A double blind, placebo-controlled trial that combines disulfiram and naltrexone for treating co-occurring cocaine and alcohol dependence
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Background This is a double blind, placebo-controlled trial that evaluated the efficacy of disulfiram, naltrexone and their combination in patients with co-occurring cocaine and alcohol dependence.Methods 208 patients were randomized to disulfiram (250 mg/day), naltrexone (100 mg/day), the combination, or placebo for 11 weeks. Outcomes were in-trial abstinence from cocaine and/or alcohol.Results Few safety concerns were reported, although medication adherence was low in a number of patients for both medications, alone or in combination. In the primary analyses (GEE modeling), abstinence from cocaine as measured by cocaine-negative urines and days of self-reported abstinence from cocaine or alcohol did not differ between placebo and any of the medication groups. However, patients taking disulfiram (alone or in combination) were most likely to achieve combined abstinence from cocaine and alcohol. Secondary analyses revealed that patients taking the disulfiram-naltrexone combination were most likely to achieve 3 consecutive weeks of abstinence from cocaine and alcohol.Conclusion There was an association between disulfiram treatment and abstinence from cocaine and alcohol. More patients taking the disulfiram-naltrexone combination achieved 3 consecutive weeks of abstinence in treatment than placebo-treated patients.
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Compliance has been a serious impediment in disulfiram research.
“Compliance has been a serious impediment in disulfiram research in numerous studies [26], [27].”
From Disulfiram Efficacy in the Treatment of Alcohol Dependence: A Meta-Analysis (2014) · cites this paper as [26]
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- Authors
- Pettinati, H. M., Kampman, K. M., Lynch, K. G., Xie, H., Dackis, C., Rabinowitz, A. R., & O′Brien, C. P.
- Affiliations
- University of Pennsylvania (US)
- Corresponding author
- Pettinati, Helen M.
- Venue
- Addictive Behaviors
- Publisher
- Elsevier BV
- Published
- 2008-05
- Volume
- 33
- Issue
- 5
- Pages
- 651-667
- ISSN
- 0306-4603 (ISSN-L)
- PMC
- PMC2374760
- OpenAlex
- W2101752617
- Cited by
- 95
- References
- 71
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 2 · 2023: 2 · 2022: 3 · 2021: 2 · 2020: 4 · 2019: 8 · 2018: 5 · 2017: 3 · 2016: 4 · 2015: 6 · 2014: 7 · 2013: 2 · 2012: 12
- FWCI
- 5.50
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Addictive Behaviors (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (5p60da005186-25)
- National Institute on Drug Abuse (P50 DA 12756, P60DA05186, P60-DA005186, P50DA012756)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
- Keywords
- disulfiram, naltrexone, cocaine dependence, alcoholism, co-occurring substance use disorders, combination pharmacotherapy, abstinence, medication adherence, treatment efficacy
- MeSH terms
- Adolescent, Adult, Aged, Alcohol Deterrents, Alcoholism, Disulfiram, Double-Blind Method, Drug Therapy, Combination, Female, Humans, Male, Middle Aged, Naltrexone, Narcotic Antagonists, Treatment Outcome, Cocaine-Related Disorders
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