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 ?
Combined efficacy of acamprosate and disulfiram in the treatment of alcoholism: a controlled study.
This study presents the results of a multicenter investigation of the efficacy of acamprosate in the treatment of patients with chronic or episodic alcohol dependence . One hundred eighteen patients were r and omly assigned to either placebo or acamprosate , and both groups were stratified for concomitant voluntary use of disulfiram . Treatment lasted for 360 days , with an additional 360-day follow-up period . The primary efficacy parameters evaluated were : relapse rate and cumulative abstinence duration ( CAD ) . Results were analyzed according to Intention-To-Treat principles using chi2 , t , and multiple regression analyses where appropriate . After 30 days on study medication , 40 of 55 ( 73 % ) acamprosate-treated patients were abstinent , compared with 26 of 55 ( 43 % ) placebo-treated patients ( p = 0.019 ) . The treatment advantage remained throughout the study medication period and was statistically significant until day 270 ( p = 0.028 ) . Twenty-seven percent of patients on acamprosate and 53 % of patients on placebo had a first drink within the first 30 days of the study . The mean CAD was 137 days ( 40 % abstinent days ) for the patients treated with acamprosate and 75 days ( 21 % abstinent days ) for the placebo group ( p = 0.013 ) . No adverse interaction between acamprosate and disulfiram occurred , and the subgroup who received both medications had a better outcome on CAD than the those on only one or no medication . Acamprosate was well tolerated . Diarrhea was the only significant treatment-induced effect . It was concluded that acamprosate was a useful and safe pharmacotherapy in the long-term treatment of alcoholism . Concomitant administration of disulfiram improved the effectiveness of acamprosate
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 ?