Naltrexone in the Treatment of Alcohol Dependence

Volpicelli, Joseph R.

doi:10.1001/archpsyc.1992.01820110040006

Cited by 1,828Substance Abuse Treatment and OutcomesAlcohol Consumption and Health EffectsAlcoholism and Thiamine Deficiency

Naltrexone in the Treatment of Alcohol Dependence

Volpicelli, Joseph R.·1992·Archives of General Psychiatry

DOI 10.1001/archpsyc.1992.01820110040006

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Abstract

Seventy male alcohol-dependent patients participated in a 12-week, double-blind, placebo-controlled trial of naltrexone hydrochloride (50 mg/d) as an adjunct to treatment following alcohol detoxification. Subjects taking naltrexone reported significantly less alcohol craving and days in which any alcohol was consumed. During the 12-week study, only 23% of the naltrexone-treated subjects met the criteria for a relapse, whereas 54.3% of the placebo-treated subjects relapsed. The primary effect of naltrexone was seen in patients who drank any alcohol while attending outpatient treatment. Nineteen (95%) of the 20 placebo-treated patients relapsed after they sampled alcohol, while only eight (50%) of 16 naltrexone-treated patients exposed to alcohol met relapse criteria. Naltrexone was not associated with mood changes or other psychiatric symptoms. Significant side effects (nausea) occurred in two naltrexone-treated subjects, and one naltrexone-treated subject complained of increased pain from arthritis. These results suggest that naltrexone may be a safe and effective adjunct to treatment in alcohol-dependent subjects, particularly in preventing alcohol relapse.

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Naltrexone significantly decreases drinking days and relapse rates in patients with alcohol use disorder.
“Naltrexone significantly decreases drinking days and relapse rates in patients with alcohol use disorder 204 , and has been shown to reduce alcohol's rewarding effects 205,206 and number of drinks per drinking day 207 .”
From Substance use disorders: a comprehensive update of classification, epidemiology, neurobiology, clinical aspects, treatment and prevention (2023) · cites this paper as [204]
Opioid antagonists reduce cravings and are now being used to treat an increasing variety of disorders including alcoholism, opioid dependence, and obesity.
“Furthermore, opioid antagonists are known to reduce cravings, and are now being used to treat an increasing variety of disorders including alcoholism, opioid dependence, and obesity (O’Malley et al 1992; Volpicelli et al 1992; Greenway et al 2010; Minozzi et al 2011).”
From The behavioral, anatomical and pharmacological parallels between social attachment, love and addiction (2012) · cites this paper as Volpicelli et al 1992

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Authors: Volpicelli, J. R.
Affiliations: University of Pennsylvania (US)
Corresponding author: Volpicelli, Joseph R.
ORCID: Volpicelli, Joseph R.
Venue: Archives of General Psychiatry
Publisher: American Medical Association (AMA)
Published: 1992-11-01
Volume: 49
Issue: 11
Pages: 876
ISSN: 0003-990X (ISSN-L)
DOI: 10.1001/archpsyc.1992.01820110040006
OpenAlex: W2104538950
Cited by: 1,828
References: 23
Citations by year: 2026: 7 · 2025: 10 · 2024: 17 · 2023: 15 · 2022: 25 · 2021: 17 · 2020: 28 · 2019: 26 · 2018: 29 · 2017: 26 · 2016: 32 · 2015: 48 · 2014: 49 · 2013: 47 · 2012: 58
FWCI: 36.57
Type: journal article
Language: en
Open access: closed
Locations: Archives of General Psychiatry (publishedVersion)
PubMed (publishedVersion)
Funders: National Institute on Alcohol Abuse and Alcoholism (AA0751701A1)
National Institute on Drug Abuse (DA-05186)
Topics: Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
Health Sciences › Medicine › Neurology › Alcoholism and Thiamine Deficiency
Keywords: naltrexone, alcoholism, alcohol craving, alcohol relapse prevention, alcohol detoxification, outpatient care, opioid antagonists, adjunct pharmacotherapy, nausea, arthritic pain
MeSH terms: Adult, Alcohol Drinking, Alcoholism, Ambulatory Care, Combined Modality Therapy, Double-Blind Method, Humans, Male, Naltrexone, Nausea, Patient Dropouts, Placebos, Psychiatric Status Rating Scales, Psychotherapy, Recurrence, Severity of Illness Index, Treatment Outcome

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Naltrexone in the Treatment of Alcohol Dependence

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