This Article  • 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  • Citing articles on Web of Science (151)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Psychopharmacology  • Public Health  • Substance Abuse/ Alcoholism  • Randomized Controlled Trial  • Drug Therapy  • Drug Therapy, Other  • Alert me on articles by topic  Social Bookmarking   What's this?

A Double-blind, Placebo-Controlled Study

Falk Kiefer, MD; Holger Jahn, MD; Timo Tarnaske; Hauke Helwig; Peer Briken, MD; Rüdiger Holzbach, MD; Philipp Kämpf, MD; Robert Stracke, MD; Michael Baehr, PhD; Dieter Naber, MD; Klaus Wiedemann, MD

Arch Gen Psychiatry. 2003;60:92-99.

Background  Naltrexone and acamprosate have been shown to be effective in relapse prevention of alcoholism via different pharmacologic mechanisms. Since it remains uncertain whether both substances are equally efficient and whether a combination of both drugs potentiates the efficacy, we conducted the first published controlled study comparing and combining both compounds.

Methods  After detoxification, 160 patients with alcoholism participated in a randomized, double-blind, placebo-controlled protocol. Patients received naltrexone, acamprosate, naltrexone plus acamprosate, or placebo for 12 weeks. Patients were assessed weekly by interview, self-report, questionnaires, and laboratory screening. Time to first drink, time to relapse, and the cumulative abstinence time were the primary outcome measures.

Results  Naltrexone, acamprosate, and the combined medication were significantly more effective than placebo. Comparing the course of nonrelapse rates between naltrexone and acamprosate, the naltrexone group showed a tendency for a better outcome regarding time to first drink and time to relapse. The combined medication was most effective with significantly lower relapse rates than placebo and acamprosate but not naltrexone.

Conclusions  The results of this study support the efficacy of pharmacotherapeutic strategies in the relapse prevention of alcoholism. Naltrexone and acamprosate, especially in combination, considerably enhance the potential of relapse prevention.

From the Department of Psychiatry (Drs Kiefer, Jahn, Briken, Holzbach, Kämpf, Naber, and Wiedemann and Messrs Tarnaske and Helwig) and the Pharmacy (Dr Baehr), University Hospital of Hamburg, and Northern Hospital of Hamburg (Dr Stracke), Hamburg, Germany.

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

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

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  

Specialised alcohol treatment services are a luxury the NHS cannot afford
Luty and Carnwath
Br. J. Psychiatry 2008;192:245-247.
ABSTRACT | FULL TEXT  

Acamprosate supports abstinence, Naltrexone prevents excessive drinking: evidence from a meta-analysis with unreported outcomes
Rosner et al.
J Psychopharmacol 2008;22:11-23.
ABSTRACT  

A randomized, multicentre, open-label, comparative trial of disulfiram, naltrexone and acamprosate in the treatment of alcohol dependence
Laaksonen et al.
Alcohol Alcohol 2008;43:53-61.
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  

Prescription procedures in medication for relapse prevention after inpatient treatment for alcohol use disorders in Switzerland
Buri et al.
Alcohol Alcohol 2007;42:333-339.
ABSTRACT | FULL TEXT  

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

Clinical Advances in Pharmacological and Integrated Treatment Approaches for Alcohol and Drug Use Disorders
Dermatis and Galanter
Focus 2007;5:141-150.
ABSTRACT | FULL TEXT  

Pharmacotherapy and behavioral intervention for alcohol dependence.
Jonas and Chabac
JAMA 2006;296:1727-1727.
FULL TEXT  

Pharmacotherapy and behavioral intervention for alcohol dependence.
Kiefer and Mann
JAMA 2006;296:1727-1728.
FULL TEXT  

Acamprosate for Alcohol Dependence: An Update for the Clinician
Mason
Focus 2006;4:505.
ABSTRACT | FULL TEXT  

Bibliography PSYCHOPHARMACOLOGY
Focus 2006;4:512.
FULL TEXT  

Combined pharmacotherapies and behavioral interventions for alcohol dependence: the COMBINE study: a randomized controlled trial.
Anton et al.
JAMA 2006;295:2003-2017.
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  

DEVELOPMENT AND VALIDATION OF THE AMSTERDAM MOTIVES FOR DRINKING SCALE (AMDS): AN ATTEMPT TO DISTINGUISH RELIEF AND REWARD DRINKERS
OOTEMAN et al.
Alcohol Alcohol 2006;41:284-292.
ABSTRACT | FULL TEXT  

RECURRENT DETOXIFICATIONS ARE ASSOCIATED WITH CRAVING IN PATIENTS CLASSIFIED AS TYPE 1 ACCORDING TO LESCH'S TYPOLOGY
HILLEMACHER et al.
Alcohol Alcohol 2006;41:66-69.
ABSTRACT | FULL TEXT  

What works in alcohol use disorders?
Luty
Adv. Psychiatr. Treat. 2006;12:13-22.
ABSTRACT | FULL TEXT  

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

Radioligands for Brain Imaging of the {kappa}-Opioid System
Machulla and Heinz
JNM 2005;46:386-387.
FULL TEXT  

Unhealthy Alcohol Use
Saitz
NEJM 2005;352:596-607.
FULL TEXT  

Review: acamprosate and naltrexone are safe and effective but have low compliance rates for people with alcohol dependence
Feeney and Connor
Evid. Based Ment. Health 2005;8:14-14.
FULL TEXT  

Correlation of Stable Elevations in Striatal {micro}-Opioid Receptor Availability in Detoxified Alcoholic Patients With Alcohol Craving: A Positron Emission Tomography Study Using Carbon 11-Labeled Carfentanil
Heinz et al.
Arch Gen Psychiatry 2005;62:57-64.
ABSTRACT | FULL TEXT  

COMBINED THERAPY: WHAT DOES ACAMPROSATE AND NALTREXONE COMBINATION TELL US?
KIEFER and WIEDEMANN
Alcohol Alcohol 2004;39:542-547.
ABSTRACT | FULL TEXT  

Pharmacotherapy in dual diagnosis
Crome and Myton
Adv. Psychiatr. Treat. 2004;10:413-424.
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.
 

Management of alcoholic hepatitis
DTB 2003;41:49-52.
ABSTRACT | FULL TEXT  

OTHER ARTICLES NOTED (24 Jan 03 to 18 Apr 03)
Evid. Based Nurs. 2003;6:e1-12.
FULL TEXT  

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

Rosack
Psychiatr. News 2003;38:25-25.
FULL TEXT