Treatments for alcohol dependence: rethinking the role of comorbidity and clinical subtypes.

摘要

This issue of the Journal includes two articles that address treatment of alcohol dependence. Pettinati et al. (1) report a 14-week, randomized controlled trial comparing naltrexone alone, sertraline alone, combination of naltrexone and sertraline, and placebo as adjunct to weekly cognitive-behavioral therapy (CBT) for depressed alcohol-dependent patients. Johnson (2) presents a look to the future on medication-assisted treatment strategies for three different clinical phenotypes of alcohol-dependent patients. This excellent review reminds us that alcoholism is a complex heterogeneous disorder with identified genetic and environmental risk factors. Alcohol-related disorders affect male and female patients alike, both young and old. Family history, early exposure to alcohol, and comorbidity are important contributors to the future risk of developing alcoholism, severity of the disorder, and response to treatment.