Authors' objectives:

The aim of this report is to evaluate the efficacy and safety of opioid antagonists and acamprosate in the treatment of alcohol dependence.

Authors' recommendations: This review has shown convincing evidence from good quality randomised controlled trials and prospective controlled clinical trials that naltrexone and acamprosate are moderately effective therapies for alcohol dependence. However, questions remain about the optimal duration of treatment; the type of patients who will benefit most from a specific drug; the impact of treatments on patients health-related quality of life and degree of satisfaction. Similarly, no evaluation was made of their effects on alcohol-dependence-related morbidity. In addition, further studies are needed to evaluate the appropriate selection of patients and to understand the relationship of pharmacotherapy to patient heterogeneity. Psychosocial interventions require more standardization and better reporting and the relationship of pharmacotherapy to these interventions needs to be better understood. Common outcome measures need to be standardized both in their definition and the way they are assessed. Studies should be made over longer time periods to establish the efficacy of both groups of drugs as maintenance treatments. Effectiveness studies are needed to establish the benefit of naltrexone and acamprosate in common clinical settings. In addition, future studies should examine ways to enhance both medication compliance and study retention.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www.isciii.es/aets

Year Published: 2002

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Spain

Organisation Name: Agencia de Evaluacion de Tecnologias Sanitarias

Contact Address: Instituto de Salud "Carlos III", Calle Sinesio Delgado 6, Pabellon 4, 28029 Madrid, Spain. Tel: +34 9 1 822 2005; Fax: +34 9 1 387 7841;

Contact Name: Luis M. Sánchez Gómez

Contact Email: luism.sanchez@isciii.es

Copyright: Agencia de Evaluacion de Tecnologias Sanitarias (AETS)