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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.
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.
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 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.
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