Effects of topiramate or naltrexone on tobacco use among male alcohol-dependent outpatients

被引:35
作者
Baltieri, Danilo Antonio [1 ,2 ,3 ]
Daro, Fabio Ruiz [1 ]
Ribeiro, Philip Leite [1 ]
de Andrade, Arthur Guerra [1 ,2 ]
机构
[1] Univ Sao Paulo, Dept Psychiat, BR-05508 Sao Paulo, Brazil
[2] ABC Med Sch, Dept Psychiat, Sao Paulo, Brazil
[3] Penitentiary Counseling Sao Paulo State, Sao Paulo, Brazil
关键词
Tobacco; Alcoholism; Pharmacotherapy; Treatment; RANDOMIZED CONTROLLED-TRIAL; NICOTINE REPLACEMENT THERAPY; SMOKING-CESSATION; CIGARETTE-SMOKING; DRINKING BEHAVIOR; ORAL TOPIRAMATE; ABUSE TREATMENT; QUIT SMOKING; SMOKERS; INDIVIDUALS;
D O I
10.1016/j.drugalcdep.2009.05.025
中图分类号
R194 [卫生标准、卫生检查、医药管理];
学科分类号
摘要
Background: A high smoking prevalence has been registered among alcoholics. It has been pointed out that alcoholic smokers may have a more severe course and greater severity of alcoholism. This study aims at comparing smoking and non-smoking alcoholics in terms of treatment outcomes and verifying the efficacy of topiramate and naltrexone to decrease the use of cigarettes among alcoholic smokers. Methods: The investigation was a double-blind, placebo-controlled, 12-week study carried out at the University of Sao Paulo, Brazil. The sample comprised 155 male alcohol-dependent outpatients (52 nonsmokers and 103 smokers). 18-60 years of age, with an International Classification of Diseases (ICD-10) diagnosis of alcohol dependence. After a 1-week detoxification period, the patients randomly received placebo, naltrexone (50 mg/day) or topiramate (up to 300 mg/day). Only the alcoholic smokers who adhered to the treatment were evaluated with reference to the smoking reduction. Results: Cox regression analysis revealed that the smoking status among alcoholics increased the odds of relapse into drinking by 65%, independently of the medications prescribed, using the intention-to-treat method. Topiramate showed effectiveness to reduce the number of cigarettes smoked when compared to placebo among adherent patients (mean difference =7.91, p < 0.01). There were no significant differences between the naltrexone group and the placebo group. Conclusions: The results of this study confirm that the treatment is more challenging for smoking alcoholics than for non-smoking ones and support the efficacy of topiramate in the smoking reduction among male alcoholic smokers who adhered to the treatment. (C) 2009 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:33 / 41
页数:9
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