Naltrexone in the treatment of alcohol dependence

Abstract

Naltrexone is a competitive antagonist of opiate μ and δ receptors characterized by blockade of endogenous and exogenous opioids. Its use in alcohol dependence is based on the blockade of β endorphins released after the acute administration of alcohol. In preclinical animal trials and in laboratory test in humans naltrexone reduced the consumption and reward (euphoria) after alcohol. In 14 double-blind studies lasting 12-52 weeks with 2498 patients with alcohol dependence naltrexone significantly reduced the number of relapses, days with alcohol, number of drinks in these days and - in the half of the studies - the intensity of craving in comparison with placebo. The therapeutic effect lasted only 1-6 monts after the naltrexone discontinuation. Naltrexone is a very important part of the complex management of alcoholism in the combination with psychotherapy. Therapeutic effect of naltrexone was observed mainly in motivated patients with the naltrexone continuation despite the first break of abstinence.