Medication Development for Protracted Abstinence in Alcoholism: Naltrexone Versus Acamprosate

Inclusion Criteria:

• Males or females ≥ 18 and ≤ 55 years of age
• Meets DSM-IV criteria for current alcohol dependence
• Does not desire treatment
• Alcohol free, as verified by breath alcohol concentration, with a CIWA ≤ 8, at the time of testing, with no evidence of drinking for at least 3 days but no more than 7 days prior to the cue reactivity session
• Able to complete and understand questionnaires and study procedures in English
• Verbal I.Q. estimate ≥ 85
• Signed informed consent

Exclusion Criteria:

• Currently meets DSM-IV criteria for dependence on substances other than alcohol or nicotine
• Significant medical disorders that will increase potential risk or interfere with study participation
• Sexually active women with childbearing potential who are pregnant, nursing, or refuse to use a reliable method of birth control
• Meets DSM-IV criteria for a major Axis I disorder, including depression or anxiety disorders
• Treatment within the month prior to screening with investigational medications or those which may influence drinking outcome, e.g., disulfiram (Antabuse), naltrexone (ReVia), acamprosate (Campral), antidepressants or other psychotropic agents
• Chronic treatment with any narcotic-containing medications during the previous month or evidence of current opiate use
• Liver function tests more than three times normal or elevated bilirubin
• No fixed domicile and/or no availability by telephone or beeper
• Current involvement in or plans for treatment prior to study completion
• Patients who have a history of adverse drug reactions to the study drugs or their ingredients
• Failure to take double-blind medication as prescribed
• Claustrophobic (MRI is small environment)
• Non removable metal, e.g., braces (metals are dangerous for MRI)
• Is in need of or currently taking psychoactive medication (could alter cerebral blood flow characteristics)
• Inability to understand or comply with the provisions of the protocol or consent form
• History of neurological disorder, e.g., seizures, meningitis, migraine, HIV, head trauma with loss of consciousness > 2 minutes, or learning disability
• Left-handed (lateralization interpretations on fMRI are complicated with left-handed subjects