The recovery process proceeds quickly during the early years of abstinence. However, recovery takes in total 10 years or longer. The relapse risk is not significantly decreased nor stable before the third year of abstinence. Outcome research on alcoholism therapy A review of the current state of outcome research shows that there have not been any sensational therapeutic improvements during the last decades. For more than 30 years, meta-analyses and literature reviews have consistently shown that alcoholism treatment is successful Inhibitors,research,lifescience,medical and cost-effective

in the short term.77-84 Good evidence exists that 12-step treatment and diverse programs of cognitive Inhibitors,research,lifescience,medical behavioral therapy (CBT) are equally effective in achieving abstinence rates of approximately 25% to 30% during the year after treatment (for examples see refs 85,86). However, most treatment studies demonstrate substantial methodological shortcomings. Treatment outcomes are normally based on subjective statements of patients concerning their state of current Inhibitors,research,lifescience,medical alcohol consumption and abstinence. On the rare occasions that studies have corroborated subjective outcome

data with objective laboratory data, the results are rather inexact and fragmented. Finally, the results of the few valid investigations of long-term outcome are inconsistent: objective information on drinking status indicates that only 6% to 18% of patients are abstinent at 2-year followup.87 In contrast, studies relying on self-report data suggest that approximately 30% of patients are abstinent 2 to 3 years after treatment.88,89 There is no evidence for a sufficient Inhibitors,research,lifescience,medical efficacy of a primarily pharmacotherapeutic treatment of alcoholism. Whereas the alcohol

deterrent disulfiram has proven to be an adjunctive of psychotherapeutic alcoholism therapy for more than 50 years,90-95 many studies have found efficacy of the anticraving substances Inhibitors,research,lifescience,medical acamprosate and naltrexone over the last 15 years.96-100 However, the results of a recent large-scale multicenter study challenge the additional efficacy of anticraving medications over PKI-587 manufacturer behavior therapy.101 Anton et al studied treatment outcomes of a large sample (N=1383) of alcohol-dependent patients who however were treated for 16 weeks and re-examined after 12-month follow-up. The authors investigated whether different combinations of naltrexone, acamprosate, and cognitive behavior therapy differ with regard to the outcome “number of abstinent days.” Whereas acamprosate did not show any efficacy, the combinations “naltrexone plus medical management” and “naltrexone plus medical management and behavior therapy” were not more successful than a simple combination of behavior therapy, placebo medication, and medical management.