Randomized controlled trial in alcohol relapse prevention: role of atenolol, alcohol craving, and treatment adherence.
Previous studies suggest that beta-adrenergic blockers reduce craving levels during acute alcohol withdrawal. We conducted a new study to assess whether the daily use of atenolol by the abstinent alcoholic could maintain a blunted craving for alcohol and result in a decreased rate of relapse for alcohol abuse. The study was designed as a randomized, controlled, double-blind clinical trial. Among all 100 patients (50 atenolol, 50 placebo), only 15 stayed in the trial and remained fully abstinent for 1 year (7 atenolol, 8 placebo). Of the remaining 85 patients, 30 withdrew early while still abstinent (17 atenolol, 13 placebo). In the 57 high-risk patients who reported craving for alcohol at baseline, the treatment failure rates were 90% for patients receiving placebo, and was reduced to 65% in those who received atenolol (risk reduction = 28%, 95% confidence interval, -3% to 49%). The data from this trial also support the observation that poorer levels of treatment adherence are strongly associated with adverse outcomes for alcoholics during follow-up. This relationship was present both for patients who received atenolol and for those who received placebo.
Gottlieb
L D
LD
Department of Internal Medicine, St Mary's Hospital, Waterbury, Connecticut.
Horwitz
R I
RI
Kraus
M L
ML
Segal
S R
SR
Viscoli
C M
CM
D000328:Adult; D000437:Alcoholism / Q000534:rehabilitation*; D001262:Atenolol / Q000627:therapeutic use*; D004311:Double-Blind Method; D015438:Health Behavior; D006801:Humans; D008875:Middle Aged; D010349:Patient Compliance; D012008:Recurrence; D013375:Substance Withdrawal Syndrome / Q000188:drug therapy*; D016896:Treatment Outcome
D001262:Atenolol