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Título:	A randomized, double-blind, placebo-controlled pilot study of naltrexone in outpatients with bipolar disorder and alcohol dependence.
Autores:	Brown, E Sherwood Carmody, Thomas J Schmitz, Joy M Caetano, Raul Adinoff, Bryon Swann, Alan C John Rush, A
Fecha:	2009-11-01
Publicador:	DigitalCommons@The Texas Medical Center
Fuente:	Ver documento Ver documento
Tipo:	text
Tema:	Adult Affect Alcoholism Bipolar Disorder Diagnosis Dual (Psychiatry) Double-Blind Method Female Humans Male Middle Aged Naltrexone Narcotic Antagonists Pilot Projects Psychiatric Status Rating Scales Regression Analysis Survival Analysis Diagnosis, Dual (Psychiatry) Medicine and Health Sciences
Descripción:	BACKGROUND: Alcohol dependence is extremely common in patients with bipolar disorder and is associated with unfavorable outcomes including treatment nonadherence, violence, increased hospitalization, and decreased quality of life. While naltrexone is a standard treatment for alcohol dependence, no controlled trials have examined its use in patients with co-morbid bipolar disorder and alcohol dependence. In this pilot study, the efficacy of naltrexone in reducing alcohol use and on mood symptoms was assessed in bipolar disorder and alcohol dependence. METHODS: Fifty adult outpatients with bipolar I or II disorders and current alcohol dependence with active alcohol use were randomized to 12 weeks of naltrexone (50 mg/d) add-on therapy or placebo. Both groups received manual-driven cognitive behavioral therapy designed for patients with bipolar disorder and substance-use disorders. Drinking days and heavy drinking days, alcohol craving, liver enzymes, and manic and depressed mood symptoms were assessed. RESULTS: The 2 groups were similar in baseline and demographic characteristics. Naltrexone showed trends (p < 0.10) toward a greater decrease in drinking days (binary outcome), alcohol craving, and some liver enzyme levels than placebo. Side effects were similar in the 2 groups. Response to naltrexone was significantly related to medication adherence. CONCLUSIONS: Results suggest the potential value and acceptable tolerability of naltrexone for alcohol dependence in bipolar disorder patients. A larger trial is needed to establish efficacy.
Idioma:	No aplica

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