From the Journals

Naltrexone cuts hospitalization, deaths in alcohol use disorder


 

‘Ravages’ of benzodiazepines

Commenting on the study in an interview, John Krystal, MD, professor and chair of psychiatry and director of the Center for the Translational Neuroscience of Alcoholism, Yale University, New Haven, Conn., said, “The main message from the study for practicing clinicians is that treatment works.”

Dr. John Krystal

Dr. John Krystal

Dr. Krystal, who was not involved with the study, noted that “many practicing clinicians are discouraged by the course of their patients with AUD, and this study highlights that naltrexone, perhaps in combination with other medications, may be effective in preventing hospitalization and, presumably, other hospitalization-related complications of AUD.”

Also commenting on the study, Raymond Anton, MD, professor, department of psychiatry and behavioral sciences, Medical University of South Carolina, Charleston, suggested that the “clinical knowledge of the harm of benzodiazepines in those with AUD is reinforced by these findings.”

In fact, the harm of benzodiazepines might be the study’s “most important message ... [a message that was] recently highlighted by the Netflix series “The Queen’s Gambit”, which shows the ravages of using both together, or how one leads to potential addiction with the other,” said Dr. Anton, who was not involved with the study.

Dr. Raymond Anton

Dr. Raymond Anton

The other “big take-home message is that naltrexone should be used more frequently,” said Dr. Anton, distinguished professor of psychiatry at the university and scientific director of the Charleston Alcohol Research Center. He noted that there are “recent data suggesting some clinical and genetic indicators that predict responsiveness to these medications, improving efficacy.”

The study was funded by the Finnish Ministry of Social Affairs and Health. Dr. Heikkinen reports no relevant financial relationships. The other authors’ disclosures are listed on the original article. Dr. Krystal consults for companies currently developing other treatments for AUDs and receives medications to test from AstraZeneca and Novartis for NIAAA-funded research programs. Dr. Anton has consulted for Alkermes, Lipha, and Lundbeck in the past. He is also chair of the Alcohol Clinical Trials Initiative, which is a public-private partnership partially sponsored by several companies and has received grant funding from the National Institutes of Health/National Institute on Alcohol Abuse and Alcoholism to study pharmacotherapies, including naltrexone, nalmefene, and acamprosate.

A version of this article first appeared on Medscape.com.

Pages

Recommended Reading

Shared medical appointments may bridge the opioid treatment gap
MDedge Psychiatry
Intense intervention may boost addiction program retention
MDedge Psychiatry
Pharmacotherapy for alcohol use disorder in patients with hepatic impairment
MDedge Psychiatry
Reducing COVID-19 opioid deaths
MDedge Psychiatry
Heavy drinking by teens may affect white-matter integrity
MDedge Psychiatry
Polydoctoring: The case against fragmented psychiatric care
MDedge Psychiatry
Machine learning flags key risk factors for suicide attempts
MDedge Psychiatry
Childhood smoking and depression contribute to young adult opioid use
MDedge Psychiatry
HHS will drop buprenorphine waiver rule for most physicians
MDedge Psychiatry
National spike in methamphetamine overdose deaths
MDedge Psychiatry