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Adding Psychotherapy to the Naltrexone Treatment of Alcohol Use Disorder: Meta-analytic Review
Background It remains unclear if naltrexone combined with psychotherapy is superior to naltrexone alone in treating alcohol use disorders (AUD). The current meta-analysis examined the hypothesis that psychotherapy is a significant moderator that influences AUD-related outcomes and that naltrexone co...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cureus
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6175267/ https://www.ncbi.nlm.nih.gov/pubmed/30338182 http://dx.doi.org/10.7759/cureus.3107 |
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author | Ahmed, Rizwan Kotapati, Vijaya Padma Khan, Ali M Hussain, Nuzhat Hussain, Mudasar Dar, Sara Kumar, Jeevan Begum, Gulshan A Esang, Michael Brainch, Navjot Ahmed, Saeed |
author_facet | Ahmed, Rizwan Kotapati, Vijaya Padma Khan, Ali M Hussain, Nuzhat Hussain, Mudasar Dar, Sara Kumar, Jeevan Begum, Gulshan A Esang, Michael Brainch, Navjot Ahmed, Saeed |
author_sort | Ahmed, Rizwan |
collection | PubMed |
description | Background It remains unclear if naltrexone combined with psychotherapy is superior to naltrexone alone in treating alcohol use disorders (AUD). The current meta-analysis examined the hypothesis that psychotherapy is a significant moderator that influences AUD-related outcomes and that naltrexone combined with psychotherapy is associated with significantly better AUD-related outcomes than naltrexone alone. Methods A total of 30 studies (N(naltrexone )= 2317; N(placebo )= 2056) were included. Random effects model meta-analyses were carried out for each of the studied outcomes. Subsequently, the random effects model pooled estimates from studies with and without psychotherapy were compared using a Wald test. A mixed-effect model, incorporating psychotherapy as a moderator, was used to examine the impact of psychotherapy on treatment outcomes. Results Naltrexone had a significant treatment effect on abstinence relapse and Gamma-Glutamyl Transferase levels, but not cravings. The pooled estimates for studies with and without psychotherapy were not significantly different for any of the studied outcomes. Psychotherapy was not a significant moderator in the mixed effects models for any of the studied outcomes. Conclusions Naltrexone treatment is efficacious in reducing alcohol consumption, but not reducing cravings. Adding psychotherapy on top naltrexone did not result in any significant additional benefit for AUD patients. |
format | Online Article Text |
id | pubmed-6175267 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-61752672018-10-18 Adding Psychotherapy to the Naltrexone Treatment of Alcohol Use Disorder: Meta-analytic Review Ahmed, Rizwan Kotapati, Vijaya Padma Khan, Ali M Hussain, Nuzhat Hussain, Mudasar Dar, Sara Kumar, Jeevan Begum, Gulshan A Esang, Michael Brainch, Navjot Ahmed, Saeed Cureus Psychiatry Background It remains unclear if naltrexone combined with psychotherapy is superior to naltrexone alone in treating alcohol use disorders (AUD). The current meta-analysis examined the hypothesis that psychotherapy is a significant moderator that influences AUD-related outcomes and that naltrexone combined with psychotherapy is associated with significantly better AUD-related outcomes than naltrexone alone. Methods A total of 30 studies (N(naltrexone )= 2317; N(placebo )= 2056) were included. Random effects model meta-analyses were carried out for each of the studied outcomes. Subsequently, the random effects model pooled estimates from studies with and without psychotherapy were compared using a Wald test. A mixed-effect model, incorporating psychotherapy as a moderator, was used to examine the impact of psychotherapy on treatment outcomes. Results Naltrexone had a significant treatment effect on abstinence relapse and Gamma-Glutamyl Transferase levels, but not cravings. The pooled estimates for studies with and without psychotherapy were not significantly different for any of the studied outcomes. Psychotherapy was not a significant moderator in the mixed effects models for any of the studied outcomes. Conclusions Naltrexone treatment is efficacious in reducing alcohol consumption, but not reducing cravings. Adding psychotherapy on top naltrexone did not result in any significant additional benefit for AUD patients. Cureus 2018-08-06 /pmc/articles/PMC6175267/ /pubmed/30338182 http://dx.doi.org/10.7759/cureus.3107 Text en Copyright © 2018, Ahmed et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Psychiatry Ahmed, Rizwan Kotapati, Vijaya Padma Khan, Ali M Hussain, Nuzhat Hussain, Mudasar Dar, Sara Kumar, Jeevan Begum, Gulshan A Esang, Michael Brainch, Navjot Ahmed, Saeed Adding Psychotherapy to the Naltrexone Treatment of Alcohol Use Disorder: Meta-analytic Review |
title | Adding Psychotherapy to the Naltrexone Treatment of Alcohol Use Disorder: Meta-analytic Review |
title_full | Adding Psychotherapy to the Naltrexone Treatment of Alcohol Use Disorder: Meta-analytic Review |
title_fullStr | Adding Psychotherapy to the Naltrexone Treatment of Alcohol Use Disorder: Meta-analytic Review |
title_full_unstemmed | Adding Psychotherapy to the Naltrexone Treatment of Alcohol Use Disorder: Meta-analytic Review |
title_short | Adding Psychotherapy to the Naltrexone Treatment of Alcohol Use Disorder: Meta-analytic Review |
title_sort | adding psychotherapy to the naltrexone treatment of alcohol use disorder: meta-analytic review |
topic | Psychiatry |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6175267/ https://www.ncbi.nlm.nih.gov/pubmed/30338182 http://dx.doi.org/10.7759/cureus.3107 |
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