The Efficacy of Acamprosate and Naltrexone in the Treatment of Alcohol Dependence: A Relative Benefits Analysis of Randomized Controlled Trials

Snyder, James L.; Bowers, Thomas G.

doi:10.1080/00952990802082198

Cited by 39 publications

(24 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Double-blind, randomized, controlled trials have found that compared to placebo, naltrexone may help reduce number of days drinking, amount of alcohol consumed, number of relapses (Snyder & Bowers, 2008), and especially in those who complete treatment. King, Cao, Zhang and O’Malley (2013) recently found that nicotine-dependent females treated with naltrexone had significantly less weight gain at a one-year follow-up after achieving abstinence from nicotine, suggesting that opioid antagonist treatment may decrease urges prompting binge eating episodes after cessation from substance addiction.…”

Section: Dopamine and Opiate Hypothesesmentioning

confidence: 99%

The overlap between binge eating disorder and substance use disorders: Diagnosis and neurobiology

Schreiber¹,

Odlaug²,

Grant³

2013

Journal of Behavioral Addictions

104

View full text Add to dashboard Cite

Background and aims: Binge eating disorder (BED) is a relatively common condition, especially in young adult females, and is characterized by chronic over-consumption of food resulting in embarrassment, distress, and potential health problems. It is formally included as a disorder in DSM-5 for the first time, an acknowledgement to its debilitating nature. This article explores the overlap between binge eating disorder and substance use disorders (SUD). Methods: The bibliographic search was a computerized screen of PubMed databases from January 1990 to the present. Binge eating disorder, substance use disorder, binging, obesity, food addiction, comorbidity, dopamine, opioid, serotonin, glutamate, and pharmacological treatment were the keywords used in searching. Results: BED shares similar phenomenology to SUD, including significant urges to engage in binging episodes, resulting in distress and impairment. Similar neurobiological pathways are found in both BED and SUD and medications based on similar neurobiology have been examined for both disorders. A subset of individuals with BED may have a “food addiction”, but there is no clinical agreement on the meaning of “food addiction”. Exploring the relationship between BED and obesity may also shed light on the extent to which BED can be viewed as an addiction. Conclusions: Overall, nascent research regarding BED and SUD suggests an overlap between these disorders, but there are discrepancies between these two disorders that need further exploration.

show abstract

Section: Dopamine and Opiate Hypothesesmentioning

confidence: 99%

The overlap between binge eating disorder and substance use disorders: Diagnosis and neurobiology

Schreiber¹,

Odlaug²,

Grant³

2013

Journal of Behavioral Addictions

104

View full text Add to dashboard Cite

show abstract

“…Several reviews and meta-analyses have reported small or mixed effects for each medication (7-14), and treatment providers cite concerns over efficacy as one barrier to greater medication use (5). Instead of further tests of the global or relative efficacy of each medication, clinicians and researchers need to know in what ways and under what circumstances each medication is more helpful.…”

mentioning

confidence: 99%

Meta‐analysis of naltrexone and acamprosate for treating alcohol use disorders: when are these medications most helpful?

et al. 2012

View full text Add to dashboard Cite

Aims Although debates over the efficacy of oral naltrexone and acamprosate in treating alcohol use disorders tend to focus on their global efficacy relative to placebo or their efficacy relative to each other, the underlying reality may be more nuanced. This meta-analysis examined when naltrexone and acamprosate are most helpful by testing: (1) the relative efficacy of each medication given its presumed mechanism of action (reducing heavy drinking versus fostering abstinence) and (2) whether different ways of implementing each medication (required abstinence before treatment, detoxification before treatment, goal of treatment, length of treatment, dosage) moderate its effects. Methods A systematic literature search identified 64 randomized, placebo-controlled, English-language clinical trials completed between 1970 and 2009 focused on acamprosate or naltrexone. Results Acamprosate had a significantly larger effect size than naltrexone on the maintenance of abstinence, and naltrexone had a larger effect size than acamprosate on the reduction of heavy drinking and craving. For naltrexone, requiring abstinence before the trial was associated with larger effect sizes for abstinence maintenance and reduced heavy drinking compared to placebo. For acamprosate, detoxification before medication administration was associated with better abstinence outcomes compared to placebo. Conclusions In treatment for alcohol use disorders, acamprosate has been found to be slightly more efficacious in promoting abstinence and naltrexone slightly more efficacious in reducing heavy drinking and craving. Detoxification before treatment or a longer period of required abstinence before treatment is associated with larger medication effects for acamprosate and naltrexone, respectively.

show abstract

“…Bazı araştırmacılar da, COMBINE çalışmasında belirgin "plasebo etkisinin" akamprosatın yararlı etkisini maskelemiş olabileceğini (41) ve aslında yaşam kalitesi gibi ayıklıkla ilişkili diğer ölçütlerdeki düzelmenin akamprosat ile tedavi edilen hastalarda, plasebo verilen hastalara göre daha yüksek olduğunu (42) öne sürmüştür. Ancak son meta-analizlerde görüle-ceği gibi, yıllar içinde akamprosat, toplam alkol kullanı-mını ve öznel alkol aşermesini azaltmada ve ayıklığı sağlamada, küçükten orta dereceye kadar değişen etki büyüklüğü sergilemiştir (43)(44)(45)(46)(47)(48)(49).…”

Section: Etkinlikle İlgili Klinik çAlışmalarunclassified

Alkol Aşermesi, Glutamat ve Akamprosat / Alcohol Craving, Glutamate and Acamprosate

Evren¹

2012

Dusunen Adam

View full text Add to dashboard Cite

The Efficacy of Acamprosate and Naltrexone in the Treatment of Alcohol Dependence: A Relative Benefits Analysis of Randomized Controlled Trials

Cited by 39 publications

References 43 publications

The overlap between binge eating disorder and substance use disorders: Diagnosis and neurobiology

The overlap between binge eating disorder and substance use disorders: Diagnosis and neurobiology

Meta‐analysis of naltrexone and acamprosate for treating alcohol use disorders: when are these medications most helpful?

Alkol Aşermesi, Glutamat ve Akamprosat / Alcohol Craving, Glutamate and Acamprosate

Contact Info

Product

Resources

About