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

Authors

  • Henry R. Kranzler,

    1. 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.
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  • Stephen Armeli,

    1. 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.
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  • Howard Tennen

    1. 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.
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Reprint requests: Dr. Henry R. Kranzler, Department of Psychiatry, University of Pennsylvania School of Medicine, Treatment Research Center, 3900 Chestnut St., Philadelphia, PA 19104; Tel.: 215-222-3200, ext. 137; Fax: 215-386-6770; E-mail:kranzler_h@mail.trc.upenn.edu

Abstract

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 (= 0.027). However, the medication group effect seen in L’/L’ EOAs during treatment was no longer significant (= 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.

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