Background
Although disulfiram and naltrexone have been approved by the Food and Drug Administration
for the treatment of alcoholism, the effect of these medications on alcohol use outcomes
and on psychiatric symptoms is still unknown in patients with co-occurring disorders
post-traumatic stress disorder (PTSD).
Methods
Patients (n = 254) with a major Axis I psychiatric disorder and comorbid alcohol dependence were
treated for 12 weeks in a medication study at three Veterans Administration outpatient
clinics. Randomization included (1) open randomization to disulfiram or no disulfiram;
and (2) double-blind randomization to naltrexone or placebo. This resulted in four
groups: (1) naltrexone alone; (2) placebo alone; (3) disulfiram and naltrexone; or
(4) disulfiram and placebo. Outcomes were measures of alcohol use, PTSD symptoms,
alcohol craving, GGT levels and adverse events.
Results
93 individuals (36.6%) met DSM-IV criteria for PTSD. Subjects with PTSD had better
alcohol outcomes with active medication (naltrexone, disulfiram or the combination)
than they did on placebo; overall psychiatric symptoms of PTSD improved. Individuals
with PTSD were more likely to report some side effects when treated with the combination.
Conclusions
The results of this study suggest that disulfiram and naltrexone are effective and
safe for individuals with PTSD and comorbid alcohol dependence.
Key Words
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Article info
Publication history
Accepted:
March 14,
2006
Received in revised form:
March 12,
2006
Received:
August 19,
2005
Identification
Copyright
© 2006 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
