© 2000 Evidence-Based Mental Health
Review: studies with sufficient follow up do not show a clear benefit for pharmacotherapy in alcohol dependence
Garbutt JC, West SL, Carey TS, et al. Pharmacological treatment of alcohol dependence. A review of the evidence. JAMA 1999 Apr 14;281:1318–25.
QUESTION: What is the efficacy of 5 classes of drugs (disulfiram, opioid antagonists [naltrexone and nalmefene], acamprosate, serotonergic agents, and lithium) for treating alcohol dependence?
Studies were identified by searching Medline, HealthSTAR, the American Society of Health-System Pharmacists International Pharmaceutical Abstracts, EMBASE/Excerpta Medica, Alcohol and Alcohol Problems Database, PsycINFO, and the Cochrane Library with terms for drugs of interest and related classes of drugs, alcoholism, alcohol drinking, and study design characteristics. Published abstracts and US Food and Drug Administration documents were also reviewed.
Studies published in English, French, or German from 1966 to December 1997 were selected if they included 
10 adults who were dependent on alcohol and were treated in any setting. Children, infants, or pregnant women were excluded.
Reviewers assessed the quality of studies by using a quality rating score and extracted data on participants, follow up, trial duration, number of drinking and non-drinking days, return to drinking, time to first drink, alcohol consumed per unit of time, craving, and relapse.
41 studies met the selection criteria. 5 randomised controlled trials (RCTs) (n=1207)
Veterans Affairs Medical Center Manchester, New Hampshire, USA
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