Few clinical trials have evaluated naltrexone as a treatment for women with alcohol use disorder. This systematic review summarizes the recovery benefit and limitations of what the medicine can and cannot do.
Few clinical trials have evaluated naltrexone as a treatment for women with alcohol use disorder. This systematic review summarizes the recovery benefit and limitations of what the medicine can and cannot do.
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Alcohol use is the third leading cause of preventable death in the US causing 88,000 (62,000 men and 26,000 women) deaths every year. Alcohol use disorder affects almost 30% of US adults at some point in their life (i.e., lifetime prevalence). The disorder is more prevalent among men (36%) yet the disorder also affects almost one in five women (22.7%). Despite this, the effects of different alcohol use disorder treatment interventions addressing women’s alcohol use are only poorly understood.
The low rate of medication prescribing for alcohol use disorder perhaps is not surprising considering the efficacy of these interventions varies considerably, yet a previous non-gender specific review found naltrexone was helpful in reducing heavy drinking and cravings. The need to evaluate the impact of treatment options for alcohol use disorders specifically in women is created by notable gender differences such as faster absorption and genetic factors that increase sensitivity to the effects of alcohol. The aim of this new study was to systematically review and summarize the evidence regarding the impact of naltrexone compared to placebo for attenuating alcohol consumption in women with an alcohol use disorder.
The study was a systematic review, meaning the authors conducted a comprehensive database search with a predefined set of criteria used to include a study in this review. In this case, they searched for peer-reviewed, randomized control trials of naltrexone compared to placebo, published between 1990-2016. The findings had to be presented for women alone or distinct from men plus they had to report a measurable drinking outcome (e.g., percent days abstinent or drinks per day).
Seven studies were identified as meeting criteria and included in the review. These studies included a total of 903 women with alcohol use disorder, with an average age range between 39 to 49, mostly Caucasian, with a treatment duration between 8 to 16 weeks.
Results from each study are detailed in table:
Only 1 of 7 studies reported a statistically significant improvement (i.e., an indicator of the size of the effect relative to the size of the sample) in drinking outcomes among women using naltrexone.
Most studies reported a nonsignificant trend that favored naltrexone and one study reported a nonsignificant trend that favored placebo. Given that four studies had fewer than 100 women they may have been underpowered to detect a significant change in drinking over time. Six studies reported results for both genders and found that three studies observed trends that showed naltrexone reduced drinking more in men than women.
This was an important systematic review given the known sex differences between men and women in alcohol metabolism and its effects and yet no review of naltrexone had focused exclusively on its effects in women.
Overall there was not consistent support that naltrexone can improve drinking outcomes in women. There is a lack of support suggesting that naltrexone can lead to modest reductions in quantity of drinking and time to relapse in women as seen by mostly non-significant trends that favored naltrexone. The number of non-significant trends reported may suggest there was a lack of power to detect a significant change in drinking due to smaller sample sizes. This review has found that naltrexone may not be useful at reducing the frequency of drinking occasions in women.
The field could benefit from study designs that examine gender differences and treatment effects explicitly among persons with alcohol use disorder and present results separately for men and women. This will fuel the development of better treatment options for women.
Canidate, S.S., Carnaby, G.D., Cook, C.L., & Cook, R.L. (2017). A systematic review of naltrexone for attenuating alcohol consumption in women with alcohol use disorders. Alcoholism: Clinical and Experimental Research, Mar; 41(3), 466-472. doi: 10.1111/acer.13313.
l
Alcohol use is the third leading cause of preventable death in the US causing 88,000 (62,000 men and 26,000 women) deaths every year. Alcohol use disorder affects almost 30% of US adults at some point in their life (i.e., lifetime prevalence). The disorder is more prevalent among men (36%) yet the disorder also affects almost one in five women (22.7%). Despite this, the effects of different alcohol use disorder treatment interventions addressing women’s alcohol use are only poorly understood.
The low rate of medication prescribing for alcohol use disorder perhaps is not surprising considering the efficacy of these interventions varies considerably, yet a previous non-gender specific review found naltrexone was helpful in reducing heavy drinking and cravings. The need to evaluate the impact of treatment options for alcohol use disorders specifically in women is created by notable gender differences such as faster absorption and genetic factors that increase sensitivity to the effects of alcohol. The aim of this new study was to systematically review and summarize the evidence regarding the impact of naltrexone compared to placebo for attenuating alcohol consumption in women with an alcohol use disorder.
The study was a systematic review, meaning the authors conducted a comprehensive database search with a predefined set of criteria used to include a study in this review. In this case, they searched for peer-reviewed, randomized control trials of naltrexone compared to placebo, published between 1990-2016. The findings had to be presented for women alone or distinct from men plus they had to report a measurable drinking outcome (e.g., percent days abstinent or drinks per day).
Seven studies were identified as meeting criteria and included in the review. These studies included a total of 903 women with alcohol use disorder, with an average age range between 39 to 49, mostly Caucasian, with a treatment duration between 8 to 16 weeks.
Results from each study are detailed in table:
Only 1 of 7 studies reported a statistically significant improvement (i.e., an indicator of the size of the effect relative to the size of the sample) in drinking outcomes among women using naltrexone.
Most studies reported a nonsignificant trend that favored naltrexone and one study reported a nonsignificant trend that favored placebo. Given that four studies had fewer than 100 women they may have been underpowered to detect a significant change in drinking over time. Six studies reported results for both genders and found that three studies observed trends that showed naltrexone reduced drinking more in men than women.
This was an important systematic review given the known sex differences between men and women in alcohol metabolism and its effects and yet no review of naltrexone had focused exclusively on its effects in women.
Overall there was not consistent support that naltrexone can improve drinking outcomes in women. There is a lack of support suggesting that naltrexone can lead to modest reductions in quantity of drinking and time to relapse in women as seen by mostly non-significant trends that favored naltrexone. The number of non-significant trends reported may suggest there was a lack of power to detect a significant change in drinking due to smaller sample sizes. This review has found that naltrexone may not be useful at reducing the frequency of drinking occasions in women.
The field could benefit from study designs that examine gender differences and treatment effects explicitly among persons with alcohol use disorder and present results separately for men and women. This will fuel the development of better treatment options for women.
Canidate, S.S., Carnaby, G.D., Cook, C.L., & Cook, R.L. (2017). A systematic review of naltrexone for attenuating alcohol consumption in women with alcohol use disorders. Alcoholism: Clinical and Experimental Research, Mar; 41(3), 466-472. doi: 10.1111/acer.13313.
l
Alcohol use is the third leading cause of preventable death in the US causing 88,000 (62,000 men and 26,000 women) deaths every year. Alcohol use disorder affects almost 30% of US adults at some point in their life (i.e., lifetime prevalence). The disorder is more prevalent among men (36%) yet the disorder also affects almost one in five women (22.7%). Despite this, the effects of different alcohol use disorder treatment interventions addressing women’s alcohol use are only poorly understood.
The low rate of medication prescribing for alcohol use disorder perhaps is not surprising considering the efficacy of these interventions varies considerably, yet a previous non-gender specific review found naltrexone was helpful in reducing heavy drinking and cravings. The need to evaluate the impact of treatment options for alcohol use disorders specifically in women is created by notable gender differences such as faster absorption and genetic factors that increase sensitivity to the effects of alcohol. The aim of this new study was to systematically review and summarize the evidence regarding the impact of naltrexone compared to placebo for attenuating alcohol consumption in women with an alcohol use disorder.
The study was a systematic review, meaning the authors conducted a comprehensive database search with a predefined set of criteria used to include a study in this review. In this case, they searched for peer-reviewed, randomized control trials of naltrexone compared to placebo, published between 1990-2016. The findings had to be presented for women alone or distinct from men plus they had to report a measurable drinking outcome (e.g., percent days abstinent or drinks per day).
Seven studies were identified as meeting criteria and included in the review. These studies included a total of 903 women with alcohol use disorder, with an average age range between 39 to 49, mostly Caucasian, with a treatment duration between 8 to 16 weeks.
Results from each study are detailed in table:
Only 1 of 7 studies reported a statistically significant improvement (i.e., an indicator of the size of the effect relative to the size of the sample) in drinking outcomes among women using naltrexone.
Most studies reported a nonsignificant trend that favored naltrexone and one study reported a nonsignificant trend that favored placebo. Given that four studies had fewer than 100 women they may have been underpowered to detect a significant change in drinking over time. Six studies reported results for both genders and found that three studies observed trends that showed naltrexone reduced drinking more in men than women.
This was an important systematic review given the known sex differences between men and women in alcohol metabolism and its effects and yet no review of naltrexone had focused exclusively on its effects in women.
Overall there was not consistent support that naltrexone can improve drinking outcomes in women. There is a lack of support suggesting that naltrexone can lead to modest reductions in quantity of drinking and time to relapse in women as seen by mostly non-significant trends that favored naltrexone. The number of non-significant trends reported may suggest there was a lack of power to detect a significant change in drinking due to smaller sample sizes. This review has found that naltrexone may not be useful at reducing the frequency of drinking occasions in women.
The field could benefit from study designs that examine gender differences and treatment effects explicitly among persons with alcohol use disorder and present results separately for men and women. This will fuel the development of better treatment options for women.
Canidate, S.S., Carnaby, G.D., Cook, C.L., & Cook, R.L. (2017). A systematic review of naltrexone for attenuating alcohol consumption in women with alcohol use disorders. Alcoholism: Clinical and Experimental Research, Mar; 41(3), 466-472. doi: 10.1111/acer.13313.