title: Comparing and combining naltrexone and acamprosate in relapse prevention of alcoholism: a double-blind, placebo-controlled study.
abstract: BACKGROUND
  Naltrexone and acamprosate have been shown to be effective in relapse prevention of alcoholism via different pharmacologic mechanisms. Since it remains uncertain whether both substances are equally efficient and whether a combination of both drugs potentiates the efficacy, we conducted the first published controlled study comparing and combining both compounds.
  
  
  METHODS
  After detoxification, 160 patients with alcoholism participated in a randomized, double-blind, placebo-controlled protocol. Patients received naltrexone, acamprosate, naltrexone plus acamprosate, or placebo for 12 weeks. Patients were assessed weekly by interview, self-report, questionnaires, and laboratory screening. Time to first drink, time to relapse, and the cumulative abstinence time were the primary outcome measures.
  
  
  RESULTS
  Naltrexone, acamprosate, and the combined medication were significantly more effective than placebo. Comparing the course of nonrelapse rates between naltrexone and acamprosate, the naltrexone group showed a tendency for a better outcome regarding time to first drink and time to relapse. The combined medication was most effective with significantly lower relapse rates than placebo and acamprosate but not naltrexone.
  
  
  CONCLUSIONS
  The results of this study support the efficacy of pharmacotherapeutic strategies in the relapse prevention of alcoholism. Naltrexone and acamprosate, especially in combination, considerably enhance the potential of relapse prevention.
authors.affiliation: Department of Psychiatry, University Hospital of Hamburg, Martinistr 52, D-20246 Hamburg, Germany. kiefer@psyunihh.de
authors.forename: Falk
authors.initials: F
authors.lastname: Kiefer
authors.forename: Holger
authors.initials: H
authors.lastname: Jahn
authors.forename: Timo
authors.initials: T
authors.lastname: Tarnaske
authors.forename: Hauke
authors.initials: H
authors.lastname: Helwig
authors.forename: Peer
authors.initials: P
authors.lastname: Briken
authors.forename: Rüdiger
authors.initials: R
authors.lastname: Holzbach
authors.forename: Philipp
authors.initials: P
authors.lastname: Kämpf
authors.forename: Robert
authors.initials: R
authors.lastname: Stracke
authors.forename: Michael
authors.initials: M
authors.lastname: Baehr
authors.forename: Dieter
authors.initials: D
authors.lastname: Naber
authors.forename: Klaus
authors.initials: K
authors.lastname: Wiedemann
mesh_terms: D000077443:Acamprosate; D000437:Alcoholism / Q000188:drug therapy* / Q000517:prevention & control*; D004311:Double-Blind Method; D004338:Drug Combinations; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009271:Naltrexone / Q000008:administration & dosage / Q000627:therapeutic use*; D010919:Placebos; D055502:Secondary Prevention; D013654:Taurine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D004338:Drug Combinations; D010919:Placebos; D013654:Taurine; D009271:Naltrexone; D000077443:Acamprosate