Naltrexone in the treatment of male alcoholics - an effectiveness study inSingapore

Naltrexone has been demonstrated in western studies to be a useful pharmaco logical adjunct within treatment programmes for alcoholic patients. We repo rt the first study of its efficacy and usefulness in an Asian region. This project was designed to allow naltrexone's performance to be assessed under routine clinical conditions but with patients selected on the basis of the ir being likely to comply. Following in-patient detoxification, 53 male alc ohol-dependent patients admitted to the Alcohol Treatment Centre at Woodbri dge Hospital, Singapore, were enrolled in a 12-week, placebo-controlled tri al of naltrexone hydrochloride (50 mg/day). Subjects were randomized on a 2 :1 basis, with 35 receiving naltrexone and 18 receiving placebo. Analyses i dentified that a higher percentage of naltrexone patients completed the stu dy (40% vs. 22%). In the study non-completers, the dropout rate due to drin king relapse was also lower in the naltrexone group (9% vs. 43%). Of the 39 patients for whom drinking status over the trial could be ascertained, few er naltrexone-treated patients drank (33% vs. 53%). Alcohol craving scores also showed a selective and distinct reduction in the naltrexone-treated gr oup. Results suggest that naltrexone may be an effective and safe aid to tr eatment of alcohol dependent patients in Asian patients, for whom the aims are to reduce alcohol craving and drinking reinstatement, but where complia nce is likely to be low.