A standardized kudzu extract (NPI-031) reduces alcohol consumption in nontreatment-seeking male heavy drinkers.

OBJECTIVE: We previously demonstrated that short-term treatment with a standardized kudzu extract (NPI-031) reduced alcohol drinking by men and women in a natural setting. The present study was conducted in nontreatment-seeking heavy drinkers to assess the safety and efficacy of 4 weeks of kudzu extract in an outpatient setting. METHOD: This randomized between-subject, double-blind, placebo-controlled study involved 2 weeks of baseline, 4 weeks of treatment, and 2 weeks of follow-up. Seventeen men (21-33 years) who reported drinking 27.6 ± 6.5 drinks/week with a diagnosis of alcohol abuse/dependence took either kudzu extract (250 mg isoflavones, t.i.d.) or matched placebo on a daily basis. They reported alcohol consumption and desire to use alcohol using a wrist actigraphy device; twice weekly laboratory visits were scheduled to monitor medication adherence and adverse events. RESULTS: Medication adherence was excellent and there were no adverse events and changes in vital signs, blood chemistry, and renal or liver function. There was no effect on alcohol craving, but kudzu extract significantly reduced the number of drinks consumed each week by 34-57 %, reduced the number of heavy drinking days, and significantly increased the percent of days abstinent and the number of consecutive days of abstinence. CONCLUSIONS: A standardized formulation of kudzu extract produced minimal side effects, was well-tolerated, and resulted in a modest reduction in alcohol consumption in young nontreatment-seeking heavy drinkers. Additional studies using treatment-seeking alcohol-dependent persons will be necessary to determine the usefulness of this herbal preparation in reducing alcohol use in other populations.

Alcohólicos ingresados en una sala de psiquiatría: mortalidad a los 14 años / Alcoholic patients hospitalized in a psychiatry unit: mortality at 14 years

Introducción: Los pacientes alcohólicos presentan una elevada mortalidad. Se conoce la de los pacientes que siguen un tratamiento ambulatorio especializado y la de los que ingresan por patologías orgánicas relacionadas con su abuso de alcohol, pero desconocemos si los alcohólicos con un perfil más psiquiátrico también fallecen de forma prematura. Objetivo: investigar las características clínicas, evolución terapéutica, supervivencia y los factores que pueden predecir mejor su mortalidad posterior. Material: Seguimiento longitudinal a los 14 años de una cohorte de 91 pacientes alcohólicos ingresados en 1993 para desintoxicación en una Sala de Psiquiatría y que siguieron tratamiento ambulatorio posterior. Resultados: Presentan una elevada presencia de patología psiquiátrica (40,6%) y múltiples antecedentes de tratamiento (78%). A los 14 años la mortalidad ha sido del 34,1%. Los pacientes fallecidos presentaban con más frecuencia deterioro cognitivo y situación de pensionistas. También recibían antidepresivos más a menudo, tenían menor soporte familiar y habían recaído más en el consumo de alcohol. Discusión: Muchos factores que predicen mayor mortalidad tienen relación con una mayor edad. En los pacientes más jóvenes la presencia de síntomas de deterioro neuropsicológico podría señalar una alteración orgánica prematura y probablemente un mayor riesgo de incumplimiento de tratamientos, mal cuidado físico y situaciones traumáticas, físicas y mentales, todo lo cual favorecería también la mortalidad prematura (AU)

Introduction: Alcoholic patients show a high mortality rate. We know about the increased mortality of outpatients following specialized treatment for alcohol abuse and inpatients with organic diseases related to alcohol, but it is not clear whether alcoholics with a comorbid psychiatric profile also die prematurely. Objective: To investigate clinical characteristics, therapeutic evolution, survival, and factors that can better predict mortality. Materials: 14-year longitudinal monitoring of 91 patients hospitalized in 1993 for detoxification in a psychiatric unit and who subsequently received outpatient treatment. Results: Patients show a high prevalence of psychiatric disorders (40.6%) and multiple periods of previous treatment (78%). After 14 years the mortality rate was 34.1%. Deceased patients more often presented cognitive decline and were more often on pensions. They were also taking more antidepressants, had less family support and were more likely to have relapsed into alcohol use. Discussion: Many of the factors that predict higher mortality are age-related. In younger patients, the presence of neuropsychological deterioration symptoms may indicate a premature organic disorder and probably greater risk of treatment failure, poor physical care and traumatic physical and mental situations, all of which would also increase the likelihood of premature mortality (AU)

The European acamprosate trials: conclusions for research and therapy.

In an excellent methodological approach, the European acamprosate study project showed that acamprosate increases sobriety times. In one randomized prospective study (n = 260) comparing acamprosate and placebo, with a 1-year treatment phase and 1-year follow-up phase, the authors found that acamprosate is effective only in Lesch type I and type II patients. To investigate the possible influence of diagnostic subgrouping, we applied the Lesch typology in a co-work with the main researchers of the UK study. The UK results concerning acamprosate's effects in the types do not mirror the Vienna results, but the numbers of type I and type II patients, retrospectively found as included in the UK centers, were too small for any conclusions. The distribution of the types points to the fact that too many type III and IV patients had been included to give acamprosate the chance to be effective. Following our typology and also these studies, we developed special treatment approaches. For relapse prevention studies, the cumulative abstinence duration together with the Lesch typology seems to be promising.