:Nausea / Q000139:chemically induced; D010352:Patient Dropouts; D010919:Placebos; D011569:Psychiatric Status Rating Scales; D011613:Psychotherapy; D012008:Recurrence; D012720:Severity of Illness Index; D016896:Treatment Outcome
D010919:Placebos; D009271:Naltrexone