title: The effects of combined acamprosate and integrative behaviour therapy in the outpatient treatment of alcohol dependence: a randomized controlled trial.
abstract: OBJECTIVE
  The aim of this randomized, controlled, multisite trial was to evaluate the efficacy of combined treatment with integrative behaviour therapy (IBT) and acamprosate on drinking behaviour in detoxified alcohol-dependent patients.
  
  
  METHODS
  A total of 371 patients were randomized to one of the three treatment conditions: IBT plus acamprosate, IBT plus placebo, or supportive counselling ('treatment as usual', TAU) plus acamprosate. The main outcome was success rate, i.e., rate of abstinence plus improvement according to the criteria of Feuerlein and Küfner (1989), at the end of the six-month treatment phase and at the subsequent six-month follow-up. Drinking status was validated by blood parameters (CDT, GGT, and MCV). Data were analyzed by an intent-to-treat model and missing data were classified as relapse.
  
  
  RESULTS
  The success rates at the end of treatment under both TAU plus acamprosate (37.7%) and IBT plus placebo (48%) almost reached the levels derived from the literature. However, adding acamprosate to IBT did not result in the expected increase in success rate (IBT plus acamprosate: 47.6%), and success rates did not differ significantly between groups. Similarly, there was no significant difference between treatment success rates at follow-up.
  
  
  CONCLUSIONS
  The results suggest that the combination of acamprosate and IBT is not more effective than treatment with either IBT or acamprosate alone. However, the two acamprosate conditions differed in success rate by about 10%, which might constitute a clinically relevant though statistically non-significant effect.
authors.affiliation: Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany. woelwer@uni-duesseldorf.de
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Wölwer
authors.forename: Nicole
authors.initials: N
authors.lastname: Frommann
authors.forename: Michaela
authors.initials: M
authors.lastname: Jänner
authors.forename: Petra E
authors.initials: PE
authors.lastname: Franke
authors.forename: Norbert
authors.initials: N
authors.lastname: Scherbaum
authors.forename: Bodo
authors.initials: B
authors.lastname: Lieb
authors.forename: Peter
authors.initials: P
authors.lastname: Falkai
authors.forename: Thomas
authors.initials: T
authors.lastname: Wobrock
authors.forename: Thomas
authors.initials: T
authors.lastname: Kuhlmann
authors.forename: Michael
authors.initials: M
authors.lastname: Radermacher
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Maier
authors.forename: Christian
authors.initials: C
authors.lastname: Schütz
authors.forename: Christian
authors.initials: C
authors.lastname: Ohmann
authors.forename: Wilhelm
authors.initials: W
authors.lastname: Burtscheidt
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Gaebel
mesh_terms: D000077443:Acamprosate; D000328:Adult; D000427:Alcohol Deterrents / Q000627:therapeutic use*; D000437:Alcoholism / Q000188:drug therapy / Q000628:therapy*; D001521:Behavior Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D003376:Counseling; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D012008:Recurrence; D013654:Taurine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000427:Alcohol Deterrents; D013654:Taurine; D000077443:Acamprosate