Search

Aims: Self-help groups such as Alcoholics Anonymous (AA) are widely recommended for aftercare of alcohol-dependent persons, even though scientific knowledge of its effectiveness is inconsistent. The aim of the present analysis was to elucidate whether persons attending AA groups regularly after detoxification have lower relapse rates within 1 year, compared to persons without self-help group attendance. Methods: Data for the present analysis were derived from the placebo-group of a multi-centre study in Germany (Wiesbeck et al., 2001). Patients were free to choose either self-help group attendance (N = 50) or no support (N = 28). Results: After I-month of follow-up, there was a lower relapse rate in patients attending a self-help group as compared to the control group, a difference, however, that leveled off during the following months. Moreover, relapse rates did not differ significantly at any point of time between both groups. Levels of social functioning improved in both groups over 1 year. Conclusions: The present study was unable to show an advantage of self-help group attendance in reducing relapses compared to the control group. [ABSTRACT FROM AUTHOR]

Summary ¶A study recently finished by our research group elucidated the effectiveness of flupenthixol decanoate (FLX) in maintaining abstinence in detoxified alcoholics. Flupenthixol decanoate is an established antipsychotic drug, which is well known for its mild antidepressant and anxiolytic activity as well as for its minimal sedation at low doses. It blocks dopamine binding at a number of receptor subtypes, primarily at D-1, D-2, D-3 and with less affinity at D4-receptors. It also affects serotonin binding at 5-HT2A and 5-HT2C receptors. In a double-blind placebo-controlled multicenter trial, 77 women and 204 men suffering from moderate or severe DSM-II-R alcohol dependence were randomly assigned to either 10 mg FLX or placebo both injected every second week over a period of 24 weeks (treatment phase) succeeded by a medication-free 24-weeks follow-up period. In the overall analysis the number of patients relapsed after 24 weeks of treatment (=main criterion of efficacy) was significantly higher in the FLX treated group (85.2%) than under placebo (65.5%). However, when differentiating this result according to sex the analysis revealed a gender-related discrepancy: while male patients had an almost 4-fold higher risk to relapse under FLX than under placebo (OR=3.95) this risk was barely elevated for female patients (OR=1.51). A significantly negative outcome due to FLX treatment was restricted to male alcoholics solely. In conclusion, gender-related differences to pharmacological relapse prevention with FLX have probably contributed to a better treatment outcome in women than in men. [ABSTRACT FROM AUTHOR]

Novelty Seeking including impulsive behaviour is a personality dimension which has been shown to be related to early-onset alcoholism and to high relapse rates. The cued Continuous Performance Test (CPT) is an experimental paradigm for active response control requiring a choice reaction between execution (Go) and inhibition (NoGo) of a prepared motor response. Metabolic functional methods have shown right frontal brain activation throughout the period of a CPT, and the spatial analysis of the associated event-related brain electrical (ERP) field potentials revealed that this right frontal activation was due to the NoGo subset of the task. The ERP fields allow distinction between the Go and NoGo conditions with one spatial parameter (NoGo-anteriorization) in single cases, and the magnitude of this parameter is thought to be related to inhibitory frontal lobe control. Twenty patients with severe alcohol dependence and 20 age- and sex-matched healthy controls were included in the study and investigated with a 21-channel electroencephalogram while performing a cued CPT. Consistent with previous studies, NoGo-anteriorization was present in every case in both groups. The ERP field differed between alcoholics and controls in the Go condition (P < 0.05) and NoGo-anteriorization in alcoholics was correlated inversely with Novelty Seeking in Cloninger's Temperament and Character Inventory (r=0.67, P < 0.01). This indicates a reduced frontal lobe contribution during response control in alcoholics with impulsive behaviour and identifies a possible biological marker for the clinical evaluation of the risk of relapse in alcoholism. [ABSTRACT FROM PUBLISHER]