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Am J Psychiatry 1995; 152:391-397
Copyright © 1995 by American Psychiatric Association
Placebo-controlled trial of fluoxetine as an adjunct to relapse prevention in alcoholics
HR Kranzler, JA Burleson, P Korner, FK Del Boca, MJ Bohn, J Brown and N Liebowitz
Department of Psychiatry, University of Connecticut Health Center, Farmington 06030-2103.
OBJECTIVE: The authors tested the hypothesis that fluoxetine, when used in
combination with relapse prevention psychotherapy, directly reduces relapse
frequency and severity for alcoholics. METHOD: The authors conducted a
randomized, placebo-controlled trial of fluoxetine (up to a maximum of 60
mg/day) for 12 weeks in combination with weekly psychotherapy for 101
alcohol-dependent subjects who were not selected on the basis of comorbid
major depression. Outcomes were measured at the end of treatment and 6
months after treatment. RESULTS: Placebo- treated subjects were more
complaint with the medication regimen and remained in the study longer than
fluoxetine-treated subjects. There was significantly less alcohol
consumption in both groups during treatment than before treatment. These
effects persisted during the posttreatment period. Although fluoxetine
treatment had no significant effects on alcohol consumption, it reduced
Hamilton Depression Rating Scale scores more than placebo treatment among
subjects with current major depression. CONCLUSIONS: Fluoxetine at a dose
of 60 mg/day is probably not of use for relapse prevention in alcoholics
with mild to moderate alcohol dependence and no comorbid depression. In
alcoholics with major depression, the drug may reduce depressive symptoms.
Subsequent studies with fluoxetine should probably focus on more severely
alcohol-dependent subjects or those with comorbid depression.
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