Clinical characterization of use of acamprosate and naltrexone: data from an addiction center in India.

There are several queries on the effectiveness of acamprosate in pharmacoprophylaxis of alcohol dependence despite studies conducted over the last decade regarding its efficacy. In this retrospective chart review, 62 patients with ICD-10-diagnosed alcohol dependence who received treatment from an addiction center in India were studied to compare those on acamprosate or naltrexone versus those on no prophylactic drugs with regard to their demographic and clinical background and short-term outcome after treatment. Compared to those on naltrexone or no drugs, significantly more patients on acamprosate came from higher socioeconomic strata and had fewer family/marital complications and less comorbid use of opioids and other drugs; however, they also had more liver function impairment and alcoholic liver disease and a higher average duration of relapse in the past (p < 0.05 or less in each case). The group on no drugs had significantly less family/social support (p = 0.006) and poorer motivation rating (p < 0.001) than the other two groups on drugs. Intent-to-treat analysis showed that there was a non-significant trend of a higher proportion of acamprosate patients remaining abstinent (77%) than those on naltrexone (36%) or no drug (50%). At follow-up, acamprosate patients had significantly better functioning in several areas. However, because many of the baseline patient characteristics might themselves have influenced the outcome, no conclusion should be drawn from this data regarding the efficacy of the drug. Logistic regression analysis showed that both family/social support and acamprosate appeared to contribute modestly toward explaining the variance in short-term outcome.