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Because naltrexone is of only limited help in treating alcohol dependence, clinicians eagerly seek strategies to enhance its effectiveness. In a government-funded, three-arm study, 150 patients with alcohol dependence (mean age, 46; 82% men; 87% white) abstained from alcohol for at least 4 consecutive days and were then randomized to naltrexone (50 mg/day) or placebo for 16 weeks; gabapentin (≤1200 mg/day) or placebo was added for the first 6 weeks. All patients received medical management and the COMBINE study's blended behavioral intervention (cognitive-behavioral therapy, motivational interviewing, and 12-step techniques).
Treatment was completed by 60% to 70% of the groups. Compared with the double-placebo group, the naltrexone + placebo…