ADVERSE DRUG REACTIONS OF BACLOFEN, NALTREXONE, AND ACAMPROSATE IN PATIENTS HAVING ALCOHOL DEPENDENCE: A CROSS-SECTIONAL PHARMACOVIGILANCE STUDY

Authors

  • SUDHIR PANDURANG PANDHARE Department of Pharmacology, Mahatma Gandhi Institute of Medical Sciences, Wardha, Maharashtra, India.
  • DEVESH GOSAVI Department of Pharmacology, Mahatma Gandhi Institute of Medical Sciences, Wardha, Maharashtra, India.
  • KSHIROD KUMAR MISHRA Department of Psychiatry, Mahatma Gandhi Institute of Medical Sciences, Wardha, Maharashtra, India.
  • HARSHAL SHRIRAM SATHE Department of Psychiatry, Mahatma Gandhi Institute of Medical Sciences, Wardha, Maharashtra, India. https://orcid.org/0000-0003-3034-7913

DOI:

https://doi.org/10.22159/ajpcr.2024.v17i4.49791

Keywords:

Pharmacovigilance, Anticraving drugs, Adverse drug reactions, Safety profile

Abstract

Objectives: The research aims to investigate the prevalence and patterns of adverse drug reactions (ADRs), gauge the severity of these reactions, establish causality in ADR cases, and assess the preventability of such adverse reactions.

Methods: ADR information was gathered through personal interviews with patients or their relatives. Causality was assessed using the Naranjo algorithm, and a modified Hartwig and Siegel Severity Assessment Scale was used for estimating the severity of ADR. ADRs were grouped into various preventability categories based on the modified Schumock and Thornton criteria.

Results: The total number of patients evaluated in the baclofen, naltrexone, and acamprosate groups was 65, 28, and 42, respectively. The most commonly reported adverse events with baclofen were nausea (31.25%), followed by fatigue (18.75%) and headache (12.50%). The majority of patients receiving acamprosate reported nausea (57.14%), followed by diarrhea (28.57%). Patients receiving naltrexone most commonly reported nausea (35.71%), followed by abdominal pain (21.43%) and headache (14.28%).

Conclusion: This study shed light on the prevalence, severity, causality, and preventability of ADRs associated with anti-craving agents used to treat patients with alcohol withdrawal syndrome, providing valuable insights into the safety profiles of these medications.

Downloads

Download data is not yet available.

References

Patterns and Consequences of alcohol Misuse in India-an Epidemiological Survey. Karnataka: National Institute of Mental Health and Neurosciences (NIMHANS); 2011.

Fuller RK, Hiller-Sturmhöfel S. Alcoholism treatment in the United States. An overview. Alcohol Res Health. 1999;23(2):69-77. PMID 10890799

Akbar M, Egli M, Cho YE, Song BJ, Noronha A. Medications for alcohol use disorders: An overview. Pharmacol Ther. 2018 May 1;185:64-85. doi: 10.1016/j.pharmthera.2017.11.007, PMID 29191394

Kalaiselvan V, Thota P, Singh GN, Pharmacovigilance programme of India. Pharmacovigilance Programme of India: Recent developments and future perspectives. Indian J Pharmacol. 2016 Nov-Dec;48(6):624-8. doi: 10.4103/0253-7613.194855, PMID 28066097

Olsson S, Parthasarathi G. Adverse drug reactions and pharmacovigilance. A Textbook of Clinical Pharmacy Practice: Essential nd Concepts and Skills. 2012;2:117-8.

Akici A, Oktay S. Rational pharmacotherapy and pharmacovigilance. Curr Drug Saf. 2007;2(1):65-9. doi: 10.2174/157488607779315408, PMID 186909517. Tandon VR, Mahajan V, Khajuria V, Gillani Z. Under-reporting of adverse drug reactions: A challenge for pharmacovigilance in India. Indian J Pharmacol. 2015;47(1):65-71. doi: 10.4103/0253- 7613.150344.

Lucca JM, Madhan R, Gurumurthy P, Dushad R. A prospective observational study to evaluate safety reporting of antidepressants at a tertiary care hospital in India. Indian J Pharmacol. 2014;46(5):543-6. doi: 10.4103/0253-7613.140591, PMID 25298586

Tripathi KD. Essentials of Medical Pharmacology. 8th ed. New Delhi: Jaypee Brothers Company. p. 384.

Latt NC, Jurd S, Houseman J, Wutzke SE. Naltrexone in alcohol dependence: A randomised controlled trial of effectiveness in a standard clinical setting. MJA. Med J Aust. 2002;176(11):530-4. doi: 10.5694/ j.1326-5377.2002.tb04550.x, PMID 12064984

Anton RF. Naltrexone for the management of alcohol dependence. N Engl J Med. 2008;359(7):715-21. doi: 10.1056/NEJMct0801733, PMID 18703474

Mason BJ, Heyser CJ. Acamprosate: A prototypic neuromodulator in the treatment of alcohol dependence. CNS Neurol Disord Drug Targets. 2010;9(1):23-32. doi: 10.2174/187152710790966641, PMID 20201812

Naranjo CA, Busto U, Sellers EM, Sandor P, Ruiz I, Roberts EA, et al. A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther. 1981 Aug;30(2):239-45. doi: 10.1038/clpt.1981.154, PMID 7249508

Hartwig SC, Siegel J, Schneider PJ. Preventability and severity assessment in reporting adverse drug reactions. Am J Hosp Pharm. 1992 Sep 1;49(9):2229-32. doi: 10.1093/ajhp/49.9.2229, PMID 1524068

Schumock GT, Thornton JP. Focusing on the preventability of adverse drug reactions. Hosp Pharm. 1992;27(6):538. PMID 10118597

Dean AG, Arner TG, Sunki GG, Friedman R, Lantinga M, Sangam S, et al. Epi Info™, a Database and Statistics Program for Public Health Professionals. Atlanta: Centers for Disease Control and Prevention (US); 2011.

Kumar A, Sharma A, Bansal PD, Bahetra M, Gill HK, Kumar R. A comparative study on the safety and efficacy of naltrexone versus Baclofen versus acamprosate in the management of alcohol dependence. Indian J Psychiatry. 2020;62(6):650-8. doi: 10.4103/ psychiatry.IndianJPsychiatry_201_19, PMID 33896969

Goh ET, Morgan MY. Review article: Pharmacotherapy for alcohol dependence-the why, the what and the wherefore. Aliment Pharmacol Ther. 2017;45(7):865-82. doi: 10.1111/apt.13965, PMID 28220511

Jung YC, Namkoong K. Pharmacotherapy for alcohol dependence: Anticraving medications for relapse prevention. Yonsei Med J. 2006;47(2):167-78. doi: 10.3349/ymj.2006.47.2.167, PMID 16642544

Namkoong K, Lee BO, Lee PG, Choi MJ, Lee E. Acamprosate in Korean alcohol-dependent patients: A multi-centre, randomized, double-blind, placebo-controlled study. Alcohol Alcohol. 2003;38(2):135-41. doi: 10.1093/alcalc/agg038, PMID 12634260

Pettinati HM, O’Brien CP, Rabinowitz AR, Wortman SP, Oslin DW, Kampman KM, et al. The status of naltrexone in the treatment of alcohol dependence: Specific effects on heavy drinking. J Clin Psychopharmacol. 2006;26(6):610-25. doi: 10.1097/01. jcp.0000245566.52401.20, PMID 17110818

Garbutt JC. Efficacy and tolerability of naltrexone in the management of alcohol dependence. Curr Pharm Des. 2010;16(19):2091-7. doi: 10.2174/138161210791516459, PMID 20482515

Reynaud M, Aubin HJ, Trinquet F, Zakine B, Dano C, Dematteis M, et al. A randomized, placebo-controlled study of high-dose Baclofen in alcohol-dependent patients-the ALPADIR study. Alcohol Alcohol. 2017;52(4):439-46. doi: 10.1093/alcalc/agx030, PMID 28525555

Soyka M, Preuss U, Schuetz C. Use of acamprosate and different kinds of psychosocial support in relapse prevention of alcoholism. Results from a non-blind, multicentre study. Drugs R D. 2002;3(1):1-12. doi: 10.2165/00126839-200203010-00001, PMID 11881521

Published

07-04-2024

How to Cite

PANDHARE, S. P., D. GOSAVI, K. KUMAR MISHRA, and H. S. SATHE. “ADVERSE DRUG REACTIONS OF BACLOFEN, NALTREXONE, AND ACAMPROSATE IN PATIENTS HAVING ALCOHOL DEPENDENCE: A CROSS-SECTIONAL PHARMACOVIGILANCE STUDY”. Asian Journal of Pharmaceutical and Clinical Research, vol. 17, no. 4, Apr. 2024, pp. 111-4, doi:10.22159/ajpcr.2024.v17i4.49791.

Issue

Section

Original Article(s)