Naltrexone treatment of adolescent alcoholics: an open-label pilot study

OBJECTIVE: This 6-week open-label trial of naltrexone was conducted in a preliminary fashion to determine whether naltrexone would be safe, well tolerated, and lead to a reduction in alcohol consumption in adolescents with alcohol dependence. METHOD: Five outpatient treatment-seeking adolescents who met Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) criteria for alcohol dependence were recruited. The Child Schedule for Schizophrenia and Affective Disorders (K-SADS), Structured Clinical Interview for DSM (SCID), and the Family History Questionnaire were administered at baseline. The Time-Line Follow-Back (TLFB) and two craving scales (Adolescent Obsessive Compulsive Drinking Scale A-OCDS] and a craving analog scale) were administered at baseline and weekly thereafter. Each subject received a 10-day supply of naltrexone (50 mg) and a 100-mg riboflavin capsule. Subjects were instructed to take naltrexone and riboflavin simultaneously. RESULTS: Overall, the average drinks per drinking day (DDD) decreased significantly from baseline to the end of week 6 with an average reduction of 7.61 standard drinks. There was a significant reduction in the average A-OCDS total score, A-OCDS Irresistibility subscale score, and craving analog score. Nausea was the only side-effect reported, and there were no elevations of liver enzymes. Naltrexone was well tolerated by the alcohol-dependent adolescent. CONCLUSIONS: Our data suggest that naltrexone is safe and well tolerated in adolescent alcoholics. Naltrexone may lead to a significant reduction in alcohol consumption and craving in adolescent alcoholics, but larger, randomized, controlled trials are needed.