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Substance use disorders among older adults: A review of randomized controlled pharmacotherapy trials.
World J Psychiatry 2019; 9(5):78-82WJ

Abstract

Substance use disorders (SUDs) are a growing problem among older adults. Acamprosate, disulfiram, and naltrexone are United States Food and Drug Administration (referred to as FDA) approved for the treatment of alcohol use disorder, and buprenorphine is approved for the treatment of opiate use disorder among adults. However, the data on the use of these medications for the treatment of SUDs among older adults are unclear from randomized controlled trials (referred to as RCTs). A review of the literature indicates that there are only two RCTs that evaluated the use of pharmacologic agents for SUDs among older adults (≥ 50 years). One trial evaluated the use of naltrexone when compared to placebo for the treatment of alcohol use disorder among individuals, 50-70 years in age. The other trial evaluated the use of naltrexone or placebo as adjuncts with sertraline in the treatment of alcohol use disorder among individuals older than 55 years in age. Both trials indicated that the use of naltrexone reduced the rates of relapse among older adults with alcohol use disorder. However, we did not identify any RCTs that studied the use of buprenorphine, acamprosate, or disulfiram for SUDs among older adults. Based on available evidence, it would be safe to conclude that limited data indicate some efficacy for naltrexone in the treatment of alcohol use disorder among older adults. However, data from controlled trials on the use of other medications that are FDA approved for the treatment of SUDs among younger adults are nonexistent among older adults with SUDs.

Authors+Show Affiliations

Department of Psychiatry and Behavioral Sciences, Cleveland Clinic Akron General, Ohio, NH 44106, United States rajesh.tampi@gmail.com.Savant Care Clinic, California, CA 90277, United States.Department of Psychiatry, MetroHealth, Cleveland, OH 44109, United States.Department of Psychiatry, MetroHealth, Cleveland, OH 44109, United States.Department of Psychiatry, MetroHealth, Cleveland, OH 44109, United States.Department of Psychiatry, MetroHealth, Cleveland, OH 44109, United States.Department of Psychiatry, MetroHealth, Cleveland, OH 44109, United States.

Pub Type(s)

Editorial

Language

eng

PubMed ID

31559148

Citation

Tampi, Rajesh R., et al. "Substance Use Disorders Among Older Adults: a Review of Randomized Controlled Pharmacotherapy Trials." World Journal of Psychiatry, vol. 9, no. 5, 2019, pp. 78-82.
Tampi RR, Chhatlani A, Ahmad H, et al. Substance use disorders among older adults: A review of randomized controlled pharmacotherapy trials. World J Psychiatry. 2019;9(5):78-82.
Tampi, R. R., Chhatlani, A., Ahmad, H., Balaram, K., Dey, J., Escobar, R., & Lingamchetty, T. (2019). Substance use disorders among older adults: A review of randomized controlled pharmacotherapy trials. World Journal of Psychiatry, 9(5), pp. 78-82. doi:10.5498/wjp.v9.i5.78.
Tampi RR, et al. Substance Use Disorders Among Older Adults: a Review of Randomized Controlled Pharmacotherapy Trials. World J Psychiatry. 2019 Sep 19;9(5):78-82. PubMed PMID: 31559148.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Substance use disorders among older adults: A review of randomized controlled pharmacotherapy trials. AU - Tampi,Rajesh R, AU - Chhatlani,Aarti, AU - Ahmad,Hajra, AU - Balaram,Kripa, AU - Dey,Joel, AU - Escobar,Ricardo, AU - Lingamchetty,Thejasvi, Y1 - 2019/09/19/ PY - 2019/04/29/received PY - 2019/08/01/revised PY - 2019/08/06/accepted PY - 2019/9/28/entrez KW - Acamprosate KW - Buprenorphine KW - Disulfiram KW - Naltrexone KW - Older adults KW - Substance use SP - 78 EP - 82 JF - World journal of psychiatry JO - World J Psychiatry VL - 9 IS - 5 N2 - Substance use disorders (SUDs) are a growing problem among older adults. Acamprosate, disulfiram, and naltrexone are United States Food and Drug Administration (referred to as FDA) approved for the treatment of alcohol use disorder, and buprenorphine is approved for the treatment of opiate use disorder among adults. However, the data on the use of these medications for the treatment of SUDs among older adults are unclear from randomized controlled trials (referred to as RCTs). A review of the literature indicates that there are only two RCTs that evaluated the use of pharmacologic agents for SUDs among older adults (≥ 50 years). One trial evaluated the use of naltrexone when compared to placebo for the treatment of alcohol use disorder among individuals, 50-70 years in age. The other trial evaluated the use of naltrexone or placebo as adjuncts with sertraline in the treatment of alcohol use disorder among individuals older than 55 years in age. Both trials indicated that the use of naltrexone reduced the rates of relapse among older adults with alcohol use disorder. However, we did not identify any RCTs that studied the use of buprenorphine, acamprosate, or disulfiram for SUDs among older adults. Based on available evidence, it would be safe to conclude that limited data indicate some efficacy for naltrexone in the treatment of alcohol use disorder among older adults. However, data from controlled trials on the use of other medications that are FDA approved for the treatment of SUDs among younger adults are nonexistent among older adults with SUDs. SN - 2220-3206 UR - https://www.unboundmedicine.com/medline/citation/31559148/Substance_use_disorders_among_older_adults:_A_review_of_randomized_controlled_pharmacotherapy_trials L2 - http://www.wjgnet.com/2220-3206/full/v9/i5/78.htm DB - PRIME DP - Unbound Medicine ER -