This Article  • References  • Full text PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

A Controlled Study

Stephanie S. O'Malley, PhD; Adam J. Jaffe, PhD; Grace Chang, MD; Richard S. Schottenfeld, MD; Roger E. Meyer, MD; Bruce Rounsaville, MD

Arch Gen Psychiatry. 1992;49(11):881-887.

Abstract
• Ninety-seven alcohol-dependent patients were treated for 12 weeks in a double-blind, placebo-controlled study evaluating naltrexone and two manual guided psychotherapies in the treatment of alcohol dependence. Patients were randomized to receive either naltrexone or placebo and either coping skills/relapse prevention therapy or a supportive therapy designed to support the patient's own efforts at abstinence without teaching specific coping skills. Naltrexone proved superior to placebo in measures of drinking and alcohol-related problems, including abstention rates, number of drinking days, relapse, and severity of alcohol-related problems. Medication interacted with the type of psychotherapy received. The cumulative rate of abstinence was highest for patients treated with naltrexone and supportive therapy. For those patients who initiated drinking, however, patients who received naltrexone and coping skills therapy were the least likely to relapse.

Author Affiliations
From the Department of Psychiatry, Yale University School of Medicine, New Haven, Conn (Drs O'Malley, Jaffe, Schottenfeld, and Rounsaville); The University of Connecticut Alcohol Research Center, Farmington (Drs O'Malley, Jaffe, Meyer, and Rounsaville); the Department of Medicine (Psychiatry), Harvard Medical School and the Brigham and Women's Hospital, Boston, Mass (Dr Chang); and the Department of Psychiatry, University of Connecticut Health Center, Farmington (Dr Meyer).

Footnotes
Accepted for publication April 7, 1992.

Presented as a poster exhibit at the Annual Meeting of the Research Society on Alcoholism, June 10, 1991, Marco Island, Fla.

Reprint requests to Alcohol Treatment Unit, Yale University School of Medicine, 285 Orchard St, New Haven, CT 06511 (Dr O'Malley).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Incidence of craving for and abuse of gamma-hydroxybutyric acid (GHB) in different populations of treated alcoholics: an open comparative study
Caputo et al.
J Psychopharmacol 2009;23:883-890.
ABSTRACT  

Alcoholism: A Systems Approach From Molecular Physiology to Addictive Behavior
Spanagel
Physiol. Rev. 2009;89:649-705.
ABSTRACT | FULL TEXT  

Effect of Naltrexone and Ondansetron on Alcohol Cue-Induced Activation of the Ventral Striatum in Alcohol-Dependent People
Myrick et al.
Arch Gen Psychiatry 2008;65:466-475.
ABSTRACT | FULL TEXT  

Prospects for a Genomic Approach to the Treatment of Alcoholism
O'Brien
Arch Gen Psychiatry 2008;65:132-133.
FULL TEXT  

Longitudinal Course of Substance Treatment Benefits in Older Male Veteran At-Risk Drinkers
Zanjani et al.
Journals of Gerontology Series A: Biological Sciences and Medical Sciences 2008;63:98-106.
ABSTRACT | FULL TEXT  

Effects of Naltrexone on Alcohol Sensitivity and Genetic Moderators of Medication Response: A Double-blind Placebo-Controlled Study
Ray and Hutchison
Arch Gen Psychiatry 2007;64:1069-1077.
ABSTRACT | FULL TEXT  

Varenicline, an {alpha}4beta2 nicotinic acetylcholine receptor partial agonist, selectively decreases ethanol consumption and seeking
Steensland et al.
Proc. Natl. Acad. Sci. USA 2007;104:12518-12523.
ABSTRACT | FULL TEXT  

Association of a Functional Polymorphism in the {micro}-Opioid Receptor Gene With Alcohol Response and Consumption in Male Rhesus Macaques
Barr et al.
Arch Gen Psychiatry 2007;64:369-376.
ABSTRACT | FULL TEXT  

Emerging approaches to managing alcohol dependence
SWIFT
Am J Health Syst Pharm 2007;64:S12-S22.
ABSTRACT | FULL TEXT  

Presynaptic {delta} Opioid Receptors Regulate Ethanol Actions in Central Amygdala
Kang-Park et al.
J. Pharmacol. Exp. Ther. 2007;320:917-925.
ABSTRACT | FULL TEXT  

Guideline Watch (April 2007): Practice Guideline for the Treatment of Patients With Substance Use Disorders, 2nd Edition
Connery and Kleber
Focus 2007;5:163-166.
ABSTRACT | FULL TEXT  

Psychotic Spectrum Disorders and Alcohol Abuse: A Review of Pharmacotherapeutic Strategies and a Report on the Effectiveness of Naltrexone and Disulfiram
Petrakis et al.
Schizophr Bull 2006;32:644-654.
ABSTRACT | FULL TEXT  

COMBINED ACAMPROSATE AND NALTREXONE, WITH COGNITIVE BEHAVIOURAL THERAPY IS SUPERIOR TO EITHER MEDICATION ALONE FOR ALCOHOL ABSTINENCE: A SINGLE CENTRES' EXPERIENCE WITH PHARMACOTHERAPY
FEENEY et al.
Alcohol Alcohol 2006;41:321-327.
ABSTRACT | FULL TEXT  

Association between two {micro}-opioid receptor gene (OPRM1) haplotype blocks and drug or alcohol dependence
Zhang et al.
Hum Mol Genet 2006;15:807-819.
ABSTRACT | FULL TEXT  

Long acting injectable naltrexone is effective and safe for treating alcohol dependence
Killeen
Evid. Based Ment. Health 2005;8:100-100.
FULL TEXT  

Pharmacokinetics of Long-Acting Naltrexone in Subjects With Mild to Moderate Hepatic Impairment
Turncliff et al.
J Clin Pharmacol 2005;45:1259-1267.
ABSTRACT | FULL TEXT  

Reduction of ethanol intake by chronic treatment with Hypericum perforatum, alone or combined with naltrexone in rats
Perfumi et al.
J Psychopharmacol 2005;19:448-454.
ABSTRACT  

Anticraving Medications for Relapse Prevention: A Possible New Class of Psychoactive Medications
O'Brien
Am. J. Psychiatry 2005;162:1423-1431.
ABSTRACT | FULL TEXT  

Review: naltrexone reduces alcohol consumption (in the short-term) in patients with alcohol dependence
Graham
Evid. Based Med. 2005;10:120-120.
FULL TEXT  

EFFECT OF COMMUNITY NURSE FOLLOW-UP WHEN TREATING ALCOHOL DEPENDENCE WITH ACAMPROSATE
PELC et al.
Alcohol Alcohol 2005;40:302-307.
ABSTRACT | FULL TEXT  

EFFECTS OF NALTREXONE ON THE ETHANOL-INDUCED CHANGES IN THE RAT CENTRAL DOPAMINERGIC SYSTEM
LEE et al.
Alcohol Alcohol 2005;40:297-301.
ABSTRACT | FULL TEXT  

CLINICAL PREDICTORS OF RESPONSE TO NALTREXONE IN ALCOHOLIC PATIENTS: WHO BENEFITS MOST FROM TREATMENT WITH NALTREXONE?
RUBIO et al.
Alcohol Alcohol 2005;40:227-233.
ABSTRACT | FULL TEXT  

Efficacy and Tolerability of Long-Acting Injectable Naltrexone for Alcohol Dependence: A Randomized Controlled Trial
Garbutt et al.
JAMA 2005;293:1617-1625.
ABSTRACT | FULL TEXT  

Evidence-Based Guidelines for the Pharmacological Management of Substance Misuse, Addiction and Comorbidity: Recommendations from the British Association for Psychopharmacology
Lingford-Hughes et al.
J Psychopharmacol 2004;18:293-335.
 

PHARMACOTHERAPEUTIC TRIALS IN ADOLESCENT ALCOHOL USE DISORDERS: OPPORTUNITIES AND CHALLENGES
Dawes and Johnson
Alcohol Alcohol 2004;39:166-177.
ABSTRACT | FULL TEXT  

Does Acamprosate Improve Reduction of Drinking As Well As Aiding Abstinence?
Chick et al.
J Psychopharmacol 2003;17:397-402.
ABSTRACT  

Initial and Maintenance Naltrexone Treatment for Alcohol Dependence Using Primary Care vs Specialty Care: A Nested Sequence of 3 Randomized Trials
O'Malley et al.
Arch Intern Med 2003;163:1695-1704.
ABSTRACT | FULL TEXT  

Acamprosate for the Adjunctive Treatment of Alcohol Dependence
Overman et al.
The Annals of Pharmacotherapy 2003;37:1090-1099.
ABSTRACT | FULL TEXT  

Naltrexone and Cognitive Behavioral Therapy for the Treatment of Outpatient Alcoholics: Results of a Placebo-Controlled Trial
Anton et al.
Focus 2003;1:183-189.
ABSTRACT | FULL TEXT  

Bridging the Gap: A Hybrid Model to Link Efficacy and Effectiveness Research in Substance Abuse Treatment
Carroll and Rounsaville
Psychiatr. Serv. 2003;54:333-339.
ABSTRACT | FULL TEXT  

COMPARISON OF CYANAMIDE AND PLACEBO IN THE TREATMENT OF ALCOHOL DEPENDENCE OF ADOLESCENTS
Niederhofer et al.
Alcohol Alcohol 2003;38:50-53.
ABSTRACT | FULL TEXT  

Comparing and Combining Naltrexone and Acamprosate in Relapse Prevention of Alcoholism: A Double-blind, Placebo-Controlled Study
Kiefer et al.
Arch Gen Psychiatry 2003;60:92-99.
ABSTRACT | FULL TEXT  

NEUROCHEMICAL MARKERS OF ALCOHOLISM VULNERABILITY IN HUMANS
Ratsma et al.
Alcohol Alcohol 2002;37:522-533.
ABSTRACT | FULL TEXT  

The Gap Between Research and Practice in Substance Abuse Treatment
Marinelli-Casey et al.
Psychiatr. Serv. 2002;53:984-987.
ABSTRACT | FULL TEXT  

DOES PSYCHOSOCIAL TREATMENT ENHANCE THE EFFICACY OF ACAMPROSATE IN PATIENTS WITH ALCOHOL PROBLEMS?
de Wildt et al.
Alcohol Alcohol 2002;37:375-382.
ABSTRACT | FULL TEXT  

Behavioral Neurobiology of Alcohol Addiction: Recent Advances and Challenges
Weiss and Porrino
J. Neurosci. 2002;22:3332-3337.
ABSTRACT | FULL TEXT  

SHORT-TERM METHADONE ADMINISTRATION REDUCES ALCOHOL CONSUMPTION IN NON-ALCOHOLIC HEROIN ADDICTS
Caputo et al.
Alcohol Alcohol 2002;37:164-168.
ABSTRACT | FULL TEXT  

Naltrexone in the Treatment of Alcohol Dependence
Krystal et al.
NEJM 2001;345:1734-1739.
ABSTRACT | FULL TEXT  

Naltrexone Treatment for Alcohol Dependence
Fuller and Gordis
NEJM 2001;345:1770-1771.
FULL TEXT  

NALTREXONE, A RELAPSE PREVENTION MAINTENANCE TREATMENT OF ALCOHOL DEPENDENCE: A META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS
Streeton and Whelan
Alcohol Alcohol 2001;36:544-552.
ABSTRACT | FULL TEXT  

NALTREXONE VERSUS ACAMPROSATE: ONE YEAR FOLLOW-UP OF ALCOHOL DEPENDENCE TREATMENT
Rubio et al.
Alcohol Alcohol 2001;36:419-425.
ABSTRACT | FULL TEXT  

Pharmacogenetics of Alcohol Response and Alcoholism: The Interplay of Genes and Environmental Factors in Thresholds for Alcoholism
Radel and Goldman
Drug Metab. Dispos. 2001;29:489-494.
ABSTRACT | FULL TEXT  

Alcoholism Treatment After Liver Transplantation: Lessons Learned From a Clinical Trial That Failed
Weinrieb et al.
Psychosomatics 2001;42:110-116.
ABSTRACT | FULL TEXT  

Addiction and the brain: the role of neurotransmitters in the cause and treatment of drug dependence
Tomkins and Sellers
CMAJ 2001;164:817-821.
ABSTRACT | FULL TEXT  

Evidence about the use of naltrexone and for different ways of using it in the treatment of alcoholism
Sinclair
Alcohol Alcohol 2001;36:2-10.
ABSTRACT | FULL TEXT  

Outpatient Management of Patients with Alcohol Problems
Fiellin et al.
ANN INTERN MED 2000;133:815-827.
ABSTRACT | FULL TEXT  

A MULTICENTRE, RANDOMIZED, DOUBLE-BLIND, PLACEBO-CONTROLLED TRIAL OF NALTREXONE IN THE TREATMENT OF ALCOHOL DEPENDENCE OR ABUSE
Chick et al.
Alcohol Alcohol 2000;35:587-593.
ABSTRACT | FULL TEXT  

Drug Dependence, a Chronic Medical Illness: Implications for Treatment, Insurance, and Outcomes Evaluation
McLellan et al.
JAMA 2000;284:1689-1695.
ABSTRACT | FULL TEXT  

THE LONG-TERM COST-EFFECTIVENESS OF IMPROVING ALCOHOL ABSTINENCE WITH ADJUVANT ACAMPROSATE
Palmer et al.
Alcohol Alcohol 2000;35:478-492.
ABSTRACT | FULL TEXT  

Naltrexone plus cognitive behavioural therapy led to fewer drinking relapses in outpatients with alcoholism
Chick
Evid. Based Ment. Health 2000;3:75-75.
FULL TEXT  

{micro}-Opioid Receptor Knockout Mice Do Not Self-Administer Alcohol
Roberts et al.
J. Pharmacol. Exp. Ther. 2000;293:1002-1008.
ABSTRACT | FULL TEXT  

Novel Uncompetitive N-Methyl-D-Aspartate (NMDA)-Receptor Antagonist MRZ 2/579 Suppresses Ethanol Intake in Long-Term Ethanol-Experienced Rats and Generalizes to Ethanol Cue in Drug Discrimination Procedure
Hölter et al.
J. Pharmacol. Exp. Ther. 2000;292:545-552.
ABSTRACT | FULL TEXT  

Oral nalmefene reduced relapse to heavy drinking and was well tolerated in patients with alcohol dependence
Chick
Evid. Based Ment. Health 2000;3:20-20.
FULL TEXT  

Naltrexone and Cognitive Behavioral Therapy for the Treatment of Outpatient Alcoholics: Results of a Placebo-Controlled Trial
Anton et al.
Am. J. Psychiatry 1999;156:1758-1764.
ABSTRACT | FULL TEXT  

TRAIT MARKERS FOR ALCOHOLISM: CLINICAL UTILITY
Farren and Tipton
Alcohol Alcohol 1999;34:649-665.
ABSTRACT | FULL TEXT  

Occurrence and Management of Depression in the Context of Naltrexone Treatment of Alcoholism
Farren and O'Malley
Am. J. Psychiatry 1999;156:1258-1262.
FULL TEXT  

A Double-blind, Placebo-Controlled Study of Oral Nalmefene for Alcohol Dependence
Mason et al.
Arch Gen Psychiatry 1999;56:719-724.
ABSTRACT | FULL TEXT  

Opioids, Reward and Addiction: An Encounter of Biology, Psychology, and Medicine
van Ree et al.
Pharmacol. Rev. 1999;51:341-396.
ABSTRACT | FULL TEXT  

Drug Therapy for Alcohol Dependence
Swift
NEJM 1999;340:1482-1490.
FULL TEXT  

Role of the Primary Care Physician in Problems of Substance Abuse
Weaver et al.
Arch Intern Med 1999;159:913-924.
ABSTRACT | FULL TEXT  

PERSONALITY AND ALCOHOL/SUBSTANCE-USE DISORDER PATIENT RELAPSE AND ATTENDANCE AT SELF-HELP GROUP MEETINGS
Janowsky et al.
Alcohol Alcohol 1999;34:359-369.
ABSTRACT | FULL TEXT  

Pharmacological Treatment of Alcohol Dependence: A Review of the Evidence
Garbutt et al.
JAMA 1999;281:1318-1325.
ABSTRACT | FULL TEXT  

Adrenocorticotropin Responses to Naloxone in Sons of Alcohol-Dependent Men
Wand et al.
J. Clin. Endocrinol. Metab. 1999;84:64-68.
ABSTRACT | FULL TEXT  

Suppression of Ethanol-Reinforced Behavior by Naltrexone Is Associated with Attenuation of the Ethanol-Induced Increase in Dialysate Dopamine Levels in the Nucleus Accumbens
Gonzales and Weiss
J. Neurosci. 1998;18:10663-10671.
ABSTRACT | FULL TEXT  

Family History of Alcoholism and Hypothalamic Opioidergic Activity
Wand et al.
Arch Gen Psychiatry 1998;55:1114-1119.
ABSTRACT | FULL TEXT  

Contribution of the Opioid System to Alcohol Aversion and Alcohol Drinking Behavior
Froehlich et al.
J. Pharmacol. Exp. Ther. 1998;287:284-292.
ABSTRACT | FULL TEXT  

Intensive Community-Focused Treatment of Veterans With Dual Diagnoses
Rosenheck et al.
Am. J. Psychiatry 1998;155:1429-1433.
FULL TEXT  

The Effect of Depression on Return to Drinking: A Prospective Study
Greenfield et al.
Arch Gen Psychiatry 1998;55:259-265.
ABSTRACT | FULL TEXT  

Patients with Alcohol Problems
O'Connor and Schottenfeld
NEJM 1998;338:592-602.
FULL TEXT  

Drug Development for Disorders of the Nervous System: Challenge and Opportunity at the Pharmaceutical-Biotech-Academic Interface
Schmidt
Neuroscientist 1998;4:9-13.
ABSTRACT  

The Safety Profile of Naltrexone in the Treatment of Alcoholism: Results From a Multicenter Usage Study
Croop et al.
Arch Gen Psychiatry 1997;54:1130-1135.
ABSTRACT  

{blacktriangledown}Acamprosate for alcohol dependence?
DTB 1997;35:70-72.
ABSTRACT | FULL TEXT  

Naltrexone and Alcohol Dependence: Role of Subject Compliance
Volpicelli et al.
Arch Gen Psychiatry 1997;54:737-742.
ABSTRACT  

Addiction Medicine
O'Brien and McLellan
JAMA 1997;277:1840-1841.
 

Daidzin inhibits mitochondrial aldehyde dehydrogenase and suppresses ethanol intake of Syrian golden hamsters
Keung et al.
Proc. Natl. Acad. Sci. USA 1997;94:1675-1679.
ABSTRACT | FULL TEXT  

Relapse Prevention by Acamprosate: Results From a Placebo-Controlled Study on Alcohol Dependence
Sass et al.
Arch Gen Psychiatry 1996;53:673-680.
ABSTRACT  

Addiction Medicine
Wesson and Ling
JAMA 1996;275:1792-1793.
ABSTRACT  

Mental Disorders and Homicidal Behavior in Finland
Eronen et al.
Arch Gen Psychiatry 1996;53:497-501.
ABSTRACT  

Management of Cocaine Abuse and Dependence
Mendelson and Mello
NEJM 1996;334:965-972.
FULL TEXT  

A Double-blind, Placebo-Controlled Trial of Desipramine for Primary Alcohol Dependence Stratified on the Presence or Absence of Major Depression
Mason et al.
JAMA 1996;275:761-767.
ABSTRACT  

Alcohol Research: At the Cutting Edge
Gordis
Arch Gen Psychiatry 1996;53:199-201.
ABSTRACT  

Six-Month Follow-up of Naltrexone and Psychotherapy for Alcohol Dependence
O'Malley et al.
Arch Gen Psychiatry 1996;53:217-224.
ABSTRACT  

The Obsessive Compulsive Drinking Scale: A New Method of Assessing Outcome in Alcoholism Treatment Studies
Anton et al.
Arch Gen Psychiatry 1996;53:225-231.
ABSTRACT  

Enhanced Sensitivity of Pituitary {beta}Endorphin to Ethanol in Subjects at High Risk of Alcoholism
Gianoulakis et al.
Arch Gen Psychiatry 1996;53:250-257.
ABSTRACT  

Addiction Medicine
Franklin
JAMA 1993;270:184-185.
ABSTRACT