Initiating acamprosate within-detoxification versus post-detoxification in the treatment of alcohol dependence.
OBJECTIVE
This trial compared the efficacy of acamprosate, started at the beginning of detoxification, to acamprosate started at the completion of detoxification, in the treatment of alcohol dependence.


METHODS
This biphasic clinical trial consisted of a randomized, double-blind, placebo-controlled Detoxification Phase (DP), followed by a 10-week open-label Rehabilitation Phase (RP). Forty alcohol dependent patients were randomly assigned to receive either 1998 mg of acamprosate daily, or matching placebo, during the DP (5-14 days). After completing detoxification, all patients received open label acamprosate (1998 mg daily) in the RP. Outcome measures during the DP included: treatment retention, alcohol withdrawal, alcohol consumption, and oxazepam used. Outcome measures during the RP included: treatment retention and alcohol consumption.


RESULTS
There were no significant outcome differences between acamprosate and placebo-treated patients during the DP. Patients given acamprosate, compared to placebo, during the DP drank more alcohol in the RP.


CONCLUSIONS
Starting acamprosate at the beginning of detoxification did not improve DP outcomes. Starting acamprosate after detoxification was completed was associated with better drinking outcomes during subsequent alcohol rehabilitation treatment.
Kampman
Kyle M
KM
Department of Psychiatry, University of Pennsylvania School of Medicine, 3900, Chestnut Street, Philadelphia, PA 19104, USA. kampman_k@mail.trc.upenn.edu
Pettinati
Helen M
HM
Lynch
Kevin G
KG
Xie
Hu
H
Dackis
Charles
C
Oslin
David W
DW
Sparkman
Thorne
T
Sharkoski
Tiffany
T
O'Brien
Charles P
CP
D000077443:Acamprosate; D000328:Adult; D000427:Alcohol Deterrents / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D000428:Alcohol Drinking; D000437:Alcoholism / Q000188:drug therapy* / Q000523:psychology / Q000534:rehabilitation; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010076:Oxazepam / Q000627:therapeutic use; D010349:Patient Compliance; D011569:Psychiatric Status Rating Scales; D013375:Substance Withdrawal Syndrome / Q000517:prevention & control*; D013654:Taurine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D013695:Temperance; D016896:Treatment Outcome
D000427:Alcohol Deterrents; D013654:Taurine; D010076:Oxazepam; D000077443:Acamprosate