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Which treatment for alcohol dependence: naltrexone, acamprosate and/or behavioural intervention?

Doggrell, SA (2006). Which treatment for alcohol dependence: naltrexone, acamprosate and/or behavioural intervention?. Expert Opinion on Pharmacotherapy,7(15):2169-2173.

Document type: Journal Article
Citation counts: Scopus Citation Count Cited 2 times in Scopus Article | Citations

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Title Which treatment for alcohol dependence: naltrexone, acamprosate and/or behavioural intervention?
Author Doggrell, SA
Journal Name Expert Opinion on Pharmacotherapy
Publication Date 2006
Volume Number 7
Issue Number 15
ISSN 1465-6566   (check CDU catalogue open catalogue search in new window)
Scopus ID 2-s2.0-33750124595
Start Page 2169
End Page 2173
Total Pages 5
Publisher Informa Healthcare
HERDC Category C1 - Journal Article (DEST)
Abstract Alcoholism is the third leading cause of preventable mortality and morbidity in the US. In the COMBINE (Combined Pharmacotherapies and Behavioural Interventions) study, the co-primary end points were the percentage of days abstinent and the time to first heavy drinking day after 16 weeks, and 1 year. The biggest difference observed in COMBINE was that seen between combined behavioural intervention (CBI; percentage of abstinent days = 66.6%) and CBI and medical management with placebos (79.8%). This illustrated a major effect of the medical management of nine sessions and/or the placebo pills. Acamprosate had no effect alone or in combination with naltrexone. At 16 weeks with medical management, there were 75.1% of the patients who were abstinent for placebos, and this was improved by naltrexone, CBI, and naltrexone with CBI (80.6, 78.2 and 77.1%, respectively). There was a follow up after 1 year, which showed that, with medical management, the amount of those who were abstinent for placebos was 61.4%, and this was improved by naltrexone, CBI, and naltrexone with CBI (66.2, 66.6 and 67.3%, respectively), but this improvement no longer reached statistical significance. After 1 year, there was no difference between groups in the overall frequency of hospitalisation, emergency treatment for alcohol problems, use of medication for drinking or emotional problems and detoxification. Being part of a study for alcohol dependence is known to increase the percentage of abstinent days. In COMBINE, this percentage was high in the group having medical management and placebo pills, and naltrexone or additional behavioural therapy only had modest additional effects.
Keywords acamprosate
alcohol dependence
clinical trial
combine
combined behavioural intervention
naltrexone
combined pharmacotherapies
abstinence
DOI http://dx.doi.org/10.1517/14656566.7.15.2169   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
 
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Created: Wed, 28 Nov 2007, 14:16:08 CST