Naltrexone vs. nefazodone for treatment of alcohol dependence - A placebo-controlled trial

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.