title: Naltrexone versus acamprosate in the treatment of alcohol dependence: A multi-centre, randomized, double-blind, placebo-controlled trial.
abstract: OBJECTIVE
  To compare the efficacy of acamprosate and naltrexone in the treatment of alcohol dependence.
  
  
  METHODS
  A double-blind, placebo-controlled trial.
  
  
  METHODS
  Three treatment centres in Australia.
  
  
  METHODS
  A total of 169 alcohol dependent subjects were given naltrexone (50 mg/day), acamprosate (1998 mg/day) or placebo for 12 weeks.
  
  
  METHODS
  All subjects were offered manualized compliance therapy, a brief intervention that targets problems that may affect treatment compliance such as ambivalence and misperceptions about medication.
  
  
  METHODS
  Time to the first drink, time to first relapse, drinks per drinking day and cumulative abstinence.
  
  
  RESULTS
  In intention-to-treat analyses, there were no differences between groups on outcome measures of drinking, craving or biochemical markers. Similarly, analyses of the 94 subjects that completed the study in full and demonstrated 80% compliance, revealed no significant treatment effects. Differential treatment effects were identified after stratification according to scores on the Alcohol Dependence Scale (ADS) and Depression Anxiety and Stress Scale (DASS). A significant beneficial treatment effect on time to first relapse was revealed for subjects with 'no depression' allocated to naltrexone (n = 56; P < 0.01). In addition, a significant beneficial treatment effect was revealed in subjects with 'low dependence' allocated to naltrexone (n = 34; P < 0.05).
  
  
  CONCLUSIONS
  The results of this study support the efficacy of naltrexone in the relapse prevention of alcoholism amongst those with low levels of clinical depression and alcohol dependence severity. No effect of acamprosate was found in our sample.
authors.affiliation: Central Clinical School of Medicine, University of Sydney, NSW, Australia.
authors.forename: Kirsten C
authors.initials: KC
authors.lastname: Morley
authors.forename: Maree
authors.initials: M
authors.lastname: Teesson
authors.forename: Sophie C
authors.initials: SC
authors.lastname: Reid
authors.forename: Claudia
authors.initials: C
authors.lastname: Sannibale
authors.forename: Clare
authors.initials: C
authors.lastname: Thomson
authors.forename: Nghi
authors.initials: N
authors.lastname: Phung
authors.forename: Martin
authors.initials: M
authors.lastname: Weltman
authors.forename: James R
authors.initials: JR
authors.lastname: Bell
authors.forename: Kylie
authors.initials: K
authors.lastname: Richardson
authors.forename: Paul S
authors.initials: PS
authors.lastname: Haber
mesh_terms: D000077443:Acamprosate; D000328:Adult; D000427:Alcohol Deterrents / Q000627:therapeutic use*; D019973:Alcohol-Related Disorders / Q000517:prevention & control*; D001007:Anxiety / Q000517:prevention & control; D001315:Australia; D003866:Depressive Disorder / Q000517:prevention & control; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009271:Naltrexone / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D010349:Patient Compliance; D010919:Placebos; D055502:Secondary Prevention; D013654:Taurine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000427:Alcohol Deterrents; D009292:Narcotic Antagonists; D010919:Placebos; D013654:Taurine; D009271:Naltrexone; D000077443:Acamprosate