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 ?
Lack of Efficacy of Naltrexone in the Prevention of Alcohol Relapse: Results From a German Multicenter Study
In a placebo-controlled , double-blind German multicenter study ( seven sites ) the efficacy of naltrexone as an adjunctive treatment in alcoholism to maintain abstinence was assessed for 12 weeks . A total of 171 detoxified patients ( 97.7 % met the DSM-III-R criteria for alcohol dependence ) were included . Patients had been abstinent for a mean of 19.5 ± 9.4 days at study entry . Eighty-four and 87 patients were r and omized to receive naltrexone  ( 50 mg/day ) and placebo , respectively . Each site was instructed to provide its usual psychosocial alcohol treatment program . The primary effectiveness measure was the time to first heavy drinking as derived from self-reports of drinking ( timeline-follow-back method ) . Secondary effectiveness measures included time to first drink , amount of alcohol consumption , intensity of craving , severity of alcoholism problems , and liver enzymes . Thirty-three ( 38 % ) placebo patients and 28 ( 33 % ) naltrexone patients discontinued the study . At endpoint , 62 % of the patients in each group did not have an episode of heavy drinking . Also , there were no significant differences between the study groups concerning secondary effectiveness measures as well as compliance and adverse clinical events — with the exception of the γ-GT , which was significantly greater reduced in the naltrexone group throughout the study . Based upon an intention-to-treat population , this study confirms the safety but not the efficacy of naltrexone in prevention of alcohol relapse . Nevertheless , the question arises whether self-reports of drinking are more reliable than γ-GT as a measure of recent alcohol consumption
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 ?