Does psychosocial treatment enhance the efficacy of acamprostate in patients with alcohol problems?

Investigated whether the addition of psychosocial intervention to the medical prescription of acamprosate contributes to treatment outcome. 249 patients (aged 18-65 yrs) meeting Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) criteria for alcohol dependence or abuse were recruited in 14 outpatient treatment centres (TCs) and randomized into 1 of 3 treatment conditions: acamprosate; acamprosate plus minimal intervention aimed at motivational enhancement; and acamprosate plus brief cognitive behavioral therapy. Drinking behavior, medication compliance and psychological distress were assessed throughout the treatment period. Follow-up assessment was undertaken 6 mo after termination of pharmacological treatment. Of 241 patients with intention to treat (ITT), 114 remained in treatment for the full 28 wks; 169 of the ITT population were seen for follow-up. No statistically significant differences were found between treatment groups for any of the drinking outcomes either at the end of the 28 wks of treatment or at 6-mo follow-up. There were no statistically significant differences in medication compliance, drop-out rates, or psychological distress. However, a significant interaction effect was observed between TC and treatment group, indicating that brief interventions were differentially effective in different TCs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)