Treating alcohol use disorder in U.S. veterans: The role of traumatic brain injury

Autores
Jorge, Ricardo E.; Li, Ruosha; Liu, Xiangyu; McGavin, Jill K.; Shorter, Daryl I.; Acion, Laura; Arndt, Stephan
Año de publicación
2019
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
Objective: The authors examined the efficacy of valproate to reduce relapse to heavy drinking among veterans with alcohol use disorder (AUD) and neuropsychiatric comorbidities and whether antecedent traumatic brain injury (TBI) or posttraumatic stress disorder (PTSD) affected treatment response. Methods: Participants were male veterans 18–60 years old with an AUD and no other substance use besides nicotine or cannabis. Sixty-two patients were randomly assigned to receive either valproate or naltrexone. Participants were evaluated at baseline and followed weekly for 24 weeks. All participants received standardized psychosocial interventions as well as treatment for coexistent psychiatric conditions. Results: During the follow-up period, nine study subjects in the naltrexone group and 14 in the valproate group relapsed to heavy drinking, but the difference did not reach statistical significance. Participants with a history of moderate to severe TBI were more likely to relapse to heavy drinking compared with those with no TBI (hazard ratio=4.834, 95% CI=1.103–21.194, p=0.033). PTSD status did not significantly affect outcome. Conclusions: Intensive outpatient programs are efficacious alternatives to treat AUD in veterans, although the role of pharmacological treatment is not completely elucidated. Glutamatergic agents appear to be less effective than opiate antagonists to prevent relapse to heavy drinking and to increase cumulative abstinence. Future studies should examine novel pharmacological and nonpharmacological options.
Fil: Jorge, Ricardo E.. Baylor College of Medicine;
Fil: Li, Ruosha. Baylor College of Medicine;
Fil: Liu, Xiangyu. Baylor College of Medicine;
Fil: McGavin, Jill K.. Baylor College of Medicine;
Fil: Shorter, Daryl I.. Baylor College of Medicine;
Fil: Acion, Laura. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Calculo. - Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Calculo; Argentina
Fil: Arndt, Stephan. University of Iowa; Estados Unidos
Materia
Traumatic Brain Injury
AUD
Veterans
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/143188

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spelling Treating alcohol use disorder in U.S. veterans: The role of traumatic brain injuryJorge, Ricardo E.Li, RuoshaLiu, XiangyuMcGavin, Jill K.Shorter, Daryl I.Acion, LauraArndt, StephanTraumatic Brain InjuryAUDVeteranshttps://purl.org/becyt/ford/3.3https://purl.org/becyt/ford/3Objective: The authors examined the efficacy of valproate to reduce relapse to heavy drinking among veterans with alcohol use disorder (AUD) and neuropsychiatric comorbidities and whether antecedent traumatic brain injury (TBI) or posttraumatic stress disorder (PTSD) affected treatment response. Methods: Participants were male veterans 18–60 years old with an AUD and no other substance use besides nicotine or cannabis. Sixty-two patients were randomly assigned to receive either valproate or naltrexone. Participants were evaluated at baseline and followed weekly for 24 weeks. All participants received standardized psychosocial interventions as well as treatment for coexistent psychiatric conditions. Results: During the follow-up period, nine study subjects in the naltrexone group and 14 in the valproate group relapsed to heavy drinking, but the difference did not reach statistical significance. Participants with a history of moderate to severe TBI were more likely to relapse to heavy drinking compared with those with no TBI (hazard ratio=4.834, 95% CI=1.103–21.194, p=0.033). PTSD status did not significantly affect outcome. Conclusions: Intensive outpatient programs are efficacious alternatives to treat AUD in veterans, although the role of pharmacological treatment is not completely elucidated. Glutamatergic agents appear to be less effective than opiate antagonists to prevent relapse to heavy drinking and to increase cumulative abstinence. Future studies should examine novel pharmacological and nonpharmacological options.Fil: Jorge, Ricardo E.. Baylor College of Medicine;Fil: Li, Ruosha. Baylor College of Medicine;Fil: Liu, Xiangyu. Baylor College of Medicine;Fil: McGavin, Jill K.. Baylor College of Medicine;Fil: Shorter, Daryl I.. Baylor College of Medicine;Fil: Acion, Laura. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Calculo. - Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Calculo; ArgentinaFil: Arndt, Stephan. University of Iowa; Estados UnidosAmerican Neuropsychiatric Association2019-10info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/143188Jorge, Ricardo E.; Li, Ruosha; Liu, Xiangyu; McGavin, Jill K.; Shorter, Daryl I.; et al.; Treating alcohol use disorder in U.S. veterans: The role of traumatic brain injury; American Neuropsychiatric Association; Journal of Neuropsychiatry and Clinical Neurosciences; 31; 4; 10-2019; 319-3270895-0172CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/url/https://psychiatryonline.org/doi/10.1176/appi.neuropsych.18110250info:eu-repo/semantics/altIdentifier/doi/10.1176/appi.neuropsych.18110250info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-sa/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-29T09:48:54Zoai:ri.conicet.gov.ar:11336/143188instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-09-29 09:48:55.155CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Treating alcohol use disorder in U.S. veterans: The role of traumatic brain injury
title Treating alcohol use disorder in U.S. veterans: The role of traumatic brain injury
spellingShingle Treating alcohol use disorder in U.S. veterans: The role of traumatic brain injury
Jorge, Ricardo E.
Traumatic Brain Injury
AUD
Veterans
title_short Treating alcohol use disorder in U.S. veterans: The role of traumatic brain injury
title_full Treating alcohol use disorder in U.S. veterans: The role of traumatic brain injury
title_fullStr Treating alcohol use disorder in U.S. veterans: The role of traumatic brain injury
title_full_unstemmed Treating alcohol use disorder in U.S. veterans: The role of traumatic brain injury
title_sort Treating alcohol use disorder in U.S. veterans: The role of traumatic brain injury
dc.creator.none.fl_str_mv Jorge, Ricardo E.
Li, Ruosha
Liu, Xiangyu
McGavin, Jill K.
Shorter, Daryl I.
Acion, Laura
Arndt, Stephan
author Jorge, Ricardo E.
author_facet Jorge, Ricardo E.
Li, Ruosha
Liu, Xiangyu
McGavin, Jill K.
Shorter, Daryl I.
Acion, Laura
Arndt, Stephan
author_role author
author2 Li, Ruosha
Liu, Xiangyu
McGavin, Jill K.
Shorter, Daryl I.
Acion, Laura
Arndt, Stephan
author2_role author
author
author
author
author
author
dc.subject.none.fl_str_mv Traumatic Brain Injury
AUD
Veterans
topic Traumatic Brain Injury
AUD
Veterans
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.3
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv Objective: The authors examined the efficacy of valproate to reduce relapse to heavy drinking among veterans with alcohol use disorder (AUD) and neuropsychiatric comorbidities and whether antecedent traumatic brain injury (TBI) or posttraumatic stress disorder (PTSD) affected treatment response. Methods: Participants were male veterans 18–60 years old with an AUD and no other substance use besides nicotine or cannabis. Sixty-two patients were randomly assigned to receive either valproate or naltrexone. Participants were evaluated at baseline and followed weekly for 24 weeks. All participants received standardized psychosocial interventions as well as treatment for coexistent psychiatric conditions. Results: During the follow-up period, nine study subjects in the naltrexone group and 14 in the valproate group relapsed to heavy drinking, but the difference did not reach statistical significance. Participants with a history of moderate to severe TBI were more likely to relapse to heavy drinking compared with those with no TBI (hazard ratio=4.834, 95% CI=1.103–21.194, p=0.033). PTSD status did not significantly affect outcome. Conclusions: Intensive outpatient programs are efficacious alternatives to treat AUD in veterans, although the role of pharmacological treatment is not completely elucidated. Glutamatergic agents appear to be less effective than opiate antagonists to prevent relapse to heavy drinking and to increase cumulative abstinence. Future studies should examine novel pharmacological and nonpharmacological options.
Fil: Jorge, Ricardo E.. Baylor College of Medicine;
Fil: Li, Ruosha. Baylor College of Medicine;
Fil: Liu, Xiangyu. Baylor College of Medicine;
Fil: McGavin, Jill K.. Baylor College of Medicine;
Fil: Shorter, Daryl I.. Baylor College of Medicine;
Fil: Acion, Laura. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Calculo. - Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Calculo; Argentina
Fil: Arndt, Stephan. University of Iowa; Estados Unidos
description Objective: The authors examined the efficacy of valproate to reduce relapse to heavy drinking among veterans with alcohol use disorder (AUD) and neuropsychiatric comorbidities and whether antecedent traumatic brain injury (TBI) or posttraumatic stress disorder (PTSD) affected treatment response. Methods: Participants were male veterans 18–60 years old with an AUD and no other substance use besides nicotine or cannabis. Sixty-two patients were randomly assigned to receive either valproate or naltrexone. Participants were evaluated at baseline and followed weekly for 24 weeks. All participants received standardized psychosocial interventions as well as treatment for coexistent psychiatric conditions. Results: During the follow-up period, nine study subjects in the naltrexone group and 14 in the valproate group relapsed to heavy drinking, but the difference did not reach statistical significance. Participants with a history of moderate to severe TBI were more likely to relapse to heavy drinking compared with those with no TBI (hazard ratio=4.834, 95% CI=1.103–21.194, p=0.033). PTSD status did not significantly affect outcome. Conclusions: Intensive outpatient programs are efficacious alternatives to treat AUD in veterans, although the role of pharmacological treatment is not completely elucidated. Glutamatergic agents appear to be less effective than opiate antagonists to prevent relapse to heavy drinking and to increase cumulative abstinence. Future studies should examine novel pharmacological and nonpharmacological options.
publishDate 2019
dc.date.none.fl_str_mv 2019-10
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/143188
Jorge, Ricardo E.; Li, Ruosha; Liu, Xiangyu; McGavin, Jill K.; Shorter, Daryl I.; et al.; Treating alcohol use disorder in U.S. veterans: The role of traumatic brain injury; American Neuropsychiatric Association; Journal of Neuropsychiatry and Clinical Neurosciences; 31; 4; 10-2019; 319-327
0895-0172
CONICET Digital
CONICET
url http://hdl.handle.net/11336/143188
identifier_str_mv Jorge, Ricardo E.; Li, Ruosha; Liu, Xiangyu; McGavin, Jill K.; Shorter, Daryl I.; et al.; Treating alcohol use disorder in U.S. veterans: The role of traumatic brain injury; American Neuropsychiatric Association; Journal of Neuropsychiatry and Clinical Neurosciences; 31; 4; 10-2019; 319-327
0895-0172
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/url/https://psychiatryonline.org/doi/10.1176/appi.neuropsych.18110250
info:eu-repo/semantics/altIdentifier/doi/10.1176/appi.neuropsych.18110250
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv American Neuropsychiatric Association
publisher.none.fl_str_mv American Neuropsychiatric Association
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
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instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
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