Extended naltrexone and broad spectrum treatment or motivational enhancement therapy.

Extended naltrexone and broad spectrum treatment or motivational enhancement therapy.
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延长纳曲酮和广谱治疗或动机增强治疗。

DOI:
10.1007/s00213-009-1615-3
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发表时间:
2009
期刊:
影响因子:
3.4
通讯作者:
Davidson,Dena
Davidson,Dena
中科院分区:
医学3区
文献类型:
--
作者:
Longabaugh,Richard;Wirtz,PhilipW;Gulliver,SuzyBird;Davidson,Dena

文献摘要

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BackgroundRandomized clinical trials on the effectiveness of naltrexone (NTX) in the treatment of alcohol dependence have produced conflicting results. One possible explanation for these discrepancies may lie in the various psychosocial treatments for which NTX is an adjunct. The goal of this study was to examine the interplay between psychosocial treatment and duration of NTX.MethodsOne hundred and seventy-four alcohol-dependent outpatients participated in a double-blind trial where they were randomly assigned to 12 vs. 24 weeks NTX duration and to one of two psychosocial treatments: motivational enhancement therapy (MET) and broad spectrum treatment (BST), a cognitive behavioral therapy tailored to the patient's specific needs. After an initial 12-week period of NTX and psychosocial treatment, half of each psychotherapy condition was assigned to continue NTX for an additional 12 weeks while the other half was assigned to placebo. Patient drinking outcomes were measured for the year following treatment completion. It was hypothesized that the combination of extended duration of NTX and the moderate intensity of BST would be predictive of longer time to a first heavy drinking day than any of the three alternative combinations: MET with short or extended NTX administration or BST with short NTX administration.ResultsThe median time to first drink and time to first heavy drinking day were found to be significantly longer for patients who received BST and extended NTX than for patients in the other three groups.ConclusionsThese results may suggest that the kind of psychosocial treatment delivered in combination with duration of NTX administration may partially explain the inconsistent findings regarding the efficacy of NTX in the treatment of alcohol dependence.