title: A double blind, placebo-controlled trial that combines disulfiram and naltrexone for treating co-occurring cocaine and alcohol dependence.
abstract: BACKGROUND
  This is a double blind, placebo-controlled trial that evaluated the efficacy of disulfiram, naltrexone and their combination in patients with co-occurring cocaine and alcohol dependence.
  
  
  METHODS
  208 patients were randomized to disulfiram (250 mg/day), naltrexone (100 mg/day), the combination, or placebo for 11 weeks. Outcomes were in-trial abstinence from cocaine and/or alcohol.
  
  
  RESULTS
  Few safety concerns were reported, although medication adherence was low in a number of patients for both medications, alone or in combination. In the primary analyses (GEE modeling), abstinence from cocaine as measured by cocaine-negative urines and days of self-reported abstinence from cocaine or alcohol did not differ between placebo and any of the medication groups. However, patients taking disulfiram (alone or in combination) were most likely to achieve combined abstinence from cocaine and alcohol. Secondary analyses revealed that patients taking the disulfiram-naltrexone combination were most likely to achieve 3 consecutive weeks of abstinence from cocaine and alcohol.
  
  
  CONCLUSIONS
  There was an association between disulfiram treatment and abstinence from cocaine and alcohol. More patients taking the disulfiram-naltrexone combination achieved 3 consecutive weeks of abstinence in treatment than placebo-treated patients.
authors: Center for the Study of Addictions, Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA. pettinati_h@mail.trc.upenn.edu <pettinati_h@mail.trc.upenn.edu>
authors: Helen M
authors: HM
authors: Pettinati
authors: Kyle M
authors: KM
authors: Kampman
authors: Kevin G
authors: KG
authors: Lynch
authors: Hu
authors: H
authors: Xie
authors: Charles
authors: C
authors: Dackis
authors: Amanda R
authors: AR
authors: Rabinowitz
authors: Charles P
authors: CP
authors: O'Brien
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000427:Alcohol Deterrents / Q000627:therapeutic use*; D000437:Alcoholism / Q000188:drug therapy*; D019970:Cocaine-Related Disorders / Q000188:drug therapy*; D004221:Disulfiram / Q000627:therapeutic use*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009271:Naltrexone / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000427:Alcohol Deterrents; D009292:Narcotic Antagonists; D009271:Naltrexone; D004221:Disulfiram