The DOI matches its Crossref record; 10 of the 10 references it cites were found in a registry or an index.
Efficacy and safety of naltrexone and acamprosate in the treatment of alcohol dependence: a systematic review
Abstract
Aims To ascertain the efficacy and safety of naltrexone and acamprosate in the treatment of alcohol dependence. Methods Systematic review of the literature (1990–2002) and meta‐analysis of full published randomized and controlled clinical trials assessing acamprosate or naltrexone therapy in alcohol dependence. Estimates of effect were calculated according to the fixed‐effects model. Measurements Relapse and abstinence rates, cumulative abstinence duration and treatment compliance were considered as primary outcomes. Findings Thirty‐three studies met the inclusion criteria. Acamprosate was associated with a significant improvement in abstinence rate [odds ratio (OR): 1.88 (1.57, 2.25), P < 0.001] and days of cumulative abstinence [WMD: 26.55 (17.56, 36.54]. Short‐term administration of naltrexone reduced the relapse rate significantly [OR: 0.62 (0.52, 0.75), P < 0.001], but was not associated with a significant modification in the abstinence rate [OR: 1.26 (0.97,1.64), P = 0.08]. There were insufficient data to ascertain naltrexone's efficacy over more prolonged periods. Acamprosate had a good safety pattern and was associated with a significant improvement in treatment compliance [OR: 1.29 (1.13,1.47), P < 0.001]. Naltrexone's side effects were more numerous, yet the drug was nevertheless tolerated acceptably without being associated with a lower adherence to treatment (OR: 0.94 (0.80, 1.1), P = 0.5). However, overall compliance was relatively low with both medications. Conclusions Both acamprosate and naltrexone are effective as adjuvant therapies for alcohol dependence in adults. Acamprosate appears to be especially useful in a therapeutic approach targeted at achieving abstinence, whereas naltrexone seems more indicated in programmes geared to controlled consumption. Both drugs are safe and acceptably tolerated but issues of compliance need to be addressed adequately to assure their usefulness in clinical practice.
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Cites
Assessing the quality of reports of randomized clinical trials: Is blinding necessary?
Jadad, A. R., Moore, R. A., Carroll, D., Jenkinson, C., Reynolds, D. J. M., Gavaghan, D. J., & McQuay, H. J. (1996) · Controlled Clinical Trials · doi:10.1016/0197-2456(95)00134-4 · Cited by 17,582
Naltrexone in the Treatment of Alcohol Dependence
Volpicelli, J. R. (1992) · Archives of General Psychiatry · doi:10.1001/archpsyc.1992.01820110040006 · Cited by 1,828
meta-analysis bias in location and selection of studies
Egger, M., & Smith, G. D. (1998) · BMJ · doi:10.1136/bmj.316.7124.61 · Cited by 1,374
Egger, M., Jüni, P., Bartlett, C., Holenstein, F., & Sterne, J. (2003) · Health Technology Assessment · doi:10.3310/hta7010 · Cited by 1,181
Naltrexone in the Treatment of Alcohol Dependence
Krystal, J. H., Cramer, J. A., Krol, W. F., Kirk, G. F., & Rosenheck, R. A. (2001) · New England Journal of Medicine · doi:10.1056/nejmoa011127 · Cited by 618
Invited commentary: a critical look at some popular meta-analytic methods
Greenland, S. (1994) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a117248 · Cited by 511
Publication and related biases.
Song, Eastwood, Gilbody, Duley, & Sutton (2000) · Health Technology Assessment · doi:10.3310/hta4100 · Cited by 427
Should Unpublished Data Be Included in Meta-analyses?: Current Convictions and Controversies
Cook, D. J. (1993) · JAMA · doi:10.1001/jama.1993.03500210049030 · Cited by 259 · cited 1×
“Although we recognize that the results of unpublished studies might be different from those of published studies, inclusion of unpublished data in scientific reviews remains controversial [68,69].”
ResultDrug therapy for alcohol dependence
Swift, R. M. (1999) · New England Journal of Medicine · doi:10.1056/nejm199905133401907 · Cited by 255 · cited 3×
“This figure, which coincides with that of previous publications [52,57,64], is clearly a cause for concern as adherence to treatment had shown itself to be a fundamental factor in the remission of alcohol dependence [4,51].”
BackgroundResultStreeton, C. (2001) · Alcohol and Alcoholism · doi:10.1093/alcalc/36.6.544 · Cited by 228 · cited 2×
“In the third place, although there are few studies that describe clearly the reasons for lack of compliance, such studies nevertheless report that only 10% of patients treated with naltrexone fail to complete the treatment due to the presence of one or more adverse drug effects, which is why we, like Streeton and Whel…”
BackgroundResult
Cited by
Saitz, R. (2005) · New England Journal of Medicine · doi:10.1056/nejmcp042262 · Cited by 599
Hollander, P., Gupta, A. K., Plodkowski, R., Greenway, F., Bays, H., Burns, C., Klassen, P., Fujioka, K., & for the COR-Diabetes Study Group (2013) · Diabetes Care · doi:10.2337/dc13-0234 · Cited by 501
Maisel, N. C., Blodgett, J. C., Wilbourne, P. L., Humphreys, K., & Finney, J. W. (2013) · Addiction · doi:10.1111/j.1360-0443.2012.04054.x · Cited by 470
Anton, R. F., Oroszi, G., O’Malley, S., Couper, D., Swift, R., Pettinati, H., & Goldman, D. (2008) · Archives of General Psychiatry · doi:10.1001/archpsyc.65.2.135 · Cited by 451
The Status of Disulfiram: A Half of a Century Later
Suh, J. J., Pettinati, H. M., Kampman, K. M., & O'Brien, C. P. (2006) · Journal of Clinical Psychopharmacology · doi:10.1097/01.jcp.0000222512.25649.08 · Cited by 382
Metadata
- Authors
- Carmen, B., Angeles, M., Ana, M., & María, A. J.
- Venue
- Addiction
- Publisher
- Wiley
- Published
- 2004-05-12
- Volume
- 99
- Issue
- 7
- Pages
- 811-828
- ISSN
- 0965-2140 (ISSN-L)
- 1360-0443
- OpenAlex
- W2043239339
- Cited by
- 504
- References
- 10
- FWCI
- 4.16
- Type
- journal article
- Language
- en
- Open access
- closed
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