Naltrexone injections for alcohol dependence: once-a-month treatment helps maintain sobriety

  • Naltrexone, an orally administered opiate receptor antagonist, has been used for the treatment of alcohol dependence in the United States since 1994.
  • A new study examines the effectiveness of a one-month injection form of naltrexone.
  • Recipients had significantly fewer drinking days and a greater likelihood of total abstinence during the three-month study than individuals who received a placebo.

In 1994, the U.S. Food and Drug Administration approved naltrexone, an orally administered opiate receptor antagonist, for the treatment of alcohol dependence. Since then, studies of its effectiveness have produced conflicting results. This may be due, at least in part, to variation in medication compliance. The July issue of Alcoholism: Clinical & Experimental Research contains findings from the first multi-site examination of the effectiveness of an inject-able, long-acting formulation of naltrexone: significantly fewer drinking days and a greater likelihood of total abstinence during the three-month study period.

"Naltrexone has not been prescribed widely," explained Henry R. Kranzler, professor of psychiatry at the University of Connecticut Health Center and first author of the study, "in part because of poor compliance with the oral formulation." The typical oral dose of naltrexone is 50 milligrams per day. Studies have shown that only individuals who are highly compliant have greater reductions in alcohol consumption and risk of relapse than those individuals treated with a placebo.

Naltrexone works by blocking brain opiate receptors, which in turn, modulate other brain chemicals like dopamine. Originally marketed for the treatment of heroin addiction, researchers discovered the medication could also block alcohol craving and reduce alcohol consumption, leading to less relapse drinking and more abstinent days. Although it is well tolerated and does not produce many adverse effects, nalt


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