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 ?
Long-term effects of pharmacotherapy on relapse prevention in alcohol dependence.
BACKGROUND There is growing evidence that pharmacological treatment with two of the best vali date d anticraving drugs , acamprosate and naltrexone , is efficacious in promoting abstinence in recently detoxified alcohol-dependent subjects . OBJECTIVE The stability of effects after termination of treatment remains to be answered , especially when combining both the drugs . METHOD After detoxification , 160 alcohol-dependent subjects participated in a r and omized , double-blind , placebo-controlled trial . Patients received naltrexone or acamprosate or a combination of naltrexone and acamprosate or placebo for 12 weeks . Patients were assessed weekly by interview , self-report , question naires and laboratory screening . Additionally , follow-up evaluation based on telephone interview of participants , general practitioners and relatives was conducted 12 weeks after terminating the medication . RESULTS At week 12 , the proportion of subjects relapsing to heavy drinking was significantly lower in the group with combined medication compared with both placebo and acamprosate ( P < 0.05 ) . No difference was detectable between acamprosate and naltrexone , both of which were superior to placebo ( P < 0.05 ) . Relapse rates were 28 % ( combined medication ) , 35 % ( naltrexone ) , 50 % ( acamprosate ) and 75 % ( placebo ) . After follow-up ( week 24 ) , combined medication led to relapse rates significantly lower than placebo , but not lower than acamprosate . Again , both naltrexone and acamprosate were superior to placebo . Relapse rates were 80 % ( placebo ) , 54 % ( acamprosate ) , 53 % ( naltrexone ) and 34 % ( combined medication ) . CONCLUSIONS The results of this study highlight the stability of effects of pharmacotherapy on relapse prevention in alcohol dependence
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 ?