Magazine article Drug Topics

Benefits of Alcoholism Drug May Linger after Treatment

Magazine article Drug Topics

Benefits of Alcoholism Drug May Linger after Treatment

Article excerpt

Naltrexone (Trexan, DuPont Merck), a drug that has been marketed for about a year as an aid for alcoholics, has more than lived up to its promise, claim some researchers.

A new Yale study shows that, in some patients, the drug's benefits may continue even beyond six months after treatment ends. An opioid antagonist that occupies opiate receptors in the brain, naltrexone apparently keeps on reducing the craving for alcohol and significantly increasing abstinence rates. It blocks the effects of opiates and may block the reinforcing effects-i.e., the "high"-of alcohol as well.

The results of this study suggest that, compared with patients treated with placebo, some who had previously improved on naltrexone "continued to experience lower relapse rates and fewer alcohol-related consequences long after their course of treatment," Stephanie S. O'Malley, Ph.D., from the department of psychiatry, Yale University School of Medicine, New Haven, Conn., told an American Medical Association media update on alcoholism in New York City recently.

The results of a previous 12-week study by the Yale researchers--along with those of a similar one conducted at the University of Pennsylvania School of Medicine-convinced the Food & Drug Administration in 1994 that naltrexone, used as an adjunct to psychotherapy, could be a valuable tool in the fight against alcoholism. Both the Yale and Pennsylvania studies showed that patients on a 50 mg/day dose of the drug had significantly better outcomes than did those on placebo. But the two different kinds of psychotherapy to which the patients had also been randomly assigned were not assessed at that time.

In the new off-treatment follow-up assessment, the Yale group looked at 80 men and women from the previous study beginning six months after the latter ended. Besides evaluating the posttreatment effect of naltrexone, they also considered the influence of the psychologic techniques used-coping skills therapy or supportive therapy-on long-term functioning. Their completed data appeared in the March issue of the Archives of General Psychiatry.

O'Malley, the study's primary author, reported, "The percentage of subjects who avoided relapse over the entire follow-up period was higher for naltrexone than for placebo-55% of naltrexone patients compared with 78% of placebo patients had one or more days of heavy drinking. …

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