Disulfiram treatment of alcoholism. A Veterans Administration cooperative study.
ABSTRACT We conducted a controlled, blinded, multicenter study of disulfiram treatment of alcoholism in 605 men randomly assigned to 250 mg of disulfiram (202 men); 1 mg of disulfiram (204 men), a control for the threat of the disulfiram-ethanol reaction; or no disulfiram (199 men), a control for the counseling that all received. Bimonthly treatment assessments were done for one year. Relative/friend interviews and blood and urine ethanol analyses were used to corroborate patients' reports. There were no significant differences among the groups in total abstinence, time to first drink, employment, or social stability. Among the patients who drank and had a complete set of assessment interviews, those in the 250-mg disulfiram group reported significantly fewer drinking days (49.0 +/- 8.4) than those in the 1-mg (75.4 +/- 11.9) or the no-disulfiram (86.5 +/- 13.6) groups. There was a significant relationship between adherence to drug regimen and complete abstinence in all groups. We conclude that disulfiram may help reduce drinking frequency after relapse, but does not enhance counseling in aiding alcoholic patients to sustain continuous abstinence or delay the resumption of drinking.
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ABSTRACT: Eine qualifizierte ambulante oder stationäre Entzugsbehandlung stellt in der Regel die erste therapeutische Intervention im Rahmen der Akutbehandlung einer Alkoholabhängigkeit dar. Allerdings lassen sich durch diese Maßnahme alleine häufig noch keine befriedigenden Therapieergebnisse erreichen.MMW Fortschritte der Medizin 05/2013; 155(8):63-66. DOI:10.1007/s15006-013-0644-3
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ABSTRACT: Background We examined whether the effects of topiramate and a single nucleotide polymorphism (rs2832407) in GRIK1, which encodes a kainate receptor subunit, persisted following a 12-week, placebo-controlled trial in 138 heavy drinkers with a treatment goal of reduced drinking. During treatment, topiramate 200 mg/d significantly reduced heavy drinking days and increased the frequency of abstinent days (Am J Psychiatry, 2014, 171:445). In the European-American (EA) subsample (n = 122), rs2832407 moderated the treatment effect on heavy drinking.Methods Patients were re-interviewed 3 and 6 months after the end of treatment. During treatment, we obtained 92.4% of drinking data, with 89.1 and 85.5% complete data at the 3- and 6-month follow-up visits, respectively. We examined 4 outcomes over time in the overall sample and the EA subsample: percent heavy drinking days (PHDD), percent days abstinent (PDA), serum γ-glutamyl transpeptidase (GGTP) concentration, and a measure of alcohol-related problems.ResultsIn the full sample, the lower PHDD and higher PDA seen with topiramate treatment were no longer significant during follow-up. Nonetheless, the topiramate-treated patients had lower alcohol-related problem scores during treatment and both follow-up periods. Further, in the EA subsample, the greater reduction in PHDD seen with topiramate treatment in rs2832407*C-allele homozygotes persisted throughout follow-up, with no significant effects in A-allele carriers. A reduction in GGTP concentration was consistent with the reduction in heavy drinking, but did not reach statistical significance.Conclusions There are persistent therapeutic effects of topiramate in heavy drinkers, principally in rs2832407*C-allele homozygotes.Alcoholism Clinical and Experimental Research 12/2014; 38(12). DOI:10.1111/acer.12578 · 3.31 Impact Factor
Neurociencias y adiciones, Edited by Eduardo Pedrero Pérez, José María Ruiz Sánchez de León, Antonio Verdejo García, Marcos Llanero Luque, Emilio Ambrosio Flores, 01/2011: chapter Factores de vulnerabilidad para desarrollar una adicción: elementos para su prevención: pages 99-110; Sociedad Española de Toxicomanías., ISBN: 978-84-615-0572-2