The only study available on disulfiram showed reduced REM sleep .
Acamprosate showed no/little effect on self-reported sleep but improved sleep continuity and architecture measured by polysomnography .
The two opioidergic drugs naltrexone and nalmefene had mainly detrimental effect on sleep , giving increased insomnia and /or somnolence compared with placebo , although not always significant .
The meta- analysis confirmed significantly increased somnolence and insomnia in the naltrexone group , compared with the placebo .
Overall , the currently available evidence s show more sleep problems with the opioidergic drugs ( especially naltrexone ) , while acamprosate seems to be well tolerated or even beneficial .
Acamprosate might be a more suitable choice when patients with AUD report sleep problems .
Background : Sleep disorders are commonly associated with acute and chronic use of alcohol and with abstinence .
To date , there are four approved drugs to treat alcohol use disorder ( AUD ) : disulfiram , acamprosate , naltrexone , and nalmefene .
These AUD therapies reduce the craving and risk of relapse into heavy drinking , but little is known about their effect on sleep .
As recent evidence s indicate a crucial role of sleep disorders in AUD , cl aim ing that sleep problems may trigger alcohol abuse and relapses , it is fundamental to clarify the impact of those drugs on the sleep quality of AUD patients .
This systematic review aims to answer the question : how does the pharmacotherapy for AUD affect sleep ?
Comparing topiramate with naltrexone in the treatment of alcohol dependence.
AIM To compare the efficacy of topiramate with naltrexone in the treatment of alcohol dependence . DESIGN The investigation was a double-blind , placebo-controlled , 12-week study carried out at the University of São Paulo , Brazil . SAMPLE A total of 155 patients , 18 - 60 years of age , with an International Classification of Diseases ( ICD-10 ) diagnosis of alcohol dependence . METHODS After a 1-week detoxification period , patients were assigned r and omly to receive topiramate ( induction to 300 mg/day ) , naltrexone ( 50 mg/day ) or placebo . MEASUREMENTS Time to first relapse ( consumption of > 60 g ethyl alcohol ) , cumulative abstinence duration and weeks of heavy drinking . FINDINGS In intention-to-treat analyses , topiramate was statistically superior to placebo on a number of measures including time to first relapse ( 7.8 versus 5.0 weeks ) , cumulative abstinence duration ( 8.2 versus 5.6 weeks ) , weeks of heavy drinking ( 3.4 versus 5.9 ) and percentage of subjects abstinent at 4 weeks ( 67.3 versus 42.6 ) and 8 weeks ( 61.5 versus 31.5 ) , but not 12 weeks ( 46.2 versus 27.8 ) . RESULTS remained significant after controlling for Alcoholics Anonymous attendance , which was higher in topiramate than in other groups . There were no significant differences between naltrexone versus placebo or naltrexone versus topiramate groups , but naltrexone showed trends toward inferior outcomes when compared to topiramate . CONCLUSIONS The results of this study support the efficacy of topiramate in the relapse prevention of alcoholism . Suggestive evidence was also obtained for superiority of topiramate versus naltrexone , but this needs to be verified in future research with larger sample sizes
The only study available on disulfiram showed reduced REM sleep .
Acamprosate showed no/little effect on self-reported sleep but improved sleep continuity and architecture measured by polysomnography .
The two opioidergic drugs naltrexone and nalmefene had mainly detrimental effect on sleep , giving increased insomnia and /or somnolence compared with placebo , although not always significant .
The meta- analysis confirmed significantly increased somnolence and insomnia in the naltrexone group , compared with the placebo .
Overall , the currently available evidence s show more sleep problems with the opioidergic drugs ( especially naltrexone ) , while acamprosate seems to be well tolerated or even beneficial .
Acamprosate might be a more suitable choice when patients with AUD report sleep problems .
Background : Sleep disorders are commonly associated with acute and chronic use of alcohol and with abstinence .
To date , there are four approved drugs to treat alcohol use disorder ( AUD ) : disulfiram , acamprosate , naltrexone , and nalmefene .
These AUD therapies reduce the craving and risk of relapse into heavy drinking , but little is known about their effect on sleep .
As recent evidence s indicate a crucial role of sleep disorders in AUD , cl aim ing that sleep problems may trigger alcohol abuse and relapses , it is fundamental to clarify the impact of those drugs on the sleep quality of AUD patients .
This systematic review aims to answer the question : how does the pharmacotherapy for AUD affect sleep ?