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Murine Drinking Models in the Development of Pharmacotherapies for Alcoholism: Drinking in the Dark and Two-bottle Choice
Published on: January 7, 2019
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Pharmacotherapy for Alcohol Use Disorder: A Systematic Review and Meta-Analysis.
Melissa McPheeters1,2, Elizabeth A O'Connor3, Sean Riley1,4
1RTI International-University of North Carolina at Chapel Hill Evidence-Based Practice Center, Chapel Hill.
JAMA
|November 7, 2023
Summary
Acamprosate and oral naltrexone are effective first-line treatments for alcohol use disorder when combined with psychosocial interventions. These medications help reduce alcohol consumption and prevent relapse in individuals with alcohol use disorder.
Area of Science:
- Pharmacology
- Addiction Medicine
- Clinical Trials
Background:
- Alcohol use disorder (AUD) is a significant public health issue in the US, leading to increased morbidity and mortality.
- Effective pharmacotherapies are crucial for managing AUD and improving patient outcomes.
Purpose of the Study:
- To systematically compare the efficacy and safety of various pharmacotherapies for alcohol use disorder.
- To provide evidence-based recommendations for first-line treatment options.
Main Methods:
- Systematic review and meta-analysis of randomized clinical trials (RCTs) and prospective cohort studies.
- Searched multiple databases (PubMed, Cochrane, PsycINFO, etc.) from November 2012 to August 2023.
- Extracted data on efficacy (alcohol consumption, relapse) and adverse effects; calculated numbers needed to treat.
Main Results:
- Data from 118 trials and 20,976 participants were analyzed.
- Acamprosate and oral naltrexone (50 mg/d) showed efficacy in preventing return to any drinking (NNT=11 and 18, respectively).
- Oral naltrexone (50 mg/d) reduced heavy drinking rates (NNT=11); injectable naltrexone reduced drinking days.
Conclusions:
- Oral naltrexone (50 mg/d) and acamprosate are recommended as first-line pharmacotherapies for AUD.
- These medications should be used in conjunction with psychosocial interventions for optimal results.
- Adverse effects include gastrointestinal distress for both acamprosate and naltrexone.
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