This study compared the effects of nefazodone, a serotonergic antidepressan
t, with the opioid antagonist naltrexone, and an inactive placebo in 183 al
cohol- dependant subjects receiving weekly relapse prevention psychotherapy
. Following a single-blind, placebo lead-in period, subjects were randomly
assigned to receive study medication, which they took under double-blind co
nditions for 11 weeks. Naltrexone treatment was associated with significant
ly more adverse neuropsychiatric and gastrointestinal effects, poorer compl
iance, and a greater rate of treatment attrition. There were no reliable be
tween-group differences in drinking behavior. These results indicate that n
efazodane is not efficacious for treatment of alcohol dependance. Furthermo
re, the clinical utility of naltrexone seems to be limited by its adverse e
ffects, a finding that has important implications for efforts to develop me
dications to treat alcohol dependance. (C) 2000 American College of Neurops
ychopharmacology.