Rationale for combining acamprosate and naltrexone for treating alcohol dependence.

Barbara J Mason
{"title":"Rationale for combining acamprosate and naltrexone for treating alcohol dependence.","authors":"Barbara J Mason","doi":"10.15288/jsas.2005.s15.148","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>This article provides an evidence-based review of acamprosate and naltrexone, used alone and in combination. Both medications are gaining increasing availability worldwide by prescription for the treatment of alcohol dependence. There is scientific and clinical interest in examining these drugs in combination, given their high tolerability, moderate effect sizes, different pharmacological profiles and potentially different effects on drinking outcomes.</p><p><strong>Method: </strong>This article includes a review of the key similarities and differences between acamprosate and naltrexone in the treatment of alcohol dependence; the published double-blind, placebo-controlled trials of acamprosate and naltrexone across a uniform range of outcome criteria to elucidate the differences and similarities in the behavioral effects of these drugs; the two published pharmacokinetic and pharmacodynamic drug interaction studies of acamprosate and naltrexone; and the single-site clinical trial of acamprosate and naltrexone used alone and in combination relative to placebo.</p><p><strong>Results: </strong>Pharmacokinetic and pharmacodynamic studies report an increase in acamprosate plasma levels with no clinically significant elevation in adverse events when the two drugs are used in combination. Data from dose-response studies for acamprosate alone suggest that the augmentation of acamprosate plasma levels by co-administration of naltrexone may have clinical benefits.</p><p><strong>Conclusions: </strong>These factors support investigating the efficacy and safety of combining acamprosate and naltrexone for the treatment of alcohol dependence in a large-scale multisite trial, with evaluation of potential predictors of response to each drug alone and in combination relative to placebo.</p>","PeriodicalId":17056,"journal":{"name":"Journal of studies on alcohol. Supplement","volume":" 15","pages":"148-56; discussion 140"},"PeriodicalIF":0.0000,"publicationDate":"2005-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.15288/jsas.2005.s15.148","citationCount":"26","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of studies on alcohol. Supplement","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.15288/jsas.2005.s15.148","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 26

Abstract

Objective: This article provides an evidence-based review of acamprosate and naltrexone, used alone and in combination. Both medications are gaining increasing availability worldwide by prescription for the treatment of alcohol dependence. There is scientific and clinical interest in examining these drugs in combination, given their high tolerability, moderate effect sizes, different pharmacological profiles and potentially different effects on drinking outcomes.

Method: This article includes a review of the key similarities and differences between acamprosate and naltrexone in the treatment of alcohol dependence; the published double-blind, placebo-controlled trials of acamprosate and naltrexone across a uniform range of outcome criteria to elucidate the differences and similarities in the behavioral effects of these drugs; the two published pharmacokinetic and pharmacodynamic drug interaction studies of acamprosate and naltrexone; and the single-site clinical trial of acamprosate and naltrexone used alone and in combination relative to placebo.

Results: Pharmacokinetic and pharmacodynamic studies report an increase in acamprosate plasma levels with no clinically significant elevation in adverse events when the two drugs are used in combination. Data from dose-response studies for acamprosate alone suggest that the augmentation of acamprosate plasma levels by co-administration of naltrexone may have clinical benefits.

Conclusions: These factors support investigating the efficacy and safety of combining acamprosate and naltrexone for the treatment of alcohol dependence in a large-scale multisite trial, with evaluation of potential predictors of response to each drug alone and in combination relative to placebo.

阿坎普罗酸联合纳曲酮治疗酒精依赖的基本原理。
目的:本文对阿坎普罗酸和纳曲酮单独和联合使用进行了循证评价。这两种药物在世界范围内作为治疗酒精依赖的处方越来越多。考虑到这些药物的高耐受性、中等效果、不同的药理学特征和对饮酒结果的潜在不同影响,研究这些药物的组合具有科学和临床意义。方法:综述阿坎普罗酸与纳曲酮治疗酒精依赖的主要异同;已发表的阿坎普罗酸和纳曲酮的双盲、安慰剂对照试验,在统一的结果标准范围内阐明了这些药物在行为效果方面的差异和相似之处;两篇已发表的阿坎前列酸和纳曲酮的药代动力学和药效学药物相互作用研究;阿坎普罗酸和纳曲酮单独使用和联合使用相对于安慰剂的单点临床试验。结果:药代动力学和药效学研究报告,当两种药物联合使用时,阿坎前列酸血浆水平增加,不良事件无临床显著升高。来自阿坎前列酸单独剂量反应研究的数据表明,通过联合纳曲酮增加阿坎前列酸血浆水平可能具有临床益处。结论:这些因素支持在一项大规模的多地点试验中调查阿坎前列酸和纳曲酮联合治疗酒精依赖的有效性和安全性,并评估每种药物单独使用和联合使用相对于安慰剂的反应的潜在预测因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信