A follow up study on the efficacy of metadoxine in the treatment of alcohol dependence

Irene Guerrini, Claudio Gentili, Gloria Nelli, Mario Guazzelli, Irene Guerrini, Claudio Gentili, Gloria Nelli, Mario Guazzelli

Abstract

Background: We carried out a three months follow-up study on the efficacy of metadoxine in a cohort of alcoholics admitted to the Alcohol misuse Long-term Treatment (ALT) Unit-University of Pisa (Italy). We analyzed the clinical data, psychometric tests and blood tests of 160 alcoholics on admission and after 3 months of treatment. We compared 58 pts treated with metadoxine (MET) with 102 pts who did not receive (NULL) any drug as an adjunct to the psycho-educational interventions provided by the ALT Unit.

Results: At follow-up, the patients in treatment with metadoxine showed a significant improvement in the rate of complete abstinence (44.8% vs. 21.6%; chi square: 8.45, df = 1, p < 0.0037). Furthermore, the number of drop-outs at three months of treatment was also significantly lower in the MET than in the NULL group (17% vs. 57%; chi square of 23.22, df = 1, p < 0.001).

Conclusion: Our findings support the use of metadoxine in the management of alcohol dependence. However, randomized clinical trials are necessary to confirm and replicate them. This study raises the importance of identifying new pharmacological compounds effective on the outcome of alcoholism in order to help patients to best adhere to treatment programs and to prevent the development of mental and physical complications due to chronic and heavy use of alcohol.

References

    1. Helzer JE. Epidemiology of alcoholism. J Consult Clin Psychol. 1987;55:284–292. doi: 10.1037/0022-006X.55.3.284.
    1. Grant BF. Prevalence and correlates of alcohol use and DSM-IV alcohol dependence in the United States: results of the National Longitudinal Alcohol Epidemiologic Survey. J Stud Alcohol. 1997;58:464–473.
    1. Pyorala E. Trends in alcohol consumption in Spain, Portugal, France and Italy from the 1950s until the 1980s. Br J Addict. 1990;85:469–477. doi: 10.1111/j.1360-0443.1990.tb01667.x.
    1. Grant BF, Dawson DA, Stinson FS, Chou SP, Dufour MC, Pickering RP. The 12-month prevalence and trends in DSM-IV alcohol abuse and dependence: United States, 1991-1992 and 2001-2002. Drug Alcohol Depend. 2004;74:223–234. doi: 10.1016/j.drugalcdep.2004.02.004.
    1. Guerrini I, Gentili C, Guazzelli M. Alcohol consumption and heavy drinking: a survey in three Italian villages. Alcohol Alcohol. 2006;41:336–340.
    1. Di Bari M, Silvestrini G, Chiarlone M, De Alfieri W, Patussi V, Timpanelli M, Pini R, Masotti G, Marchionni N. Features of excessive alcohol drinking in older adults distinctively captured by behavioral and biological screening instruments. An epidemiological study. J Clin Epidemiol. 2002;55:41–47. doi: 10.1016/S0895-4356(01)00408-5.
    1. Corrao G, Rubbiati L, Zambon A, Arico S. Alcohol-attributable and alcohol-preventable mortality in Italy. A balance in 1983 and 1996. Eur J Public Health. 2002;12:214–223. doi: 10.1093/eurpub/12.3.214.
    1. Stickel F, Hoehn B, Schuppan D, Seitz HK. Review article: Nutritional therapy in alcoholic liver disease. Aliment Pharmacol Ther. 2003;18:357–373. doi: 10.1046/j.1365-2036.2003.01660.x.
    1. Thomson AD. Malnutrition and tissue injury. Alcohol Alcohol. 1985;20:87–88.
    1. Thomson AD, Pratt OE, Jeyasingham M, Shaw GK. Alcohol and brain damage. Hum Toxicol. 1988;7:455–463.
    1. Preedy VR, Ohlendieck K, Adachi J, Koll M, Sneddon A, Hunter R, Rajendram R, Mantle D, Peters TJ. The importance of alcohol-induced muscle disease. J Muscle Res Cell Motil. 2003;24:55–63. doi: 10.1023/A:1024842817060.
    1. Gloria L, Cravo M, Camilo ME, Resende M, Cardoso JN, Oliveira AG, Leitao CN, Mira FC. Nutritional deficiencies in chronic alcoholics: relation to dietary intake and alcohol consumption. Am J Gastroenterol. 1997;92:485–489.
    1. Thomson AD. Mechanisms of vitamin deficiency in chronic alcohol misusers and the development of the Wernicke-Korsakoff syndrome. Alcohol Alcohol Suppl. 2000;35 Suppl 1:2–7.
    1. Thomson AD, Marshall EJ. The treatment of patients at risk of developing Wernicke's encephalopathy in the community. Alcohol Alcohol. 2006;41:159–167.
    1. Thomson AD, Cook CC, Touquet R, Henry JA. The Royal College of Physicians report on alcohol: guidelines for managing Wernicke's encephalopathy in the accident and Emergency Department. Alcohol Alcohol. 2002;37:513–521.
    1. Thomson AD, Marshall EJ. The natural history and pathophysiology of Wernicke's Encephalopathy and Korsakoff's Psychosis. Alcohol Alcohol. 2006;41:151–158.
    1. Addolorato G, Ancona C, Capristo E, Gasbarrini G. Metadoxine in the treatment of acute and chronic alcoholism: a review. Int J Immunopathol Pharmacol. 2003;16:207–214.
    1. Caballeria J, Pares A, Bru C, Mercader J, Garcia Plaza A, Caballeria L, Clemente G, Rodrigo L, Rodes J. Metadoxine accelerates fatty liver recovery in alcoholic patients: results of a randomized double-blind, placebo-control trial. Spanish Group for the Study of Alcoholic Fatty Liver. J Hepatol. 1998;28:54–60. doi: 10.1016/S0168-8278(98)80202-X.
    1. Rizzo A, Breda A, Moretto F, Pace M, Dotta C, Gelso E, Sanzuol F, Tossani C. [Therapeutic use of metadoxine in chronic alcoholism. Double blind study of patients in a department of general medicine] Clin Ter. 1993;142:243–250.
    1. Bono G, Sinforiani E, Merlo P, Belloni G, Soldati M, Gelso E. Alcoholic abstinence syndrome: short-term treatment with metadoxine. Int J Clin Pharmacol Res. 1991;11:35–40.
    1. Shpilenya LS, Muzychenko AP, Gasbarrini G, Addolorato G. Metadoxine in acute alcohol intoxication: a double-blind, randomized, placebo-controlled study. Alcohol Clin Exp Res. 2002;26:340–346.
    1. Antonelli T, Carla V, Lambertini L, Moroni F, Bianchi C. Pyroglutamic acid administration modifies the electrocorticogram and increases the release of acetylcholine and GABA from the guinea-pig cerebral cortex. Pharmacol Res Commun. 1984;16:189–197. doi: 10.1016/S0031-6989(84)80094-6.
    1. Garau B, Fadda F, Melis F, Gelso E, Gessa GL. Metadoxine (pyrrolidone carboxylate of pyridoxine) antagonizes the locomotor-stimulatory effect of ethanol in mice. Alcohol Alcohol. 1992;27:501–504.
    1. Fornai F, Grazia Alessandri M, Bonuccelli U, Scalori V, Corsini GU. Effect of metadoxine on striatal dopamine levels in C57 black mice. J Pharm Pharmacol. 1993;45:476–478.
    1. Wei IL, Huang YH, Wang GS. Vitamin B6 deficiency decreases the glucose utilization in cognitive brain structures of rats. J Nutr Biochem. 1999;10:525–531. doi: 10.1016/S0955-2863(99)00040-6.
    1. Calabrese V, Randazzo G, Ragusa N, Rizza V. Long-term ethanol administration enhances age-dependent modulation of redox state in central and peripheral organs of rat: protection by metadoxine. Drugs Exp Clin Res. 1998;24:85–91.
    1. Gorenc KD, Bruner CA, Nadelsticher A, Pacurucu S, Feuerlein W. A cross-cultural study: a comparison of German, Spanish and Ecuadorian alcoholics using the Munich Alcoholism Test (MALT) Am J Drug Alcohol Abuse. 1984;10:429–446.
    1. Araujo L, Goldberg P, Eyma J, Madhusoodanan S, Buff DD, Shamim K, Brenner R. The effect of anxiety and depression on completion/withdrawal status in patients admitted to substance abuse detoxification program. J Subst Abuse Treat. 1996;13:61–66. doi: 10.1016/0740-5472(95)02043-8.

Source: PubMed

스폰서 및 공동 작업자

건강 상태

약물 개입

3
구독하다