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Pharmacopsychiatry 2016; 49(02): 66-75
DOI: 10.1055/s-0035-1565184
Original Paper
© Georg Thieme Verlag KG Stuttgart · New York

Comparing Nalmefene and Naltrexone in Alcohol Dependence: Are there any Differences?
Results from an Indirect Meta-Analysis

M. Soyka
1   Department of Psychiatry and Psychotherapy, Ludwig Maximilian University, Munich, Germany
2   Privatklinik Meiringen, Meiringen, Switzerland
,
M. Friede
3   Lundbeck GmbH, Hamburg, Germany
,
J. Schnitker
4   Institut für angewandte Statistik GmbH, Bielefeld, Germany
› Author Affiliations
Further Information

Publication History

received 12 May 2015
revised 07 October 2015

accepted 20 October 2015

Publication Date:
04 February 2016 (online)

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Abstract

Background: The mu-opioid antagonist naltrexone is one of the few approved pharmacotherapies for the treatment of alcohol dependence. Recently, the mu-opioid antagonist and partial kappa agonist nalmefene was approved by the European Medicines Agency for the reduction of alcohol consumption in adult patients with alcohol dependence. To date, no head-to-head studies have compared the efficacy and safety of naltrexone and nalmefene in reducing alcohol consumption.

Methods: An indirect meta-analysis of randomized controlled studies on these 2 medications was conducted. A random effects model was used to measure effects and compare the 2 medications. 4 placebo-controlled studies with nalmefene and 13 with naltrexone were included.

Results: A statistically significant advantage of nalmefene towards naltrexone in the 2 patient-relevant outcome efficacy criteria, quantity and frequency of drinking, was found. Both drugs had a benign safety profile.

Conclusions: This indirect meta-analysis indicates an advantage of nalmefene over naltrexone. Nalmefene is an effective and well-tolerated medication for the reduction of alcohol consumption. Additional data are necessary to demonstrate possible advantages of nalmefene over naltrexone in the treatment of alcohol dependence.

Key words

nalmefene - naltrexone - alcohol - alcohol use disorders - meta-analysis - pharmacotherapy
 

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