Naltrexone exerts a favourable effect on plasma lipids in abstinent patients with alcohol dependence

Epidemiological studies suggest that abstinence periods in some patients wi th alcohol dependence may increase their cardiovascular risk via proatherog enic changes in plasma lipid levels. Because of this, drugs administered in withdrawal therapy should not exacerbate these effects. The aim of this st udy was to estimate the influence of naltrexone, carbamazepine. and lithium carbonate on plasma lipid levels in 160 alcohol-dependent males during wit hdrawal therapy. Plasma concentrations of total cholesterol (TC), HDL chole sterol MDL-C), LDL cholesterol (LDL-C), and triglycerides (TGL) were determ ined every 2 weeks for 20 weeks. Pharmacotherapy (naltrexone 50 mg, carbama zepine 600-800 mg, lithium carbonate 500-1000 mg once per day or placebo) w as given within the framework of a double-blind study between the fourth an d twentieth weeks of the study. The results of 116 patients who maintained abstinence during the whole 20-week observation period were analysed. In pa tients treated with naltrexone significant decreases in TC (239 +/- 58 vs 2 16 +/- 52 mg/dl; P < 0.01) and TGL (125 +/- 65 vs 86 +/- 33 mg/dl; P < 0.02 ) concentrations after 16 weeks of pharmacotherapy were observed. In patien ts treated with carbamazepine, significant increases in TC (224 +/- 39 vs 2 43 +/- 54 mg/dl P < 0.04) and HDL (40 +/- 10 vs 44 +/- 8 mg/dl, P < 0.01) a fter 16 weeks of pharmacotherapy were observed. After 16 weeks of pharmaco: therapy, patients treated with naltrexone had lower mean TC (P < 0.03) and LDL-C (P < 0.01) concentrations than patients created with carbamazepine. lower mean LDL-C levels than patients treated with lithium carbonate (149 /- 54 vs 164 +/- 57 mg/dl, P < 0.01), and lower TGL concentrations than pat ients of the remaining pharmacotherapy groups. We conclude that naltrexone, by its hypolipaemic effect, could be useful for withdrawal therapy in alco holic patients, because it may decrease the cardiovascular risk in abstinen t patients with alcohol dependence by lipid mechanisms.