Six-Month Outcome in Bipolar Spectrum Alcoholics Treated with Acamprosate after Detoxification: A Retrospective Study

Angelo Giovanni Icro Maremmani, Silvia Bacciardi, Luca Rovai, Fabio Rugani, Enrico Massimetti, Denise Gazzarrini, Liliana Dell'Osso and Icro Maremmani
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Angelo Giovanni Icro Maremmani: Vincent P. Dole Dual Diagnosis Unit, Department of Neurosciences, Santa Chiara University Hospital, University of Pisa, Pisa 56100, Italy
Silvia Bacciardi: Vincent P. Dole Dual Diagnosis Unit, Department of Neurosciences, Santa Chiara University Hospital, University of Pisa, Pisa 56100, Italy
Luca Rovai: Vincent P. Dole Dual Diagnosis Unit, Department of Neurosciences, Santa Chiara University Hospital, University of Pisa, Pisa 56100, Italy
Fabio Rugani: Vincent P. Dole Dual Diagnosis Unit, Department of Neurosciences, Santa Chiara University Hospital, University of Pisa, Pisa 56100, Italy
Enrico Massimetti: Vincent P. Dole Dual Diagnosis Unit, Department of Neurosciences, Santa Chiara University Hospital, University of Pisa, Pisa 56100, Italy
Denise Gazzarrini: Vincent P. Dole Dual Diagnosis Unit, Department of Neurosciences, Santa Chiara University Hospital, University of Pisa, Pisa 56100, Italy
Liliana Dell'Osso: Section of Psychiatry, Department of Experimental and Clinical Medicine, University of Pisa, Pisa 56100, Italy
Icro Maremmani: Vincent P. Dole Dual Diagnosis Unit, Department of Neurosciences, Santa Chiara University Hospital, University of Pisa, Pisa 56100, Italy

IJERPH, 2014, vol. 11, issue 12, 1-14

Abstract: Background : Glutamate system is modified by ethanol and contributes both to the euphoric and the dysphoric consequences of intoxication, but there is now growing evidence that the glutamatergic system also plays a central role in the neurobiology and treatment of mood disorders, including major depressive disorders and bipolar disorders. We speculate that, using acamprosate, patients with bipolar depression (BIP-A) can take advantage of the anti-glutamate effect of acamprosate to “survive” in treatment longer than peers suffering from non-bipolar depression (NBIP-A) after detoxification. Method : We retrospectively evaluated the efficacy of a long-term (six-month) acamprosate treatment, after alcohol detoxification, in 41 patients (19 males and 22 females), who could be classified as depressed alcoholics, while taking into account the presence/absence of bipolarity. Results : During the period of observation most NBIP-A patients relapsed, whereas a majority of BIP-A patients were still in treatment at the end of their period of observation. The cumulative proportion of ‘surviving’ patients was significantly higher in BIP-A patients, but this finding was not related to gender or to other demographic or clinically investigated characteristics. The treatment time effect was significant in both subgroups. The treatment time-group effect was significant (and significantly better) for bipolar patients on account of changes in the severity of their illness. Limitations : Retrospective methodology and the lack of DSM criteria in diagnosing bipolarity. Conclusions : Bipolarity seems to be correlated with the efficacy of acamprosate treatment in inducing patients to refrain from alcohol use after detoxification (while avoiding relapses) in depressed alcoholics. Placebo-controlled clinical trials are now warranted to check the validity of this hypothesis.

Keywords: acamprosate; depression; bipolarity; long-term outcome; glutamate (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2014
References: View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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