O'Malley 1996: what lasted six months after naltrexone stopped

What they tested

This follow-up looked again at people from O'Malley's 1992 trial, in which 97 people with alcohol dependence were randomly given naltrexone or placebo plus either coping skills therapy or supportive therapy for 12 weeks.

Eighty of the 97 were assessed during the 6 months after treatment ended, while no one was taking the study medicine.

What they found

People who had received naltrexone were less likely to drink heavily or to meet criteria for alcohol abuse or dependence than those who had received placebo.

Naltrexone's effect on abstinence rates persisted only through the first month of follow-up.

Coping skills therapy was linked to less drinking among people who had taken placebo. Which therapy people had did not predict whether they had an alcohol diagnosis at follow-up.

Limits

• Not everyone was followed up: 80 of the 97 original participants were assessed.
• The abstract gives no rates or effect sizes for the follow-up period.
• The original trial was small, and this follow-up covers 6 months, so it can't speak to longer-term outcomes.

What it means if you're considering naltrexone

Some benefits of a short course of naltrexone outlasted the pills, especially less heavy drinking, but the effect on staying fully abstinent faded quickly. The authors concluded that continued treatment with naltrexone may help some people, which is a question to raise with a prescriber rather than a rule about how long to take it.