Alcoholism Treatment

The highest incidence of relapse in patients with alcohol dependence occurs during the first few months following cessation of drinking. In the United States, currently available drug therapies for alcohol dependence include aversion therapy with disulfiram, and naltrexone, an opioid antagonist. Naltrexone has been moderately successful in some small trials, but dose-dependent liver toxicity and a high incidence of nausea limit its use. Acamprosate, available internationally, is being studied in the United States as a nonaversive pharmacotherapeutic agent. Nalmefene is a newer opioid antagonist that, like naltrexone, has no agonist activity and no abuse potential. Additional advantages include a longer half-life, greater bioavailability and no dose-dependent liver toxicity.

Patients were given a two-week trial of a placebo medication while eligibility criteria were assessed. The primary criteria required that patients be between 18 and 65 years of age and have a Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R) diagnosis of alcohol dependence. At baseline, all patients underwent electrocardiography, laboratory tests (including determination of gamma-glutamyltransferase level) and a urine toxicology screen for drug abuse. Exclusion criteria included a history of illicit drug dependence, current use of narcotic or psychotropic medications, history of cirrhosis or baseline liver function studies more than twice the normal levels.

There has also been development of an implant that slowly releases nalmefene over a period of six months.

Nalmefene has been shown to have an effect even in people who are not trying to quit drinking, meaning it is more than a placebo.

Another test report.