Singh Samant, Kataria Lakhan, Alam Mohd Rashid
All India Institute of Medical Sciences, Gorakhpur, Uttar Pradesh, India.
Smt. B. K. Shah Medical Institute and Research Centre, Vadodara, Sumandeep Vidyapeeth University, Gujarat, India.
Ind Psychiatry J. 2025 Jan-Apr;34(1):97-102. doi: 10.4103/ipj.ipj_413_24. Epub 2025 Apr 18.
Alcohol use disorders (AUDs) are characterized by excessive alcohol consumption, negatively impacting health, social life, and economic status. Globally, AUD contributes to significant disease burden, causing millions deaths annually. Despite the availability of treatments, relapse rates remain high. Naltrexone and acamprosate, two FDA-approved anticraving agents, are widely used to prevent relapse. However, comparative studies in Indian populations are limited, prompting this study to assess the efficacy of these drugs in treating AUD.
This study aimed to compare the effectiveness of naltrexone and acamprosate as anticraving agents in treating AUD, evaluating the time to first drink (lapse) and time to relapse among patients using either medication at 1 and 3 months. It also assessed the correlation between baseline severity of AUD and the efficacy of naltrexone and acamprosate as anticraving agents, as well as compared demographic and clinical variables between the two treatment groups.
A prospective observational study was conducted on 70 patients diagnosed with AUD, divided into two groups: naltrexone (n = 35) and acamprosate (n = 35). Patients were assessed using the Obsessive Compulsive Drinking Scale (OCDS) and followed for 3 months to evaluate craving intensity, time to first drink, and relapse rates. The Quality of Life Scale (QOLS) and Clinical Global Impression (CGI) were used to assess treatment impact.
Both groups were comparable at baseline. At 3 months, naltrexone patients had higher abstinence rates (63.64%) compared with acamprosate (34.68%, = 0.018). Naltrexone also significantly extended the time to first drink and relapse compared to acamprosate.
Naltrexone demonstrated superior efficacy in maintaining abstinence and reducing relapse rates in AUD patients compared to acamprosate. These findings suggest that naltrexone may be more effective for long-term treatment in the Indian context.
酒精使用障碍（AUDs）的特征是过度饮酒，对健康、社会生活和经济状况产生负面影响。在全球范围内，AUD导致了重大的疾病负担，每年造成数百万人死亡。尽管有多种治疗方法，但复发率仍然很高。纳曲酮和阿坎酸是两种经美国食品药品监督管理局（FDA）批准的抗渴望药物，被广泛用于预防复发。然而，针对印度人群的比较研究有限，促使本研究评估这些药物治疗AUD的疗效。
本研究旨在比较纳曲酮和阿坎酸作为抗渴望药物治疗AUD的有效性，评估使用这两种药物的患者在1个月和3个月时首次饮酒（失误）时间和复发时间。研究还评估了AUD基线严重程度与纳曲酮和阿坎酸作为抗渴望药物疗效之间的相关性，并比较了两个治疗组之间的人口统计学和临床变量。
对70例诊断为AUD的患者进行了一项前瞻性观察研究，分为两组：纳曲酮组（n = 35）和阿坎酸组（n = 35）。使用强迫性饮酒量表（OCDS）对患者进行评估，并随访3个月以评估渴望强度、首次饮酒时间和复发率。使用生活质量量表（QOLS）和临床总体印象量表（CGI）评估治疗效果。
两组在基线时具有可比性。3个月时，纳曲酮组患者的戒酒率（63.64%）高于阿坎酸组（34.68%，P = 0.018）。与阿坎酸相比，纳曲酮还显著延长了首次饮酒时间和复发时间。
与阿坎酸相比，纳曲酮在维持AUD患者戒酒和降低复发率方面显示出更高的疗效。这些发现表明，在印度背景下，纳曲酮可能对长期治疗更有效。
