Clinical predictors of response to naltrexone in alcoholic patients: who benefits most from treatment with naltrexone?
OBJECTIVE
To determine the clinically ascertained variables that are related to satisfactory response to naltrexone (NTX) treatment of alcohol dependence after detoxification.


METHODS
The use of intake and outcome variables were measured in a randomized 3-month open-controlled trial comparing the effects of naltrexone plus psychotherapy treatment versus psychotherapy treatment alone on the maintenance of abstinence in the final 28 days (n = 336, all male).


RESULTS
Predictors of a positive response to NTX treatment were family history of alcoholism (P = 0.010), early age at onset of drinking problems (P = 0.014) and comorbid use of other drugs of abuse (P < 0.001). Among the subjects not treated with NTX, the greater the number of predictor variables, the lower the final 28 days abstinence rates (P = 0.00003), but this was not the case in patients treated with NTX (P = 0.844).


CONCLUSIONS
Patients with these features, suggesting biological vulnerability overall have poorer outcomes, but this can be reduced with NTX treatment. The type of alcoholism should be considered before deciding on the pharmacological strategy.
Rubio
G
G
Alcoholism Research Program, Servicios de Salud Mental, Retiro, Madrid, Spain. garuva@inicia.es
Ponce
G
G
Rodriguez-Jiménez
R
R
Jiménez-Arriero
M A
MA
Hoenicka
J
J
Palomo
T
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009271:Naltrexone / Q000627:therapeutic use*; D011237:Predictive Value of Tests; D013030:Spain / Q000453:epidemiology; D013695:Temperance
D009271:Naltrexone