Opioid antagonists for alcohol dependence

Srisurapanont, Manit; Jarusuraisin, Ngamwong

doi:10.1002/14651858.cd001867.pub2

Cited by 308 publications

(173 citation statements)

References 60 publications

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“…This effect was modest ( g = −.277) but reliable, with minimal heterogeneity observed across studies. By comparison, effect sizes for heavy drinking or drinking quantity outcomes across randomized clinical trials generally range between g = .10 and .20 (Jonas et al , 2014; Maisel et al , 2013; Rösner et al , 2010). Thus, a modest effect on laboratory SA is consistent with what is known about naltrexone's effects on self‐reported drinking quantity during longer periods of treatment.…”

Section: Discussionmentioning

confidence: 99%

“…In the seminal trial naltrexone reduced the incidence of relapse to heavy drinking, quantity of consumption and weekly reports of craving, but not the likelihood of an initial lapse (Volpicelli et al , 1992). The relative specificity of treatment effects to heavy drinking outcomes (as opposed to abstinence) has since been replicated across clinical trials (Pettinati et al , 2006) and meta‐analyses (Rösner et al , 2010). Early trials also suggested that patients treated with naltrexone reported fewer drinks consumed and diminished ‘high’ during initial lapses (Volpicelli et al , 1995), implicating reductions in event‐level consumption and hedonic effects of alcohol as putative biobehavioral mechanisms for naltrexone's efficacy (Pettinati et al , 2006; Sinha and O'Malley, 1999; Volpicelli et al , 1995).…”

Section: Introductionmentioning

confidence: 97%

“…Meta‐analyses support that, as an adjunct to psychosocial therapy, daily naltrexone reduces the number of drinking days, quantity of alcohol consumed and incidence of relapse to heavy drinking relative to placebo—albeit with modest effect sizes (Jonas et al , 2014; Maisel et al , 2013; Rösner et al , 2010). Meta‐analyses further indicate relatively greater efficacy of naltrexone versus acamprosate for reducing heavy drinking and craving (Maisel et al , 2013).…”

Section: Introductionmentioning

confidence: 99%

“…dependent versus non‐dependent drinkers) and laboratory paradigms across studies. Additionally, considering that naltrexone's effects on clinical outcomes are modest in magnitude (Rösner et al , 2010), inadequate statistical power in small‐scale human laboratory studies could partly account for inconsistent findings.…”

Section: Introductionmentioning

confidence: 99%

“…several days) medication schedules has, among other reasons, rendered them ineligible for prior meta‐analyses, which have required a minimum treatment duration of 4–12 weeks (e.g. Jonas et al , 2014; Rösner et al , 2010). Meta‐analysis permits aggregation of results across studies, improving power and precision in effect size estimates.…”

Section: Introductionmentioning

confidence: 99%

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Effects of naltrexone on alcohol self‐administration and craving: meta‐analysis of human laboratory studies

et al. 2016

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Randomized clinical trials have established the efficacy of naltrexone for reducing quantity of alcohol consumption and incidence of relapse to heavy drinking. To evaluate putative treatment mechanisms, human laboratory studies have examined naltrexone's effects on alcohol responses and self‐administration during short‐term medication protocols. Results from these studies are inconsistent and have yet to be examined in aggregate. This meta‐analysis aimed to quantify naltrexone's effects on alcohol self‐administration and craving in the context of placebo‐controlled human laboratory trials. Potential moderators of medication effects were also examined. Meta‐analyses of alcohol self‐administration (k = 9, N = 490) and craving (k = 16, N = 748) confirmed that, under controlled experimental conditions, naltrexone reduces the quantity of consumption (Hedges' g = −.277, SE = .074, 95 percent CI = −.421, −.133, p < .001) and magnitude of self‐reported craving (g = −.286, SE = .066, 95 percent CI = −.416, −.156, p < .001) relative to placebo. Subgroup and moderation analyses found no evidence that effect sizes differed by study population (dependent versus non‐dependent drinkers), laboratory paradigm or duration of medication exposure. These results substantiate prior evidence for reductions in event‐level craving and consumption as potential treatment mediators, also establishing effect sizes to inform future human laboratory trials. From a clinical perspective, these results may provide additional evidence regarding naltrexone's efficacy in the context of acute or subacute dosing regimens.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effects of naltrexone on alcohol self‐administration and craving: meta‐analysis of human laboratory studies

et al. 2016

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Diagnosis and Pharmacotherapy of Alcohol Use Disorder

Kranzler

Soyka

2018

JAMA

464

356

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Alcohol consumption is associated with a high rate of morbidity and mortality, and heavy alcohol use is the major risk factor for AUD. Simple, valid screening methods can be used to identify patients with heavy alcohol use, who can then be evaluated for the presence of an AUD. Patients receiving a diagnosis of the disorder should be given brief counseling and prescribed a first-line medication (eg, naltrexone) or referred for a more intensive psychosocial intervention.

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Efficacy and Tolerability of Long-Acting Injectable Naltrexone for Alcohol Dependence

Garbutt

Kranzler

O’Malley

et al. 2005

JAMA

564

477

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jor public health problem, which worldwide is the fourth leading cause of disability. 1 Alcohol dependence is present in approximately 4% of the US adult population, 2 is common among primary care patients, 3,4 and may contribute to more than 100 000 preventable deaths per year. 5 Addiction counseling, behavioral treatments, and self-help groups (eg, Alcoholics Anonymous) are the primary interventions used to treat alcohol dependence in the United States. Although these treatments are often effective, a substantial number of patients fail to complete them or relapse. 6 Similar to diabetes, hypertension, and asthma, alcohol dependence is increasingly recognized as a chronic disease in which genetic vulnerability and social and environmental factors are involved in the etiology and course of the disease. 7 As with other chronic diseases, long-term comprehensive man-

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Opioid antagonists for alcohol dependence

Cited by 308 publications

References 60 publications

Effects of naltrexone on alcohol self‐administration and craving: meta‐analysis of human laboratory studies

Effects of naltrexone on alcohol self‐administration and craving: meta‐analysis of human laboratory studies

Diagnosis and Pharmacotherapy of Alcohol Use Disorder

Efficacy and Tolerability of Long-Acting Injectable Naltrexone for Alcohol Dependence

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