title: Long-term effects of pharmacotherapy on relapse prevention in alcohol dependence.
abstract: BACKGROUND
  There is growing evidence that pharmacological treatment with two of the best validated anticraving drugs, acamprosate and naltrexone, is efficacious in promoting abstinence in recently detoxified alcohol-dependent subjects.
  
  
  OBJECTIVE
  The stability of effects after termination of treatment remains to be answered, especially when combining both the drugs.
  
  
  METHODS
  After detoxification, 160 alcohol-dependent subjects participated in a randomized, double-blind, placebo-controlled trial. Patients received naltrexone or acamprosate or a combination of naltrexone and acamprosate or placebo for 12 weeks. Patients were assessed weekly by interview, self-report, questionnaires and laboratory screening. Additionally, follow-up evaluation based on telephone interview of participants, general practitioners and relatives was conducted 12 weeks after terminating the medication.
  
  
  RESULTS
  At week 12, the proportion of subjects relapsing to heavy drinking was significantly lower in the group with combined medication compared with both placebo and acamprosate (P < 0.05). No difference was detectable between acamprosate and naltrexone, both of which were superior to placebo (P < 0.05). Relapse rates were 28% (combined medication), 35% (naltrexone), 50% (acamprosate) and 75% (placebo). After follow-up (week 24), combined medication led to relapse rates significantly lower than placebo, but not lower than acamprosate. Again, both naltrexone and acamprosate were superior to placebo. Relapse rates were 80% (placebo), 54% (acamprosate), 53% (naltrexone) and 34% (combined medication).
  
  
  CONCLUSIONS
  The results of this study highlight the stability of effects of pharmacotherapy on relapse prevention in alcohol dependence.
authors.affiliation: 1Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health (CIMH), University of Heidelberg, Mannheim, Germany.
authors.forename: F
authors.initials: F
authors.lastname: Kiefer
authors.affiliation: 2Department of Psychiatry and Psychotherapy, University Hospital of Hamburg, Hamburg, Germany.
authors.forename: F
authors.initials: F
authors.lastname: Andersohn
authors.affiliation: 2Department of Psychiatry and Psychotherapy, University Hospital of Hamburg, Hamburg, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Otte
authors.affiliation: 2Department of Psychiatry and Psychotherapy, University Hospital of Hamburg, Hamburg, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Wolf
authors.affiliation: 2Department of Psychiatry and Psychotherapy, University Hospital of Hamburg, Hamburg, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Jahn
authors.affiliation: 2Department of Psychiatry and Psychotherapy, University Hospital of Hamburg, Hamburg, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Wiedemann