Study Aims To Determine Which, If Any, Medication-Assisted Treatment For Alcohol Dependence Is Effective
Researchers recently published a study in the journal Addiction that examined 32 randomized controlled trials of medications indicated to treat alcohol use disorders. They included pharmaceutical drugs such as acamprosate, baclofen, nalmefene, naltrexone, and topiramate.
What they concluded is this: there is not enough evidence that these medications are effective at treating alcoholism. Specifically, they revealed that neither acamprosate or naltrexone is effective at reducing overall alcohol use, which was the primary outcome of the investigation.
They did find that the other medications were more effective than placebo at lowering alcohol consumption, but the studies that revealed positive outcomes for these drugs had significant design flaws, such as unreliable reporting by study participants.
From the study:
“Overall, there is no evidence for a significant reduction in serious adverse events or mortality. As for studies on substances aiming to maintain abstinence, no study was designed with sufficient power, and study durations were inadequate to investigate these health outcomes.”
Also, some of the medications, such as acamprosate and topiramate can cause severe side effects when used with alcohol. And according to an analysis of the study population, this was a common occurrence. Some studies were compromised by high rates of participants dropping out.
“Indirect comparisons suggested that topiramate was superior to nalmefene, naltrexone, and acamprosate on consumption outcomes, but its safety profile is known to be poor.”
If drugs such as these are going to continue to be used as medication-assisted treatment, they need to be scientifically validated.
About The Medications
Nalmefene and naltrexone are opioid antagonists, which means they are indicated to lessen the pleasurable effects of alcohol use, and therefore, reduce consumption.
Acamprosate is intended to treat chemical imbalances that can exacerbate alcohol addiction.
Baclofen is a central nervous system depressant and muscle relaxer and is used to treat the withdrawal symptoms of alcohol and benzodiazepines.
Topiramate is an anti-convulsive and is prescribed off-label for the treatment of alcohol dependence.
~ G. Nathalee Serrels, M.A., Psychology