A potential new treatment for alcoholism called nalmefene is effective and safe for reducing drinking in alcohol dependent individuals, says new research published in the journal of Biological Psychiatry.
Traditionally, abstinence has become considered to be the principal treatment goal for alcohol dependence, and current pharmacological treatments for alcoholism are approved just for relapse prevention. However, relapse rates remain high plus a goal of abstinence is unacceptable to many people patients. To cope with these concerns and supply opportunities for improved patient outcomes, new evidence-based treatments are necessary.
“Our new findings may mark a true paradigm transfer of the treating of women and men that suffer from alcohol related disorders. While abstinence needs to be the best choice, a reduction in consumption is often a valuable alternative for your many patients who cannot attain abstinence or are certainly not (yet) able to sing so,” said Dr. Karl Mann at Central Institute of Mental Health in Germany, who led your research.
Mann with his fantastic colleagues conducted a medical trial to research the effectiveness of nalmefene in reducing drinking. They recruited 604 alcohol-dependent patients, 1 / 2 of whom were randomized to receive nalmefene, even though the spouse received visually-identical placebo pills. Neither patients nor their doctors knew which treatment these folks were receiving. Patients were instructed to take one tablet on on a daily basis they perceived a risk of having a drink, and were accompanied by the research investigators for twenty-four weeks..
The things they found is promising. Nalmefene was significantly a lot better than placebo in reducing alcohol consumption and it also improved patients’ clinical status and liver enzymes. It had been also generally well-tolerated, with most unwanted side effects characterized as mild or moderate and quickly resolved.
“With nalmefene, we look like able to ‘block the excitement’ making people carry on and drink larger amounts. With this type of harm reduction approach, a fresh chapter in treating alcoholism may be opened,” said Mann.
These bits of information prove “as-needed” prescription of nalmefene is an efficient treatment for alcohol dependence. Unlike medications that need to be taken every day, the as-needed approach targets medication administration to periods where alcohol use is more probable.
“It’s encouraging to determine the efficacy of nalmefene in this particular medical trial. There is a requirement of more treatment plans to the pharmacotherapy of alcoholism,” said Dr. John Krystal, Editor of Biological Psychiatry. “These studies also provides support for ‘as-needed’ treatment, a strategy that could be appealing to many patients. However, it flies industry by storm the notion that daily treatment may protect people who are either ambivalent about treatment or unaware when they’re particularly in danger of relapse.”
The 1st medication developed for your therapy for alcohol dependence was naltrexone, an opioid receptor blocker. At therapeutic doses, it blocks most of the mu subtype of opioid receptors in the brain nonetheless it has lesser effects at the delta and kappa subtype of opioid receptors. Nalmefene is really a newer opioid receptor modulator that has a subtly different profile at opioid receptor subtypes, with an increase of relative potency for kappa opiate receptors compared to its potency at mu opiate receptors. It turned out studied here given it can have prospect of reducing alcohol consumption.
“It remains to appear regardless of if the differences between nalmefene and naltrexone at opioid receptors yield meaningful variations in their effectiveness,” cautioned Krystal.
Associated with pension transfer studies, additional studies necessary, but this research provides strong evidence that nalmefene can provide a crucial clinical benefit for alcohol-dependent patients.
The abstract of this article is given as below.
There is a large treatment gap in alcohol dependence, and current treatments are only moderately effective in preventing relapse. New treatment modalities, allowing for reduction of alcohol consumption as a treatment goal are needed. This study evaluated the efficacy of as-needed use of the opioid system modulator nalmefene in reducing alcohol consumption in patients with alcohol dependence.
Six hundred and four patients (placebo = 298; nalmefene = 306),≥18 years of age, with a diagnosis of alcohol dependence,≥6 heavy drinking days, and average alcohol consumption≥World Health Organization medium drinking risk level in the 4 weeks preceding screening, were randomized (1:1) to 24 weeks of as-needed placebo or nalmefene 18 mg.
Patients taking placebo (n = 289) and patients taking nalmefene (n = 290) were included in the efficacy analyses. At Month 6, there was a significant effect of nalmefene compared with placebo in reducing the number of heavy drinking days (-2.3 days [95% confidence interval:-3.8 to-.8]; p = .0021) and total alcohol consumption (-11.0 g/day [95% confidence interval:-16.8 to-5.1]; p = .0003). Improvements in Clinical Global Impression and liver enzymes were larger in the nalmefene group compared with placebo at Week 24. Adverse events (most mild or moderate) and dropouts due to adverse events were more common with nalmefene than placebo. The number of patients with serious adverse events was similar in the two groups.
Nalmefene provides clinical benefit, constitutes a potential new pharmacological treatment paradigm in terms of the treatment goal and dosing regimen, and provides a method to address the unmet medical need in patients with alcohol dependence that need to reduce their alcohol consumption.
Read full article here.
Reference:Karl Mann, Anna Bladström, Lars Torup, Antoni Gual, and Wim van den Brink. “Extending the Treatment Options in Alcohol Dependence: A Randomized Controlled Study of As-Needed Nalmefene”. Biol Psychiatry. 2013 Apr 15;73(8):706-13. (doi: 10.1016/j.biopsych.2012.10.020).
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