title: Nalmefene and its use in alcohol dependence.
abstract: Nalmefene is the first available drug approved in the E.U. to reduce alcohol use in alcohol-dependent patients. Reduction in alcohol use in heavy drinkers diminishes mortality risk and socio-economic burden. Nalmefene has shown efficacy at 6 months in alcohol-dependent patients with high or very high drinking risk levels in reducing total alcohol consumption (-7.6 g/day [95% confidence interval (CI): -11.6 to -3.5]; P = 0.0003), heavy drinking days (-2.00 days/month [95% CI: -3.00 to -1.00]; P ⟨ 0.00001) and other secondary outcome measures such as γ-glutamyl transferase, alanine aminotransferase, drinking risk level and Clinical Global Impression. It is generally well tolerated and has limited contraindications and interactions. As-needed dosage is a novel concept in the addictions field, which may overcome limitations of traditional regimens. In the pivotal trials, nalmefene was taken 52% of the days and compliance with the as-needed treatment regimen was good (above 80% of the days) in 68% of the nalmefene-treated patients. A new pharmacological approach combined with a brief psychosocial intervention for alcoholism is available and appears to be feasible, safe and efficacious.
authors.affiliation: Addictions Unit, Department of Psychiatry, Clinical Institute of Neuroscience, Hospital Clínic, Barcelona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Gual
authors.affiliation: Addictions Unit, Department of Psychiatry, Clinical Institute of Neuroscience, Hospital Clínic, Barcelona, Spain. pbruguer@clinic.cat.
authors.forename: P
authors.initials: P
authors.lastname: Bruguera
authors.affiliation: Addictions Unit, Department of Psychiatry, Clinical Institute of Neuroscience, Hospital Clínic, Barcelona, Spain.
authors.forename: H
authors.initials: H
authors.lastname: López-Pelayo
mesh_terms: D000437:Alcoholism / Q000188:drug therapy*; D004347:Drug Interactions; D006801:Humans; D009271:Naltrexone / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D009271:Naltrexone; C038981:nalmefene
keywords: Adverse events; Alcohol dependence; As-needed; Harm reduction; Nalmefene; Treatment efficacy