Naltrexone in the treatment of alcoholism: predicting response to naltrexone

The pooled results of 99 subjects from our Veterans Affairs population show that naltrexone-treated subjects had a greater reduction in alcohol craving, number of drinking days, and alcoholic relapse rates when compared with placebo-treated subjects. Based on our findings and results from other double-blind trials of naltrexone, we conclude that naltrexone is a safe and useful adjunct in the rehabilitation of alcohol-dependent patients. Increased baseline levels of psychological distress and craving as well as higher levels of somatic distress, anxiety, phobic anxiety, and obsessive-compulsive symptoms predicted an increased number of drinking days during the study. Significant interactions between naltrexone treatment, initial craving, and somatic distress suggest that naltrexone may be useful for subjects who present with high levels of craving and somatic symptoms.