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Pregabalin versus naltrexone in alcohol dependence: a randomised, double-blind, comparison trial
G Martinotti1, M Di Nicola, D Tedeschi
1Department of Psychiatry, Catholic University Medical School, Rome, Italy. giovanni.martinotti@libero.it
Journal of Psychopharmacology (Oxford, England)
|April 7, 2009
Summary
Pregabalin (PRE) showed similar efficacy to naltrexone (NAL) in reducing alcohol dependence. PRE demonstrated benefits in improving comorbid psychiatric symptoms and extending abstinence duration.
Area of Science:
- Neuroscience
- Psychiatry
- Pharmacology
Background:
- Alcohol dependence is a chronic relapsing disorder with significant public health implications.
- Current treatments for alcohol dependence include medications like naltrexone, but efficacy can be limited.
- Pregabalin, an alpha(2)-delta ligand, has shown potential in treating substance use disorders.
Purpose of the Study:
- To compare the efficacy of pregabalin (PRE) with naltrexone (NAL) in treating alcohol dependence.
- To evaluate the effects of PRE and NAL on alcohol drinking indices, craving, withdrawal, and psychiatric symptoms.
- To explore the potential of PRE in improving abstinence duration and outcomes in patients with comorbid psychiatric disorders.
Main Methods:
- A randomized, double-blind, controlled trial involving 71 alcohol-dependent subjects.
- Subjects received either naltrexone (50 mg) or pregabalin (150-450 mg) after detoxification.
- Efficacy was assessed using measures of alcohol drinking indices, craving (VAS, OCDS), withdrawal (CIWA-Ar), and psychiatric symptoms (SCL-90-R).
Main Results:
- No significant differences were observed between PRE and NAL in alcohol drinking indices or craving scores.
- Pregabalin showed significantly greater improvement in anxiety, hostility, and psychoticism symptoms compared to naltrexone.
- Pregabalin also demonstrated a better outcome in terms of duration of abstinence and in patients with comorbid psychiatric disorders.
Conclusions:
- Pregabalin is comparable to naltrexone in overall efficacy for alcohol dependence.
- Pregabalin's effectiveness may be linked to its impact on comorbid psychiatric symptoms rather than solely on alcohol craving.
- Pregabalin represents a viable treatment option for alcohol dependence, particularly for individuals with co-occurring psychiatric conditions.
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