Evidence map›Paper›PMID 30153753›Full record

Trial reportThe American journal of psychiatry2018

Double-Blind Randomized Clinical Trial of Prazosin for Alcohol Use Disorder.

Tracy L Simpson, Andrew J Saxon, Cynthia Stappenbeck, Carol A Malte, Robert Lyons, Dana Tell, Steven P Millard, Murray Raskind

Open access · bronzeAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The American journal of psychiatry, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
40citing papers in PubMed, 1 pooled it
3.8field-weighted citation impact, top 5% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

40 citing papers in PubMed, 1 synthesis or guideline pooled it, 77 citations in OpenAlex.

  1. Yohimbine as a pharmacological probe for alcohol research: a systematic review of rodent and human studies.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2022
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  17. An ensemble recruited by αNeuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2023
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Tracy L SimpsonFrom the Center of Excellence in Substance Abuse Treatment and Education and the Mental Illness Research, Education, and Clinical Center, VA Puget Sound Health Care System, Seattle; the Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle; and the Seattle Institute for Biomedical and Clinical Research, Seattle.
Andrew J SaxonFrom the Center of Excellence in Substance Abuse Treatment and Education and the Mental Illness Research, Education, and Clinical Center, VA Puget Sound Health Care System, Seattle; the Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle; and the Seattle Institute for Biomedical and Clinical Research, Seattle.
Cynthia StappenbeckFrom the Center of Excellence in Substance Abuse Treatment and Education and the Mental Illness Research, Education, and Clinical Center, VA Puget Sound Health Care System, Seattle; the Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle; and the Seattle Institute for Biomedical and Clinical Research, Seattle.
Carol A MalteFrom the Center of Excellence in Substance Abuse Treatment and Education and the Mental Illness Research, Education, and Clinical Center, VA Puget Sound Health Care System, Seattle; the Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle; and the Seattle Institute for Biomedical and Clinical Research, Seattle.
Robert LyonsFrom the Center of Excellence in Substance Abuse Treatment and Education and the Mental Illness Research, Education, and Clinical Center, VA Puget Sound Health Care System, Seattle; the Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle; and the Seattle Institute for Biomedical and Clinical Research, Seattle.
Dana TellFrom the Center of Excellence in Substance Abuse Treatment and Education and the Mental Illness Research, Education, and Clinical Center, VA Puget Sound Health Care System, Seattle; the Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle; and the Seattle Institute for Biomedical and Clinical Research, Seattle.
Steven P MillardFrom the Center of Excellence in Substance Abuse Treatment and Education and the Mental Illness Research, Education, and Clinical Center, VA Puget Sound Health Care System, Seattle; the Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle; and the Seattle Institute for Biomedical and Clinical Research, Seattle.
Murray RaskindFrom the Center of Excellence in Substance Abuse Treatment and Education and the Mental Illness Research, Education, and Clinical Center, VA Puget Sound Health Care System, Seattle; the Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle; and the Seattle Institute for Biomedical and Clinical Research, Seattle.
Seattle Institute for Biomedical and Clinical Research · US

Funding

Clinical Trials of the Adrenergic a-1 Antagonist Prazosin for Alcohol DependenceR01AA017184 · NIAAA · SEATTLE INST FOR BIOMEDICAL/CLINICAL RES · PI SIMPSON, TRACY L. · 2008 to 2012
$1.4M
NIAAA NIH HHS R01 AA017184
6 · The paper itself

Abstract

objectiveCurrent medications for alcohol use disorder do not target brain noradrenergic pathways. Theoretical and preclinical evidence suggests that noradrenergic circuits may be involved in alcohol reinforcement and relapse. After a positive pilot study, the authors tested the α-1 adrenergic receptor antagonist prazosin to treat alcohol use disorder in a larger sample.

methodNinety-two participants with alcohol use disorder but without posttraumatic stress disorder were randomly assigned to receive prazosin or placebo in a 12-week double-blind study. Medication was titrated to a target dosing schedule of 4 mg in the morning, 4 mg in the afternoon, and 8 mg at bedtime by the end of week 2. The behavioral platform was medical management. Participants provided daily data on alcohol consumption. Generalized linear mixed-effects models were used to examine the impact of prazosin compared with placebo on number of drinks per week, number of drinking days per week, and number of heavy drinking days per week.

resultsEighty participants completed the titration period and were included in the primary analyses. There was a significant interaction between condition and week for both number of drinks and number of heavy drinking days, such that the rate of drinking and the probability of heavy drinking showed a greater decrease over time for participants in the prazosin condition compared with those in the placebo condition. Participants in the prazosin condition were more likely to report drowsiness and edema than participants in the placebo condition.

conclusionsPrazosin holds promise as a harm-reduction pharmacologic treatment for alcohol use disorder and deserves further evaluation by independent research groups.

Indexed as

Adrenergic alpha-1 Receptor AntagonistsAlcohol DrinkingAlcoholismDouble-Blind MethodDrug Administration ScheduleEthanolFemaleHumansMaleMiddle AgedPrazosinAdrenergic alpha-1 Receptor AntagonistsEthanolPrazosinAlcohol AbuseClinical Drug StudiesNoradrenergicPrazosin

Identifiers

PMID30153753
PMCPMC6395537
OpenAlexW2889479634

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.