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A One-Year Pragmatic Trial of Naltrexone vs. Disulfiram in the Treatment of Alcohol Dependence

by deSouza & deSouza; Alcohol and Alcoholism; 39(6); pages 528-531; 2004.
Originally posted: 11/19/2004:  [www.doctordeluca.com/Library/AddictionMeds/SDTvsSNT.htm]. I would like to thank Dr. Colin Brewer who, with the authors permissions, made this Abstract of what was then an as-yet-unpublished article currently "in press."
 
Revised 1/5/2005: Link to FULL TEXT PDF added

[Link to Full Text in PDF format]

ABSTRACT

OBJECTIVE
Naltrexone and Disulfiram both are known to reduce relapse in alcohol dependence. They have been rarely compared in clinical trials. The aim of this study was to compare the efficacy of these compounds in conditions similar to those in routine clinical practice.

METHOD
Random allocation of a year of treatment with either Naltrexone or Disulfiram were made to 100 alcoholic men with Alcohol Dependence (DSM-IV criteria). All patients were such who would be accompanied by a family member for follow up. The alcohol consumption, craving and adverse events were recorded weekly for the first 3 months, then fortnightly for a year by the treating psychiatrist. Serum GGT was also measured. The results were statistically correlated and presented.

RESULTS
At the end of the year the number of patients that remained abstinent with Disulfiram were twice that with Naltrexone. The survival time till the first relapse was greater with Disulfiram than Naltrexone. The number of patients who were abstaining at the end of one year was 86% with Disulfiram compared to 56% with Naltrexone. However, with regards to carving the patients with Naltrexone had significantly lower scores than those with Disulfiram.

CONCLUSIONS
Disulfiram has a considerable superiority over Naltrexone in preventing relapse among the patients of Alcohol Dependence. However, comparative studies between these two molecules in various treatment settings and among different types of alcoholics warrants a consideration.

[Link to Full Text in PDF format]

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