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Letters
August 24/31, 2005

Naltrexone Treatment for Alcohol Dependency—Reply

JAMA. 2005;294(8):899-900. doi:10.1001/jama.294.8.900

In Reply: Dr Ameisen notes that the number of heavy drinking days did not progressively decrease in our trial, suggesting that longer treatment would be of no additional benefit. We believe that maintenance of a reduction in heavy drinking is itself of benefit to patients. What might constitute additional benefit is a complex matter and may include progressive reduction of heavy drinking, establishment of abstinence, or improved quality of life. In our trial, participants who had 7 days or more of lead-in abstinence dramatically reduced their heavy drinking with naltrexone. Furthermore, a secondary analysis of individuals with at least 4 days of abstinence prior to starting medication showed that the naltrexone 380-mg dosage significantly increased the likelihood of abstinence compared with placebo,1 which does represent additional benefit. Further studies are needed to examine treatment outcomes over longer periods and across different subgroups of alcoholics.

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