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Evidence-Based Medicine 2002; 7:125
© 2002 Evidence-Based Medicine


Therapeutics

Naltrexone for 3 or 12 months did not reduce drinking in alcohol dependence

Krystal JH, Cramer JA, Krol WF, et al, for the Veterans Affairs Naltrexone Cooperative Study 425 Group. Naltrexone in the treatment of alcohol dependence.N Engl J Med 2001 Dec 13;345:1734–9[Abstract/Free Full Text]

QUESTION: In patients with alcohol dependence and a recent history of drinking to intoxication, is treatment with naltrexone for 3 or 12 months in addition to standardised psychosocial treatment more effective than placebo for reducing alcohol consumption?

The first 150 words of the full text of this article appear below.

Design
Randomised {allocation concealed*}{dagger}, blinded (participants and health care providers),* controlled trial with 52 weeks of follow up.

Setting
15 Veterans Affairs medical centres in the US.

Patients
627 outpatients (mean age 49 y, 98% men) who had a diagnosis of alcohol dependence according to the Diagnostic and Statistical Manual of Mental Disorders, 4th ed, criteria; who had not drunk for >= 5 days; and who had a recent history of drinking to intoxication (>= 6 drinks for men and >= 4 drinks for women at least twice during a 1 wk period in the 30 d before screening). Exclusion criteria included previous use of naltrexone and other substance abuse or dependence. Follow up was 90% and 93% at 13 and 52 weeks, respectively.

Intervention
209 patients each were allocated to naltrexone, 50 mg once daily, for 3 months (short term group); naltrexone, 50 mg once daily, for 12 months (long term group); . . . [Full text of this article]

Jonathan Chick, MA, MPhil, FRCPsych

Royal Edinburgh Hospital, Edinburgh, Scotland, UK







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