Nalmefene in alcohol use disorder subjects with psychiatric comorbidity: A preliminary report

Abstract

Introduction Nalmefene is the first drug approved to reduce alcohol consumption in Alcohol Use Disorder (AUD) patients with a high drinking risk level. There is a high prevalence of concurrent psychiatric disorders in AUD patients, with an associated increased morbidity and poorer prognosis. Objectives Despite high comorbidity rates, little attention has been paid to the clinical management of these patients. Aims The aims of our study were to evaluate the use of nalmefene in AUD patients with psychiatric comorbidity, previously treated unsuccessfully for alcohol dependence, and to assess reduction in craving. Methods Thirty AUD outpatients (M/F: 19/11) with stabilized anxiety and affective comorbid disorders were treated with as-needed nalmefene 18mg plus psychosocial support for 24weeks. Primary outcome measures were: changes in heavy drinking days (HDDs) and total alcohol consumption (TAC, g/day). Secondary outcome measures were: changes in Drinking Risk Level (DRL) and craving levels (Obsessive-Compulsive Drinking Scale [OCDS] and Visual Analogue Scale for craving [VASc]). Results The reduction of HDDs and TAC over time was significant ( P P Conclusions As-needed nalmefene was well tolerated and useful in reducing drinking in AUD patients with stabilized psychiatric comorbidity that had not responded to previous interventions for alcohol dependence. Nalmefene also reduced craving, which is related to the motivation to consume alcohol.