Rohsenow 2000: what predicted who kept taking naltrexone

What they tested

After leaving a 1- to 2-week partial hospital program, 128 people with alcohol dependence were randomly given naltrexone 50 mg a day or a placebo for 12 weeks (64 in each group). They saw a physician and a research assistant weekly for 4 weeks, then every other week for 8 weeks.

The researchers looked at which traits and early experiences were linked to compliance, measured as the number of days people took their medicine.

What they found

Demographic details and how much people drank before treatment did not predict pill-taking.

The number and severity of side effects in the first week, particularly nausea and fatigue, predicted dropping out early.

Commitment to abstinence and confidence about staying abstinent did not predict pill-taking, but belief that the medicine would help did. A general urge to drink in the first week did not predict it either, though people with a stronger urge to drink when shown alcohol in the lab took their medicine more.

Limits

• These are links found by looking at who took their pills, not the results of randomly changing anything, so they can't show cause and effect.
• Everyone came from a partial hospital program, which may not match people starting naltrexone in a regular clinic or online.
• The abstract doesn't give the size of each link.

What it means if you're considering naltrexone

Naltrexone only helps if people keep taking it, and this study points to two things linked to sticking with it: getting through first-week side effects, and believing the medicine can help. The authors suggested reducing side effects and building people's confidence in naltrexone as ways to improve pill-taking.