Evaluation of lithium therapy for alcoholism

Fawcett, Jan; Clark, David; Gibbons, Robert D.; Aagesen, Carl A.; Pisani, Vincent D.; Tilkin, J M; Sellers, Donald; Stutzman, Danielle

doi:10.1097/00004714-198506000-00019

Cited by 11 publications

(12 citation statements)

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“…drinking frequency and amount of alcohol consumption (Garbutt et al, 1999). While the results of some studies showed that lithium reduced drinking in alcohol-dependent patients with mood disorders (Fawcett et al, 1984;Merry et al, 1976), a randomized controlled trial (RCT) failed to demonstrate any benefit of this drug in either depressed or non-depressed patients (Dorus et al, 1989). The efficacy of selective serotonin reuptake inhibitors (SSRIs) remains to be tested in placebo-controlled, randomized trials with large sample sizes.…”

Section: Introductionmentioning

confidence: 99%

Naltrexone for the treatment of alcoholism: a meta-analysis of randomized controlled trials

Srisurapanont

Jarusuraisin

2005

Int. J. Neuropsychopharm.

197

114

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Many trials of naltrexone have been carried out in alcohol-dependent patients. This paper is aimed to systematically review its benefits, adverse effects, and discontinuation of treatment. We assessed and extracted the data of double-blind, randomized controlled trials (RCTs) comparing naltrexone with placebo or other treatment in people with alcoholism. Two primary outcomes were subjects who relapsed (including heavy drinking) and those who returned to drinking. Secondary outcomes were time to first drink, drinking days, number of standard drinks for a defined period, and craving. All outcomes were reported for the short, medium, and long term. Five common adverse effects and dropout rates in short-term treatment were also examined. A total of 2861 subjects in 24 RCTs presented in 32 papers were included. For short-term treatment, naltrexone significantly decreased relapses [relative risk (RR) 0.64, 95% confidence interval (CI) 0.51-0.82], but not return to drinking (RR 0.91, 95% CI 0.81-1.02). Short-term treatment of naltrexone significantly increased nausea, dizziness, and fatigue in comparison to placebo [RRs (95% CIs) 2.14 (1.61-2.83), 2.09 (1.28-3.39), and 1.35 (1.04-1.75)]. Naltrexone administration did not significantly diminish short-term discontinuation of treatment (RR 0.85, 95% CI 0.70-1.01). Naltrexone should be accepted as a short-term treatment for alcoholism. As yet, we do not know the appropriate duration of treatment continuation in an alcohol-dependent patient who responds to short-term naltrexone administration. To ensure that the real-world treatment is as effective as the research findings, a form of psychosocial therapy should be concomitantly given to all alcohol-dependent patients receiving naltrexone administration.

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Section: Introductionmentioning

confidence: 99%

Naltrexone for the treatment of alcoholism: a meta-analysis of randomized controlled trials

Srisurapanont

Jarusuraisin

2005

Int. J. Neuropsychopharm.

197

114

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“…Fawcett et al (1987) evaluated 122 alcoholic men after inpatient alcohol treatment. Subjects who maintained a minimal lithium blood level of 0.4 mmol/liter or more, compared with both placebo-treated subjects and those failing to maintain this minimal blood level, had significantly higher abstinence rates (Fawcett et al, 1984(Fawcett et al, , 1987. Depressive symptoms or a diagnosis of depression did not affect outcome.…”

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confidence: 86%

Pharmacological Treatments for Alcoholism: Revisiting Lithium and Considering Buspirone

Fawcett

Kravitz

McGuire

et al. 2000

Alcoholism Clin & Exp Res

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“…Five double-blind, placebo-controlled trials enrolled patients with alcohol use disorders with or without depressive symptoms. [83][84][85][86][87] Results of these trials were mixed, with one trial showing no benefit, 85 three trials showing a benefit of lithium treatment on drinking outcomes, 83,86,87 and one trial showing that lithium treatment had a beneficial effect on drinking outcomes in depressed patients only. 84 A subsequent well-designed, double-blind, placebocontrolled multicenter trial of 457 patients with alcohol dependence with or without depressive symptoms found no effect of lithium treatment on either depressed or nondepressed patients.…”

Section: Lithiummentioning

confidence: 99%

Pharmacotherapy for Alcohol-Related Disorders: What Clinicians Should Know

Mariani

Levin

2004

Harvard Review of Psychiatry

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Alcohol-related disorders are a major public health problem in the United States. Alcohol interacts with several neurotransmitter systems causing both acute and chronic effects in the brain. While the mainstay of treatment of alcohol-related disorders, with the exception of alcohol withdrawal, has historically been psychosocial, pharmacotherapy is increasingly being investigated and incorporated into standard clinical practice. Patients with alcohol use disorders and comorbid psychiatric conditions, most commonly depressive and anxiety disorders, can benefit from symptom-targeted pharmacotherapy, even if the patient fails to achieve abstinence from alcohol. Although benzodiazepines remain the treatment of choice to treat alcohol withdrawal, a variety of other agents is being investigated, particularly in the outpatient setting. Further randomized clinical trials of alcohol-related disorder pharmacotherapy, particularly of comorbid subpopulations, are needed to better inform clinical decision making. The routine exclusion of alcohol-dependent patients from pharmacotherapy trials of psychiatric disorders presents a barrier to gathering more data. Recommendations for future research are discussed.

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Evaluation of lithium therapy for alcoholism

Cited by 11 publications

References 0 publications

Naltrexone for the treatment of alcoholism: a meta-analysis of randomized controlled trials

Naltrexone for the treatment of alcoholism: a meta-analysis of randomized controlled trials

Pharmacological Treatments for Alcoholism: Revisiting Lithium and Considering Buspirone

Pharmacotherapy for Alcohol-Related Disorders: What Clinicians Should Know

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