A double-blind, placebo-controlled, randomized pilot study comparing quetiapine with placebo, associated to naltrexone, in the treatment of alcohol-dependent patients

Guardia, Josep; Roncero, Carlos; Galan, J.L.; Gonzalvo, Begoña; Burguete, Teresa; Casas, Miquel

doi:10.1016/j.addbeh.2010.11.006

Cited by 20 publications

(18 citation statements)

References 25 publications

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“…More recently, a placebocontrolled study of quetiapine as adjunct therapy with lithium or divalproex for patients with bipolar I disorder and co-existing alcohol dependence did not find support for its efficacy with regard to alcohol use measures in this comorbid sample (Stedman et al 2010). Likewise, a study combining naltrexone and quetiapine did not demonstrate a benefit of the combination over naltrexone alone (Guardia et al 2011). While the efficacy of quetiapine for alcoholism has not been definitively demonstrated in the literature to date, understanding the mechanisms of action of this pharmacotherapy may be useful in identifying responders as no one pharmacotherapy is likely to be effective for all patients with alcohol dependence, a complex and heterogeneous disorder.…”

Section: Introductionmentioning

confidence: 99%

A human laboratory study of the effects of quetiapine on subjective intoxication and alcohol craving

et al. 2011

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Section: Introductionmentioning

confidence: 99%

A human laboratory study of the effects of quetiapine on subjective intoxication and alcohol craving

et al. 2011

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“…The combination group reported more daytime somnolence (p=0.02), blurred vision (p=0.02), and premature ejaculation (p=0.02), but improved sleep quality more than the other groups, and was overall well tolerated. additional benefit or side effect burden beyond that of naltrexone [67].…”

Section: Safety Considerations For Oral Naltrexone Combined With Othementioning

confidence: 99%

Safety and Tolerability of Pharmacological Treatment of Alcohol Dependence: Comprehensive Review of Evidence

et al. 2016

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Alcohol use disorders (AUD) cause significant morbidity and mortality worldwide, but pharmacological treatments for them are underused, despite evidence of efficacy.Acamprosate, naltrexone, nalmefene and disulfiram are all approved in one or more region for the treatment of alcohol use disorders. Baclofen currently has a temporary indication in France. Safety considerations for using psychopharmacological treatments in this patient group include the impact of concurrent alcohol consumption at high levels, multiple physical comorbidities which may interfere with pharmacological effects, distribution and metabolism, and concomitant medication for the treatment of comorbid physical and psychiatric conditions. The five drugs, including an extended-release injectable suspension of naltrexone, have different safety profiles which need to be balanced with the objective of treatment (initiation or continuation of abstinence, or reduction of drinking), individual patient preferences and comorbid conditions. Appropriate treatment will be based on the unique riskbenefit profile in each case. KEY POINTS Acamprosate has an excellent safety profile and is recommended as first line treatment for patients wishing abstinence. Naltrexone and nalmefene are contraindicated with opioid-containing medication, but have reasonable tolerability  The disulfiram-alcohol reaction is integral to its use, but careful patient selection and monitoring can mitigate safety risks  Baclofen is a CNS depressant so there are potential concerns regarding overdose: it may have a role in patients with severe liver disease Pharmacological treatments for alcohol dependence 3

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“…Los estudios efectuados sobre la farmacoterapia del alcoholismo han comprobado que ni los agonistas 21 ni los antagonistas de los receptores dopaminérgicos 22,23 consiguen una eficacia superior a placebo para la prevención de recaídas. Los agonistas de los receptores GABA-A pueden ser de utilidad para la prevención y el tratamiento del síndrome de abstinencia aguda del alcohol, pero presentan bastantes inconvenientes y también algunos riesgos (dependencia y sobredosificación), cuando el tratamiento se prolonga más allá de la fase aguda de la abstinencia.…”

Section: Tratamiento Farmacológico De La Prevención De Recaídasunclassified

“…Studies on the pharmacotherapy of alcoholism have shown than neither dopaminergic agonists 21 nor antagonists 22,23 obtain greater efficacy than placebo in relapse prevention treatment. GABA-A agonists can be useful for withdrawal prevention and treatment, but they present some drawbacks and also risks (of overdose and addiction) when their treatment goes beyond the acute abstinence phase.…”

Section: Relapse Prevention Pharmacotherapymentioning

confidence: 99%

Cambio de paradigma en el tratamiento del alcoholismo de baja gravedad

Guardia-Serecigni¹

2011

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IntroductionRecent pharmacotherapy findings from new alcohol reduction programmes could change the paradigm of alcohol-dependence treatment. Material and MethodThis study reviews the neurobiological background and pharmacotherapy of alcohol-dependence disorder, focusing on opioid receptor antagonists, abstinence-oriented treatment and moderation-oriented treatment. Results 1.Alcohol-dependence treatment programs show only low to moderate efficacy. 2. Patients usually show low motivation to sustain abstinence but high motivation to reduce alcohol use. 3. A treatment program based on continued reduction of drinking and associated with intermittent treatment with naltrexone can be useful for low-severity alcohol-dependent patients. DiscussionAlthough high severity alcohol-dependent patients should stop drinking alcohol, low severity patients may have the option of reducing their alcohol consumption if they take an opioid antagonist medication every day that they decide to drink alcohol. In the short term, the continuing drinking-reduction programmes may reduce the number of drinks per drinking day and in the long term, they may progressively decrease the obsession for drinking, alcohol seeking behavior, and related medical, behavioral and social disorders. To change the paradigm in the treatment of alcohol-dependence disorder there is a need for further randomized controlled trials in order to assess their efficacy and tolerability.

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A double-blind, placebo-controlled, randomized pilot study comparing quetiapine with placebo, associated to naltrexone, in the treatment of alcohol-dependent patients

Cited by 20 publications

References 25 publications

A human laboratory study of the effects of quetiapine on subjective intoxication and alcohol craving

A human laboratory study of the effects of quetiapine on subjective intoxication and alcohol craving

Safety and Tolerability of Pharmacological Treatment of Alcohol Dependence: Comprehensive Review of Evidence

Cambio de paradigma en el tratamiento del alcoholismo de baja gravedad

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