Alcohol and Alcoholism Advance Access originally published online on March 29, 2005
Alcohol and Alcoholism 2005 40(3):227-233; doi:10.1093/alcalc/agh151
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CLINICAL PREDICTORS OF RESPONSE TO NALTREXONE IN ALCOHOLIC PATIENTS: WHO BENEFITS MOST FROM TREATMENT WITH NALTREXONE?
Alcoholism Research Program, Servicios de Salud Mental, Retiro, Madrid, Spain and 1 Unidad de Conductas Adictivas (UCA), Servicio de Psiquiatría, Hospital Universitario 12 de Octubre, Madrid, Spain
* Author to whom correspondence should be addressed at: Alcoholism Research Program, "Retiro" Mental Health Centre, Doctor Castelo, 60, 28009 Madrid, Spain. E-mail: garuva{at}inicia.es
(Received 6 September 2004; first review notified 8 October 2004; in revised form 12 January 2005; accepted 7 March 2005; Advance Access publication 29 March 2005)
Aims: To determine the clinically ascertained variables that are related to satisfactory response to naltrexone (NTX) treatment of alcohol dependence after detoxification. Methods: The use of intake and outcome variables were measured in a randomized 3-month open-controlled trial comparing the effects of naltrexone plus psychotherapy treatment versus psychotherapy treatment alone on the maintenance of abstinence in the final 28 days (n = 336, all male). Results: Predictors of a positive response to NTX treatment were family history of alcoholism (P = 0.010), early age at onset of drinking problems (P = 0.014) and comorbid use of other drugs of abuse (P < 0.001). Among the subjects not treated with NTX, the greater the number of predictor variables, the lower the final 28 days abstinence rates (P = 0.00003), but this was not the case in patients treated with NTX (P = 0.844). Conclusions: Patients with these features, suggesting biological vulnerability overall have poorer outcomes, but this can be reduced with NTX treatment. The type of alcoholism should be considered before deciding on the pharmacological strategy.
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