November 1992

Naltrexone and Coping Skills Therapy for Alcohol DependenceA Controlled Study

Author Affiliations

From the Department of Psychiatry, Yale University School of Medicine, New Haven, Conn (Drs O'Malley, Jaffe, Schottenfeld, and Rounsaville); The University of Connecticut Alcohol Research Center, Farmington (Drs O'Malley, Jaffe, Meyer, and Rounsaville); the Department of Medicine (Psychiatry), Harvard Medical School and the Brigham and Women's Hospital, Boston, Mass (Dr Chang); and the Department of Psychiatry, University of Connecticut Health Center, Farmington (Dr Meyer).

Arch Gen Psychiatry. 1992;49(11):881-887. doi:10.1001/archpsyc.1992.01820110045007

• Ninety-seven alcohol-dependent patients were treated for 12 weeks in a double-blind, placebo-controlled study evaluating naltrexone and two manual guided psychotherapies in the treatment of alcohol dependence. Patients were randomized to receive either naltrexone or placebo and either coping skills/relapse prevention therapy or a supportive therapy designed to support the patient's own efforts at abstinence without teaching specific coping skills. Naltrexone proved superior to placebo in measures of drinking and alcohol-related problems, including abstention rates, number of drinking days, relapse, and severity of alcohol-related problems. Medication interacted with the type of psychotherapy received. The cumulative rate of abstinence was highest for patients treated with naltrexone and supportive therapy. For those patients who initiated drinking, however, patients who received naltrexone and coping skills therapy were the least likely to relapse.