title: Randomized controlled trial in alcohol relapse prevention: role of atenolol, alcohol craving, and treatment adherence.
abstract: 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.
authors.affiliation: Department of Internal Medicine, St Mary's Hospital, Waterbury, Connecticut.
authors.forename: L D
authors.initials: LD
authors.lastname: Gottlieb
authors.forename: R I
authors.initials: RI
authors.lastname: Horwitz
authors.forename: M L
authors.initials: ML
authors.lastname: Kraus
authors.forename: S R
authors.initials: SR
authors.lastname: Segal
authors.forename: C M
authors.initials: CM
authors.lastname: Viscoli
mesh_terms: 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
chemical_list: D001262:Atenolol