Post-Treatment Outcomes in a Double-Blind, Randomized Trial of Sertraline for Alcohol Dependence.

Author(s): Kranzler HR, Armeli S, Tennen H

Affiliation(s): From the Department of Psychiatry (HRK), University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania; VISN 4 MIRECC (HRK), Philadelphia VAMC, Philadelphia, Pennsylvania; Department of Psychology (SA), Fairleigh Dickinson University, Teaneck, New Jersey; and Department of Community Medicine and Healthcare (HT), University of Connecticut School of Medicine, Farmington, Connecticut.

Publication date & source: 2011-10-07, Alcohol Clin Exp Res., [Epub ahead of print]

Background: Pharmacotherapy studies in alcohol dependence (AD) are generally of short duration and do not include post-treatment follow-up. We examined the durability of treatment effects in a placebo-controlled trial of sertraline for AD. Methods: As previously reported, patients received 12 weeks of treatment with sertraline (n = 63) or placebo (n = 71), followed by assessments at 3 and 6 months post-treatment (Kranzler et al., 2011, J Clin Psychopharmacol 31:22-30). We examined the main and interaction effects with time of 3 between-subject factors (medication group, age of onset of AD [late-onset alcoholics, LOAs, vs. early-onset alcoholics, EOAs], and the tri-allelic 5-HTTLPR genotype) on drinking days (DDs) and heavy drinking days (HDDs). Results: The medication group effect, which was significant during treatment, remained significant during the 3-month follow-up period for L'/L' LOAs, with the sertraline group having fewer DDs than the placebo group (p = 0.027). However, the medication group effect seen in L'/L' EOAs during treatment was no longer significant (p = 0.48). There were no significant effects in S' carriers at the 3-month follow-up visit, or in either genotype group at the 6-month follow-up. Conclusions: The beneficial effects of sertraline observed in LOAs during treatment persisted during the 3-month post-treatment period. Additional studies are needed to validate these pharmacogenetic findings, which together with the effects seen during active treatment support the use of sertraline only in LOAs. Copyright (c) 2011 by the Research Society on Alcoholism.