The effects of venlafaxine and cognitive behavioral therapy alone and combined in the treatment of co-morbid alcohol use-anxiety disorders

Abstract

The effects of the antidepressant venlafaxine (VEN-225 mg daily) and transdiagnostic cognitive behavioral treatment (CBT) alone and in combination on alcohol intake in subjects with co-morbid alcohol use disorders (AUDs) and anxiety disorders were compared. Drinking outcomes and anxiety were assessed for 81 subjects treated for 11 weeks with one of 4 conditions:1) VEN-CBT, 2)VEN-Progressive Muscle Relaxation therapy (PMR),3) Placebo (PLC)-CBT and 4) a comparison group of PLC-PMR. For subjects who reported taking at least one dose of study medication, the Time × Group interaction was significant for percent days of heavy drinking and drinks consumed per day. For the measure of percent days heavy drinking, the paired comparison of PLC-CBT versus PLC-PMR group indicated that the PLC-CBT group had greater drinking reductions, whereas other groups were not superior to the comparison group. In Week 11, the proportion of subjects in the PLC-CBT group that had a 50% reduction from baseline in percent days heavy drinking was significantly greater than those in the comparison group. Of the 3 “active treatment” groups only the PLC-CBT group had significantly decreased heavy drinking when contrasted to the comparison group. This finding suggests that the transdiagnostic CBT approach of Barlow and colleagues may have value in the management of heavy drinking in individuals with co-morbid alcoholism and anxiety.

Relationships among adaptive and maladaptive emotion regulation strategies and psychopathology during the treatment of comorbid anxiety and alcohol use disorders

“…Five patients (6%) identified as African American, and six patients (7.4%) identified as another race. Detailed information regarding the sample can be found in Ciraulo et al (2013).…”

“…The current study was conducted using data from a clinical trial, which utilized a 2×2 design to investigate the efficacy of 11 weekly sessions of transdiagnostic cognitive-behavioral therapy (the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders; Barlow, Allen, & Choate, 2004) versus progressive muscle relaxation combined with either venlafaxine or placebo as a treatment for patients with comorbid alcohol use and anxiety disorders (for full study description, see Ciraulo et al, 2013). The procedures of the aforementioned clinical trial were approved by Institutional Review Boards (IRBs) at the following institutions: Boston University, Boston University Medical Center, and Central Texas Veterans Health Care System.…”

“… 1 There were significant improvements in depression, anxiety, and craving from pre- to post-treatment, though no significant differences were observed between treatment conditions, see Ciraulo et al, (2013) for details of these analyses. …”

Toward a Unified Treatment for Emotional Disorders: Update on the Science and Practice

“…Some protocols and trials are underway or in the works, including a combined F-SET/cannabiscessation treatment (Buckner et al, 2014), a pilot of CBT for epilepsy patients with comorbid depression and/or anxiety (Macrodimitris et al, 2011) a brief CBT package for cancer-related PTSD, depression and anxiety (Kangas, Milross, & Bryant, 2014), a framework for transdiagnostic treatment of pain and emotional symptoms (Linton, 2013), as well as the trial of alcohol use disorders and anxiety (Ciraulo et al, 2013). Additionally, a emergent literature (e.g.,…”

Eficácia da terapia cognitiva processual no tratamento do transtorno de ansiedade social: avaliação de um ensaio clínico randomizado

“…Inicialmente, foi delineado um N de no mínimo 60 participantes ( A seleção do tamanho da amostra também foi pautada com base nos estudos de diferentes centros de pesquisa internacionais, uma vez que é comum encontrar na literatura ensaios clínicos randomizados na abordagem de TCC que utilizam um N que varia entre 20 a 30 participantes por grupo, ou até com uma amostra menor por condição (Ciraulo et al, 2013;Hoexter et al, 2013;Niles, Mesri, Burklund, Lieberman, & Craske, 2013;Wuthrich & Rapee, 2013 …”