Targeted Versus Daily Naltrexone: Secondary Analysis of Effects on Average Daily Drinking

Hernández-Ávila, Carlos A.; Song, Changhong; Kuo, Lynn; Tennen, Howard; Armeli, Stephen; Kranzler, Henry R.

doi:10.1111/j.1530-0277.2006.00101.x

Cited by 67 publications

(70 citation statements)

References 13 publications

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“…The primary analysis strategy consisted of six separate zero-inflated Poisson (ZIP) regression models to examine predictors of participantto-partner aggression (psychological-, physical-, injury-) and partner-to-participant aggression (psychological-, physical-, injury-). ZIP regression is appropriate to use with event count data (i.e., data composed of the total number of counts of a specified behavior within a given time period), particularly event data in which the possibility exists for a large number of 0 scores (Zorn, 1996;Hernandez-Avila, 2006). Given that our outcome measures involved event count data for aggression, ZIP regression is the most appropriate approach to account for the large number of zeros.…”

Section: Discussionmentioning

confidence: 99%

Partner aggression among men and women in substance use disorder treatment: Correlates of psychological and physical aggression and injury

Chermack

Murray

Walton

et al. 2008

Drug and Alcohol Dependence

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This study examined intimate partner aggression in a sample of 489 participants enrolled in substance use disorder treatment, and expands on prior research by including measures of various forms of aggression, a mixed gender sample (76% men, 24% women), and measurement of several potential risk domains. Aggression measures included both participant-to-partner and partner-to-participant psychological aggression, physical aggression and injury. Analyses focused on the role of distal and proximal risk factors, including demographics, history of childhood physical and sexual abuse, and family history of problems with alcohol, drugs and depression, as well as recent substance use and symptoms of depression. Overall rates of participant-to-partner psychological aggression (77%), physical aggression (54%) and injuring partners (33%) were high, as were rates of partner-to-participant psychological aggression (73%), physical aggression (51%), and injury (33%). Several distal (family history variables, physical abuse) and proximal factors (binge drinking, several different drugs, depressive symptoms) were bivariately related to most of the aggression measures. However, according to multivariate analyses predicting aggression and injury measures, binge drinking and cocaine use were the drugs significantly associated with most measures, depression symptoms also were related to most aggression and injury measures, and a history of reported childhood physical abuse was related to all frequency of aggression and injury measures among those reporting such behaviors. Overall, the high rates of aggression among both men and women observed in this study further illustrate the need for interventions targeting substance use and aggression, and for further research regarding the interrelationships among substance, aggression and depressive symptoms.

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Section: Discussionmentioning

confidence: 99%

Partner aggression among men and women in substance use disorder treatment: Correlates of psychological and physical aggression and injury

Chermack

Murray

Walton

et al. 2008

Drug and Alcohol Dependence

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“…Although the cognitive effects of acute and chronic NTX may differ, recent data supports equivalent or greater efficacy of acute NTX dosing, relative to daily maintenance, in reducing excessive alcohol intake (Hernandez-Avila et al, 2006). Thus, determining the cognitive effects of acute NTX doses is warranted.…”

Section: Discussion Ntx Effects On Impulsive Choicementioning

confidence: 99%

“…NTX reduces alcohol consumption, craving, and relapse in subjects with a history of alcohol abuse (O'Brien et al, 1996;Anton et al, 1999;Davidson et al, 1999;Hernandez-Avila et al, 2006;see Heidbreder, 2005 for a recent review). Moreover, NTX significantly reduces ethanol consumption in rats (Stromberg et al, 1998) and monkeys (Boyle et al, 1998).…”

Section: Introductionmentioning

confidence: 99%

Endogenous Opioid Blockade and Impulsive Responding in Alcoholics and Healthy Controls

Mitchell

Fields

et al. 2006

Neuropsychopharmacol

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The opioid receptor antagonist naltrexone (NTX) is one of few approved treatments for alcoholism, yet the mechanism by which it reduces drinking remains unclear. In rats, NTX reduces morphine-induced impulsive choice bias; however, nothing is known about the drug's effect on discrete aspects of impulsive behavior in humans, such as decision-making and inhibitory control. Here, we used a modified delay discounting procedure to investigate whether NTX improves decision-making or inhibitory control in humans. We measured the effect of acute NTX (50 mg) on choice between smaller sooner (SS) and larger later monetary rewards and on response errors (motor mismatch) in a high conflict condition in a group of abstinent alcoholics (AA) and healthy control subjects (CS). We previously reported that AA selected the SS option significantly more often than did CS in this paradigm. If the choice bias of AA is due to enhanced endogenous opioid signaling in response to potential reward, NTX should reduce such bias in the AA group. We found that NTX did not reliably reduce impulsive choice in the AA group; however, NTX's effect on choice bias across individuals was robustly predictable. NTX's effect on choice bias was significantly correlated with scores on Rotter's Locus of Control (LOC) scale; increasingly internal LOC scores predicted increasing likelihood of impulsive choices on NTX. In addition, we found that NTX significantly enhanced control of motor responses, particularly within the CS group. These results suggest that endogenous opioids may impair response selection during decision-making under conflict, and that NTX's effects on explicit decision-making are personality-dependent. Determining the biological basis of this dependence could have important implications for effective alcoholism treatment.

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“…Accumulating data have suggested that men and women with alcohol or drug dependence can respond differently to the same pharmacological treatment, typically with men having better treatment outcomes than women (Garbutt et al, 2005;Hernandez-Avila et al, 2006;Pettinati, Dundon, & Lipkin, 2004). However, at least one naltrexone study has suggested that alcohol-dependent women treated with 50mg/day of naltrexone abstained from alcohol for a longer duration than men (Kiefer, Jahn, & Wiedemann, 2005).…”

Section: Introductionmentioning

confidence: 99%

Gender differences with high-dose naltrexone in patients with co-occurring cocaine and alcohol dependence

Pettinati

Kampman

Lynch

et al. 2008

Journal of Substance Abuse Treatment

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This is a randomized, double blind, placebo-controlled clinical trial that evaluated the efficacy of a higher than typical daily dose of naltrexone (150mg/day), taken for 12 weeks, in 164 patients (n=116 men and n=48 women) with co-occurring cocaine and alcohol dependence. Patients were stratified by gender, and then randomly assigned to naltrexone or placebo, and to either cognitive behavioral therapy, or a type of medical management. The two primary outcomes were cocaine and alcohol use. Significant gender by medication interactions were found for cocaine use via urine drug screens [3-way with time] and self-reports [2-way], for drug severity [2-way], and for alcohol use [2-way]. Type of psychosocial treatment did not affect outcomes. Thus, 150mg/day of naltrexone added to a psychosocial treatment resulted in reductions in cocaine and alcohol use, and drug severity in men, compared to higher rates of cocaine and alcohol use and drug severity in women.

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Targeted Versus Daily Naltrexone: Secondary Analysis of Effects on Average Daily Drinking

Cited by 67 publications

References 13 publications

Partner aggression among men and women in substance use disorder treatment: Correlates of psychological and physical aggression and injury

Partner aggression among men and women in substance use disorder treatment: Correlates of psychological and physical aggression and injury

Endogenous Opioid Blockade and Impulsive Responding in Alcoholics and Healthy Controls

Gender differences with high-dose naltrexone in patients with co-occurring cocaine and alcohol dependence

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