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Gabapentin combined with naltrexone for the treatment of alcohol dependence.
Am J Psychiatry. 2011 Jul; 168(7):709-17.AJ

Abstract

OBJECTIVE

Naltrexone, an efficacious medication for alcohol dependence, does not work for everyone. Symptoms such as insomnia and mood instability that are most evident during early abstinence might respond better to a different pharmacotherapy. Gabapentin may reduce these symptoms and help prevent early relapse. This clinical trial evaluated whether the combination of naltrexone and gabapentin was better than naltrexone alone and/or placebo during the early drinking cessation phase (first 6 weeks), and if so, whether this effect persisted.

METHOD

A total of 150 alcohol-dependent individuals were randomly assigned to a 16-week course of naltrexone alone (50 mg/day [N=50]), naltrexone (50 mg/day) with gabapentin (up to 1,200 mg/day [N=50]) added for the first 6 weeks, or double placebo (N=50). All participants received medical management.

RESULTS

During the first 6 weeks, the naltrexone-gabapentin group had a longer interval to heavy drinking than the naltrexone-alone group, which had an interval similar to that of the placebo group; had fewer heavy drinking days than the naltrexone-alone group, which in turn had more than the placebo group; and had fewer drinks per drinking day than the naltrexone-alone group and the placebo group. These differences faded over the remaining weeks of the study. Poor sleep was associated with more drinking in the naltrexone-alone group but not in the naltrexone-gabapentin group, while a history of alcohol withdrawal was associated with better response in the naltrexone-gabapentin group.

CONCLUSIONS

The addition of gabapentin to naltrexone improved drinking outcomes over naltrexone alone during the first 6 weeks after cessation of drinking. This effect did not endure after gabapentin was discontinued.

Authors+Show Affiliations

Medical University of South Carolina, Institute of Psychiatry, SC 29425, USA. antonr@musc.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

21454917

Citation

Anton, Raymond F., et al. "Gabapentin Combined With Naltrexone for the Treatment of Alcohol Dependence." The American Journal of Psychiatry, vol. 168, no. 7, 2011, pp. 709-17.
Anton RF, Myrick H, Wright TM, et al. Gabapentin combined with naltrexone for the treatment of alcohol dependence. Am J Psychiatry. 2011;168(7):709-17.
Anton, R. F., Myrick, H., Wright, T. M., Latham, P. K., Baros, A. M., Waid, L. R., & Randall, P. K. (2011). Gabapentin combined with naltrexone for the treatment of alcohol dependence. The American Journal of Psychiatry, 168(7), 709-17. https://doi.org/10.1176/appi.ajp.2011.10101436
Anton RF, et al. Gabapentin Combined With Naltrexone for the Treatment of Alcohol Dependence. Am J Psychiatry. 2011;168(7):709-17. PubMed PMID: 21454917.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Gabapentin combined with naltrexone for the treatment of alcohol dependence. AU - Anton,Raymond F, AU - Myrick,Hugh, AU - Wright,Tara M, AU - Latham,Patricia K, AU - Baros,Alicia M, AU - Waid,L Randolph, AU - Randall,Patrick K, Y1 - 2011/03/31/ PY - 2011/4/2/entrez PY - 2011/4/2/pubmed PY - 2011/8/31/medline SP - 709 EP - 17 JF - The American journal of psychiatry JO - Am J Psychiatry VL - 168 IS - 7 N2 - OBJECTIVE: Naltrexone, an efficacious medication for alcohol dependence, does not work for everyone. Symptoms such as insomnia and mood instability that are most evident during early abstinence might respond better to a different pharmacotherapy. Gabapentin may reduce these symptoms and help prevent early relapse. This clinical trial evaluated whether the combination of naltrexone and gabapentin was better than naltrexone alone and/or placebo during the early drinking cessation phase (first 6 weeks), and if so, whether this effect persisted. METHOD: A total of 150 alcohol-dependent individuals were randomly assigned to a 16-week course of naltrexone alone (50 mg/day [N=50]), naltrexone (50 mg/day) with gabapentin (up to 1,200 mg/day [N=50]) added for the first 6 weeks, or double placebo (N=50). All participants received medical management. RESULTS: During the first 6 weeks, the naltrexone-gabapentin group had a longer interval to heavy drinking than the naltrexone-alone group, which had an interval similar to that of the placebo group; had fewer heavy drinking days than the naltrexone-alone group, which in turn had more than the placebo group; and had fewer drinks per drinking day than the naltrexone-alone group and the placebo group. These differences faded over the remaining weeks of the study. Poor sleep was associated with more drinking in the naltrexone-alone group but not in the naltrexone-gabapentin group, while a history of alcohol withdrawal was associated with better response in the naltrexone-gabapentin group. CONCLUSIONS: The addition of gabapentin to naltrexone improved drinking outcomes over naltrexone alone during the first 6 weeks after cessation of drinking. This effect did not endure after gabapentin was discontinued. SN - 1535-7228 UR - https://www.unboundmedicine.com/medline/citation/21454917/Gabapentin_combined_with_naltrexone_for_the_treatment_of_alcohol_dependence_ L2 - https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2011.10101436?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -