Six-Month Outcome in Bipolar Spectrum Alcoholics Treated with Acamprosate after Detoxification: A Retrospective Study
AbstractBackground: Glutamate system is modified by ethanol and contributes both to the euphoric and the dysphoric consequences of intoxication, but there is now growing evidence that the glutamatergic system also plays a central role in the neurobiology and treatment of mood disorders, including major depressive disorders and bipolar disorders. We speculate that, using acamprosate, patients with bipolar depression (BIP-A) can take advantage of the anti-glutamate effect of acamprosate to “survive” in treatment longer than peers suffering from non-bipolar depression (NBIP-A) after detoxification. Method: We retrospectively evaluated the efficacy of a long-term (six-month) acamprosate treatment, after alcohol detoxification, in 41 patients (19 males and 22 females), who could be classified as depressed alcoholics, while taking into account the presence/absence of bipolarity. Results: During the period of observation most NBIP-A patients relapsed, whereas a majority of BIP-A patients were still in treatment at the end of their period of observation. The cumulative proportion of ‘surviving’ patients was significantly higher in BIP-A patients, but this finding was not related to gender or to other demographic or clinically investigated characteristics. The treatment time effect was significant in both subgroups. The treatment time-group effect was significant (and significantly better) for bipolar patients on account of changes in the severity of their illness. Limitations: Retrospective methodology and the lack of DSM criteria in diagnosing bipolarity. Conclusions: Bipolarity seems to be correlated with the efficacy of acamprosate treatment in inducing patients to refrain from alcohol use after detoxification (while avoiding relapses) in depressed alcoholics. Placebo-controlled clinical trials are now warranted to check the validity of this hypothesis. View Full-Text
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Icro Maremmani, A.G.; Bacciardi, S.; Rovai, L.; Rugani, F.; Massimetti, E.; Gazzarrini, D.; Dell'Osso, L.; Maremmani, I. Six-Month Outcome in Bipolar Spectrum Alcoholics Treated with Acamprosate after Detoxification: A Retrospective Study. Int. J. Environ. Res. Public Health 2014, 11, 12983-12996.
Icro Maremmani AG, Bacciardi S, Rovai L, Rugani F, Massimetti E, Gazzarrini D, Dell'Osso L, Maremmani I. Six-Month Outcome in Bipolar Spectrum Alcoholics Treated with Acamprosate after Detoxification: A Retrospective Study. International Journal of Environmental Research and Public Health. 2014; 11(12):12983-12996.Chicago/Turabian Style
Icro Maremmani, Angelo G.; Bacciardi, Silvia; Rovai, Luca; Rugani, Fabio; Massimetti, Enrico; Gazzarrini, Denise; Dell'Osso, Liliana; Maremmani, Icro. 2014. "Six-Month Outcome in Bipolar Spectrum Alcoholics Treated with Acamprosate after Detoxification: A Retrospective Study." Int. J. Environ. Res. Public Health 11, no. 12: 12983-12996.