SynthesisAlcoholism, clinical and experimental research2013
The declining efficacy of naltrexone pharmacotherapy for alcohol use disorders over time: a multivariate meta-analysis.
Synthesis in Alcoholism, clinical and experimental research, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 5 syntheses or guidelines pooled it, 30 citations in OpenAlex.
- Study Characteristics Influence the Efficacy of Substance Abuse Treatments: A Meta-analysis of Medications for Smoking Cessation.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2020Pooled it
- Run-in periods and clinical outcomes of antipsychotics in dementia: A meta-epidemiological study of placebo-controlled trials.Pharmacoepidemiology and drug safety · 2020Pooled it
- Naltrexone effects on subjective responses to alcohol in the human laboratory: A systematic review and meta-analysis.Addiction biology · 2019Pooled it
- A meta-analysis of topiramate's effects for individuals with alcohol use disorders.Alcoholism, clinical and experimental research · 2014Pooled it
- The placebo effect in clinical trials for alcohol dependence: an exploratory analysis of 51 naltrexone and acamprosate studies.Alcoholism, clinical and experimental research · 2013Pooled it
- Behavioral economic analysis of topiramate pharmacotherapy for alcohol: a placebo-controlled investigation of effects on alcohol reinforcing value and delayed reward discounting.Psychopharmacology · 2022Trial
- Trial
- Gene polymorphism Mu opioid receptor & its impact on naltrexone treatment response in alcohol-dependent individuals: A pilot study from north India.The Indian journal of medical research · 2025Article
- Evidence of subgroup differences in meta-analyses evaluating medications for alcohol use disorder: An umbrella review.Alcohol, clinical & experimental research · 2024Review
- Precision medicine in alcohol use disorder: Mapping etiologic and maintenance mechanisms to mechanisms of behavior change to improve patient outcomes.Experimental and clinical psychopharmacology · 2023Article
- Targeting Unmet Clinical Needs in the Treatment of Alcohol Use Disorder.Frontiers in psychiatry · 2022Review
- Medication-enhanced behavior therapy for alcohol use disorder: Naltrexone, Alcoholics Anonymous Facilitation, and OPRM1 genetic variation.Journal of substance abuse treatment · 2019Article
- Naltrexone Acutely Enhances Connectivity Between the Ventromedial Prefrontal Cortex and a Left Frontoparietal Network.Alcoholism, clinical and experimental research · 2019Article
- Bupropion, Alone and in Combination with Naltrexone, Blunts Binge-Like Ethanol Drinking and Intake Following Chronic Intermittent Access to Ethanol in Male C57BL/6J Mice.Alcoholism, clinical and experimental research · 2019Article
- Effects of glucagon-like peptide 1 analogs on alcohol intake in alcohol-preferring vervet monkeys.Psychopharmacology · 2019Article
- Weak evidence on nalmefene creates dilemmas for clinicians and poses questions for regulators and researchers.Addiction (Abingdon, England) · 2016Review
- Evidence that Melanocortin Receptor Agonist Melanotan-II Synergistically Augments the Ability of Naltrexone to Blunt Binge-Like Ethanol Intake in Male C57BL/6J Mice.Alcoholism, clinical and experimental research · 2015Article
- Advances in Medications and Tailoring Treatment for Alcohol Use Disorder.Alcohol research : current reviews · 2015Review
- Alcohol addiction: toward a patient-oriented pharmacological treatment.Expert opinion on pharmacotherapy · 2013Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundOral naltrexone is an FDA-approved medication for treating alcohol use disorders. Although its efficacy has been supported in multiple clinical trials, an earlier review found that its effect sizes (ESs) on relapse to heavy drinking and, to a lesser extent, percent days drinking were smaller in more recent trials and in multicenter than in single-site studies. We examined whether these findings held when studies from 2004 to 2009 were taken into account, and whether single-site versus multicenter trials, the use of placebo run-in periods, and placebo group improvement accounted for variation in naltrexone effects and decreasing effects over time.
methodsA multivariate meta-analysis of naltrexone pharmacotherapy trials for alcohol use disorders was conducted. All analyses simultaneously modeled ESs on outcomes of percent days abstinent and relapse to heavy drinking. Potential moderators of medication effects that were examined included publication year, multicenter design (vs. single site), placebo run-in period, and placebo group improvement.
resultsStatistically significant between-group differences on percent days abstinent (the inverse of percent days drinking) and relapse to heavy drinking favored naltrexone over placebo. Year of publication was a significant moderator for both outcomes, with more recent trials having smaller ESs. Neither multi- versus single-site study, the interaction between multi- versus single-site study and year of publication, nor placebo run-in period was a significant moderator of naltrexone effects. Although placebo group improvement was modestly associated with smaller between-group naltrexone versus placebo ESs, only 21 studies provided usable information on placebo group improvement. Within those studies, there was no relationship between naltrexone ESs and time, so placebo group improvement was not examined as a moderator of that relationship.
conclusionsNaltrexone ESs have attenuated over time. Moderators that explain why effects have been decreasing remain to be determined.
Indexed as
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.