title: Gabapentin combined with naltrexone for the treatment of alcohol dependence.
abstract: OBJECTIVE
  Naltrexone, an efficacious medication for alcohol dependence, does not work for everyone. Symptoms such as insomnia and mood instability that are most evident during early abstinence might respond better to a different pharmacotherapy. Gabapentin may reduce these symptoms and help prevent early relapse. This clinical trial evaluated whether the combination of naltrexone and gabapentin was better than naltrexone alone and/or placebo during the early drinking cessation phase (first 6 weeks), and if so, whether this effect persisted.
  
  
  METHODS
  A total of 150 alcohol-dependent individuals were randomly assigned to a 16-week course of naltrexone alone (50 mg/day [N=50]), naltrexone (50 mg/day) with gabapentin (up to 1,200 mg/day [N=50]) added for the first 6 weeks, or double placebo (N=50). All participants received medical management.
  
  
  RESULTS
  During the first 6 weeks, the naltrexone-gabapentin group had a longer interval to heavy drinking than the naltrexone-alone group, which had an interval similar to that of the placebo group; had fewer heavy drinking days than the naltrexone-alone group, which in turn had more than the placebo group; and had fewer drinks per drinking day than the naltrexone-alone group and the placebo group. These differences faded over the remaining weeks of the study. Poor sleep was associated with more drinking in the naltrexone-alone group but not in the naltrexone-gabapentin group, while a history of alcohol withdrawal was associated with better response in the naltrexone-gabapentin group.
  
  
  CONCLUSIONS
  The addition of gabapentin to naltrexone improved drinking outcomes over naltrexone alone during the first 6 weeks after cessation of drinking. This effect did not endure after gabapentin was discontinued.
authors: Medical University of South Carolina, Institute of Psychiatry, SC 29425, USA. antonr@musc.edu
authors: Raymond F
authors: RF
authors: Anton
authors: Hugh
authors: H
authors: Myrick
authors: Tara M
authors: TM
authors: Wright
authors: Patricia K
authors: PK
authors: Latham
authors: Alicia M
authors: AM
authors: Baros
authors: L Randolph
authors: LR
authors: Waid
authors: Patrick K
authors: PK
authors: Randall
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000523:psychology; D000437:Alcoholism / Q000188:drug therapy* / Q000523:psychology; D000588:Amines / Q000627:therapeutic use*; D003509:Cyclohexanecarboxylic Acids / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D000077206:Gabapentin; D006801:Humans; D008297:Male; D008875:Middle Aged; D009271:Naltrexone / Q000008:administration & dosage / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D055502:Secondary Prevention; D013375:Substance Withdrawal Syndrome / Q000517:prevention & control; D016896:Treatment Outcome; D005680:gamma-Aminobutyric Acid / Q000627:therapeutic use*
chemical_list: D000588:Amines; D003509:Cyclohexanecarboxylic Acids; D009292:Narcotic Antagonists; D005680:gamma-Aminobutyric Acid; D009271:Naltrexone; D000077206:Gabapentin