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Acamprosate, Naltrexone Comparable in Alcohol Use D/O

No significant differences seen between the two drugs in adults with alcohol use disorders

Acamprosate, Naltrexone Comparable in Alcohol Use D/O

WEDNESDAY, May 14, 2014 (HealthDay News) -- Acamprosate and oral naltrexone are associated with comparable reduction in return to drinking in adults with alcohol use disorders, according to a review published in the May 14 issue of the Journal of the American Medical Association.

For the review, Daniel E. Jonas, M.D., from the University of North Carolina at Chapel Hill, and colleagues conducted a systematic literature search to identify randomized clinical trials (RCTs) of at least 12 weeks' duration. The authors sought to determine the benefits and harms of medications (U.S. Food and Drug Administration-approved and others) for adults with alcohol use disorders.

The researchers found that, based on the 122 RCTs and one cohort study (total, 22,803 participants), the number needed to treat (NNT) to prevent return to any drinking for acamprosate was 12, while the number was 20 for oral naltrexone (50 mg/d; NNT of 12 to prevent return to heavy drinking). In meta-analyses, there were no significant differences found between acamprosate and naltrexone for return to any drinking or heavy drinking. Also noted in meta-analyses, there was an association with reduction in heavy drinking days for injectable naltrexone. There was moderate evidence to support an association with improvement in some consumption outcomes for nalmefene and topiramate (medications used off-label).

"Factors such as dosing frequency, potential adverse events, and availability of treatments may guide medication choice," the authors write.

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