EFFECTS OF FLUVOXAMINE AND CITALOPRAM IN MAINTAINING ABSTINENCE IN A SAMPLE OF ITALIAN DETOXIFIED ALCOHOLICS

A 16-week, randomized study was performed to test the efficacy of two selective serotonin reuptake inhibitors (SSRIs) fluvoxamine and citalo pram. in decreasing relapse and craving in alcoholics, and to investig ate possible differences in their clinical profile. After detoxificati on, each of the 81 patients (55 males and 26 females) was randomly ass igned to one of three groups: 23 subjects did not receive any pharmaco logical treatment, 25 were treated with fluvoxamine, 150 mg/day, and 3 3 with citalopram, 20 mg/day. All patients received standard cognitive -behavioural therapy. Craving was assessed twice a month using a 10-st ep scale. Every intake of alcohol was considered a relapse and the sub ject was taken out of the study. At the end of the study, both the flu voxamine and citalopram groups showed a statistically higher rate of c ontinuous abstinence (63.6 and 60.7%, respectively) compared to the gr oup without pharmacological treatment (30.4%). Relapse severity did no t differ among the three groups. Only citalopram showed a significant effect on craving throughout the study period. This study confirmed th e efficacy of SSRIs as an adjunct to psychotherapy to prevent relapse in alcoholics. The relationship between the effects of these SSRIs on abstinence and craving, as well as the differences between their profi les, are discussed.