Journal
EUROPEAN NEUROPSYCHOPHARMACOLOGY
Volume 17, Issue 8, Pages 558-566Publisher
ELSEVIER SCIENCE BV
DOI: 10.1016/j.euroneuro.2007.02.012
Keywords
alcoholism; naltrexone; acamprosate; efficacy; craving; cue reactivity
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Introduction: Acamprosate and naltrexone have been shown to be effective in relapse prevention of alcoholism. It is hypothesized that naltrexone exerts its effects primarily on cue-induced craving and neuroendocrine cue reactivity, whereas acamprosate exerts its effect primarily on autonomic nervous system reactions to alcohol-related cues. Experimental procedures: In a randomized double-blind experiment, 131 abstinent alcoholics received either acamprosate (n=56), naltrexone (n=52) or placebo (n=23) for three weeks and participated in two cue-exposure sessions: the first the day before and the second at the last day of medication. Results: Consistent with the hypotheses, naltrexone reduced craving more than acamprosate, and acamprosate reduced heart rate more than naltrexone. No medication effect was found on cueinduced cortisot. Discussion: The findings provide some evidence for differential effects of naltrexone and acamprosate: nattrexone may exert its effect, at least partly, by the reduction of cue-induced craving, whereas acamprosate may exert its effect, at least partly, by the reduction of autonomic nervous system reactions to alcohol-related cues. (c) 2007 Elsevier B.V. and ECNR All rights reserved.
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