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Review: studies with sufficient follow up do not show a clear benefit for pharmacotherapy in alcohol dependence

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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?

Data sources

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.

Study selection

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.

Data extraction

Reviewers assessed the quality of studies by using a quality …

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