Pharmacological Relapse Prevention of Alcoholism: Clinical Predictors of Outcome

Vol. 11, No. 2, 2005

Free Abstract Article (References) Article (PDF 192 KB)

Research Report

Pharmacological Relapse Prevention of Alcoholism: Clinical Predictors of Outcome
Falk Kiefer, Hauke Helwig, Timo Tarnaske, Christian Otte, Holger Jahn, Klaus Wiedemann

^aDepartment of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health (CIMH), University of Heidelberg, Heidelberg;
^bDepartment of Psychiatry and Psychotherapy, University Hospital of Hamburg, Hamburg, Germany

Address of Corresponding Author

Eur Addict Res 2005;11:83-91 (DOI: 10.1159/000083037)

Key Words

Alcohol
Acamprosate
Naltrexone
Craving
Relapse
Cloninger
Lesch

Abstract

Objective: The efficacy of pharmacological relapse prevention in alcoholism with acamprosate and naltrexone has been supported by several controlled trials. It remains uncertain whether any differential indication for treatment exists. Methods: We evaluated outcome data of a controlled trial on acamprosate and naltrexone in patients with low vs. high baseline somatic distress, depression and anxiety (Symptom Checklist-90, SCL-90), low vs. high baseline craving, and according to typological differentiation as proposed by Cloninger and Lesch. These variables have previously been suggested to be predictors of outcome. Results: Comparing the course of abstinence rates, acamprosate was mainly efficacious in patients with low baseline somatic distress, whereas naltrexone was effective especially in patients with high baseline depression. Baseline craving showed no predictive value. Pharmacological treatment was efficacious in type II alcoholics according to Cloninger. Applying Lesch's typological differentiation, acamprosate was shown to be mainly effective in type I, whereas naltrexone revealed best treatment effects in type III and IV. Conclusion: The study supports the hypothesis that different subgroups of alcohol dependent subjects might benefit from a differential treatment with either naltrexone or acamprosate. Baseline psychopathology and especially typological differentiation might be useful in matching patients to distinct pharmacotherapeutic interventions.

Author Contacts

Dr. Falk Kiefer
Department of Addictive Behaviour and Addiction Medicine
Central Institute of Mental Health (CIMH), University of Heidelberg J5,
DE-68159 Mannheim (Germany)
Tel +49 621 1703 3502, Fax +49 621 1703 3505, E-Mail kiefer@zi-mannheim.de

Article Information

Number of Print Pages : 9
Number of Figures : 2, Number of Tables : 3, Number of References : 40

Medline Abstract (ID 15785069)

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