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Acamprosate reduces risk of return to drinking after detoxification, but is similarly effective to naltrexone

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Question

Question

Is acamprosate an effective treatment for alcohol dependence compared with placebo and other pharmaceutical agents?

Outcomes

The primary outcomes were return to any drinking and duration of abstinence (cumulative abstinence duration; proportion of days in trial spent abstinent). Secondary outcomes included return to heavy drinking, γ-glutamyl transpeptidase (GGT) levels, side effects, drop-out and posttreatment outcomes.

Methods

Design

Systematic review, Cochrane systematic review and meta analysis.

Data sources

Cochrane Drugs and Alcohol Group Specialised Register, PubMed, EMBASE and CINAHL searched in January 2009. Key informants, experts, public sponsors and the drug manufacturer (Merck Serono) were contacted to indentify further relevant studies. Hand searching of reference lists of included studies and current reviews was also conducted.

Study selection and analysis

All double-blind randomised controlled trials (RCTs) comparing acamprosate versus placebo or active control and reporting drinking-related outcomes. All studies included patients who fulfilled the criteria of alcohol dependence (according to DSM-III-R, DSM-IV or ICD-10).

Main results

Twenty-four RCTs (6894 patients) were included in the review. Compared with placebo, acamprosate reduced the risk of return to any drinking after detoxification (RR 0.86, 95% CI 0.81 to 0.91) …

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