NEW DRUG TREATMENTS FOR ALCOHOL-PROBLEMS - A CRITICAL-APPRAISAL

This review considers the novel drug treatments that have been suggest ed to help prevent relapse or attenuate drinking in people with alcoho l problems. The evidence from randomized controlled trials for the eff icacy of some of the main candidates: acamprosate, naltrexone, bromocr iptine, selective serotonin re-uptake inhibitors and buspirone, was ex amined. Important methodological problems which may have introduced bi as were detected in many of the trials. These included failure to test the integrity of the double blind, excluding or estimating outcome in early withdrawals and the comparison of groups on multiple outcome me asures with selective reporting of results. In addition, the generaliz ability of some studies was limited by the procedures used for sample selection. In view of the potential adverse effects of drug treatment it is concluded that the evidence is not strong enough to support the introduction of any of these substances into routine clinical practice at present. The review also emphasizes the importance of methodologic al rigour to maximize objectivity in treatment evaluation research.