Outpatient cognitive behavioural therapy programme for alcohol dependence impact of naltrexone use on outcome

Feeney, GFX, Young, RM, Connor, JP, Tucker, J and McPherson, A (2001) Outpatient cognitive behavioural therapy programme for alcohol dependence impact of naltrexone use on outcome. Australian And New Zealand Journal of Psychiatry, 35 4: 443-448. doi:10.1046/j.1440-1614.2001.00935.x


Author Feeney, GFX
Young, RM
Connor, JP
Tucker, J
McPherson, A
Title Outpatient cognitive behavioural therapy programme for alcohol dependence impact of naltrexone use on outcome
Journal name Australian And New Zealand Journal of Psychiatry   Check publisher's open access policy
ISSN 0004-8674
Publication date 2001
Sub-type Article (original research)
DOI 10.1046/j.1440-1614.2001.00935.x
Volume 35
Issue 4
Start page 443
End page 448
Total pages 6
Editor Sidney Bloch
Place of publication Carlton, Victoria
Publisher Blackwell Science Asia
Collection year 2001
Language eng
Subject C1
321021 Psychiatry
730211 Mental health
Abstract Objective: Cognitive-behavioural therapy (CBT) has been effectively used in the treatment of alcohol dependence. Clinical studies report that the anticraving drug naltrexone, is a useful adjunct to treatment. Currently, few data are available on the impact of adding this medication to programmes in more typical, outpatient, and rehabilitation settings. The objective of this study was to examine the impact on outcome of adding naltrexone to an established outpatient alcohol rehabilitation program which employed CBT. Method: Fifty patients participated in an established 12-week, outpatient, 'contract'-based alcohol abstinence programme which employed CBT. They also received naltrexone 50 mg orally daily (CBT + naltrexone). Outcomes were compared with 50 historical, matched controls, all of whom participated in the same programme without an anticraving medication (CBT alone). All patients met DSM-IV criteria for alcohol dependence. Results: Programme attendance across the eight treatment sessions was lower in the CBT alone group (p < 0.001). Relapse to alcohol use occurred sooner and more frequently in the CBT alone group (p < 0.001). Rehabilitation programme completion at 12 weeks was 88% (CBT + naltrexone) compared with 36% for (CBT alone) (p < 0.001). Alcohol abstinence at 12 weeks was 76% (CBT + naltrexone) compared with 18% (CBT alone) (p < 0.001). Conclusion: When employing the same outpatient rehabilitation programme and comparing outcomes using matched historical controls, the addition of naltrexone substantially improves programme attendance, programme completion and reported alcohol abstinence. In a typical outpatient programme, naltrexone addition was associated with significantly improved programme participation, better outcomes and was well tolerated.
Keyword Psychiatry
Alcohol Dependence
Cbt
Naltrexone
Treatment
Placebo-controlled Trial
Double-blind
Relapse Prevention
Cost-effectiveness
Fluoxetine
Efficacy
Approximation
Acamprosate
Abstinence
Q-Index Code C1

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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Created: Tue, 14 Aug 2007, 16:06:31 EST