Naltrexone's effect on cue-elicit craving among alcoholics in treatment

Background: Advancing knowledge of biobehavioral effects of interventions c an result in improved treatments. Thus, a standardized laboratory cue react ivity assessment has been developed and validated to assess the cognitive a nd psychophysiological responses to a simulated high-risk situation: alcoho l cues. The present study investigates the effects of a pharmacotherapy (na ltrexone) on a laboratory-based, cue-elicited urge to drink among abstinent alcoholics in treatment. Methods: Alcohol-dependent subjects were randomized to 12 weeks of naltrexo ne or placebo after completing a partial hospital program. After similar to 1 week on medication, all received cue reactivity assessment. Results: Significantly fewer patients taking naltrexone reported any urge t o drink during alcohol exposure than did those on placebo. Those with any u rges reported no decrement in level of the urges. Mean arterial pressure de creased significantly for those on placebo, but not for those on naltrexone , whereas cue-elicited decreases in heart rate were not affected by the med ication. Conclusions: The results have implications for models of relapse and naltre xone's effects. Cue reactivity methodology has utility for investigating hy pothesized mediators of therapeutic effects of pharmacotherapies as well as behavioral treatments.