title: The effect of naltrexone and acamprosate on cue-induced craving, autonomic nervous system and neuroendocrine reactions to alcohol-related cues in alcoholics.
abstract: BACKGROUND
  Acamprosate and naltrexone have been shown to be effective in relapse prevention of alcoholism. It is hypothesized that naltrexone exerts its effects primarily on cue-induced craving and neuroendocrine cue reactivity, whereas acamprosate exerts its effect primarily on autonomic nervous system reactions to alcohol-related cues.
  
  
  METHODS
  In a randomized double-blind experiment, 131 abstinent alcoholics received either acamprosate (n=56), naltrexone (n=52) or placebo (n=23) for three weeks and participated in two cue-exposure sessions: the first the day before and the second at the last day of medication.
  
  
  RESULTS
  Consistent with the hypotheses, naltrexone reduced craving more than acamprosate, and acamprosate reduced heart rate more than naltrexone. No medication effect was found on cue-induced cortisol.
  
  
  CONCLUSIONS
  The findings provide some evidence for differential effects of naltrexone and acamprosate: naltrexone may exert its effect, at least partly, by the reduction of cue-induced craving, whereas acamprosate may exert its effect, at least partly, by the reduction of autonomic nervous system reactions to alcohol-related cues.
authors: Amsterdam Institute for Addiction Research, Amsterdam, The Netherlands. w.ooteman@amc.uva.nl
authors: Wendy
authors: W
authors: Ooteman
authors: Maarten W J
authors: MW
authors: Koeter
authors: Roel
authors: R
authors: Verheul
authors: Gerard M
authors: GM
authors: Schippers
authors: Wim
authors: W
authors: van den Brink
mesh_terms: D000077443:Acamprosate; D000339:Affect; D000427:Alcohol Deterrents / Q000494:pharmacology*; D000437:Alcoholism / Q000523:psychology*; D001341:Autonomic Nervous System / Q000502:physiology*; D003463:Cues; D004311:Double-Blind Method; D005712:Galvanic Skin Response / Q000187:drug effects; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D009271:Naltrexone / Q000494:pharmacology*; D009292:Narcotic Antagonists / Q000494:pharmacology*; D009490:Neurosecretory Systems / Q000502:physiology*; D010349:Patient Compliance; D011569:Psychiatric Status Rating Scales; D011795:Surveys and Questionnaires; D013654:Taurine / Q000031:analogs & derivatives* / Q000494:pharmacology
chemical_list: D000427:Alcohol Deterrents; D009292:Narcotic Antagonists; D013654:Taurine; D009271:Naltrexone; D000077443:Acamprosate; D006854:Hydrocortisone