Another in combination with BPI sessions at weeks

Another prospective, single blinded,
placebo-controlled study was conducted to see whether the SSRI citalopram in
addition to brief psychosocial interventions (BPIs) are effective in treating
alcohol abuse similarly in non-depressed men and women. Sixty-one subjects
recruited form a newspaper ad and deemed socially and medically stable, who
consumed at lease 28 drinks per week for the past three months and were
categorized as mild-moderate alcohol abusers by the Alcohol Dependence Scale (ADS)
and the Diagnostic and Statistical Manual
of Mental Disorders, 3rd edition, revised (DSM-III-R) were
included in the study (34 men and 27 women). Depressed individuals or those
with psychiatric disorders like anxiety or other dependencies (drug related)
were excluded from the study.

            The 99 subjects were enrolled into the
study however, 38 withdrew due to unrelated problems (57%), missed appointments
(27%), and those who were experiencing possible unspecified adverse reactions
(16%). The remaining 61 subjects began a two-week baseline assessment before being
randomized into two groups. The intervention group, further subdivided into
males and females, received 40 mg citalopram every night at 8 pm in combination
with BPI sessions at weeks 2, 4, 8, and 12; while the control group, also
divided by sex, received the same treatment but with a placebo pill. Two-four
hours after the 8 pm dose, each subject was required to give a urine sample
that was analyzed for riboflavin and ethanol concentrations to confirm the use
of alcohol and medication consumption. Subjects selected individual alcohol
goals of either moderation or abstinence and were monitored for non-alcoholic
drinks, alcoholic drinks, and tobacco use.

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The primary outcome measured was the percent
change from baseline in drinks consumed per day, the secondary outcome measured
was the percent change from baseline in drinks consumed per drinking day, and
the third and last outcome measured was percent total days of abstinence relative
to baseline.2 The outcome differences between sexes were analyzed
using a 2-way ANOVA test while Duncan’s post hoc was used to analyze the
specific group differences due to the unequal sample size of men to women.
Depression, anxiety, and alcohol problems were considered covariates. Baseline
measurements concluded women consumed a statistically significant less amount
of alcohol than men and were assessed to have higher anxiety levels. There were
no significant differences between men and women in alcohol cravings or level
of alcohol dependence.

            Only one statistical significant
outcome was concluded from this study, men receiving citalopram showed a
statistically significant reduction in alcoholic drinks per day than women
receiving citalopram (p=0.045). No significance was found in reduction of
drinks per drinking day between sexes, abstinent days between sexes, or placebo
groups between sexes. Though both men and women receiving citalopram did have
greater reductions in alcohol consumption in comparison to those in the placebo
group, it was not statistically significant.

            The final conclusion to this study
implies that citalopram might be more efficacious in treating men for alcohol
abuse than women, because of the lack of data in this area, further studies
should be completed to confirm this. In future studies, more care should be
taken in selecting the study population. Although the treatment groups were adequately
randomized, more information is needed to extrapolate this data, like sample
ethnicities. Also, as stated in the introduction, many women who abuse alcohol
also suffer from depression, only using non-depressed women in this study may
also limit the external validity.3 Whether power was met was not addressed and the failure
to meet statistical significance could be the result of the small sample size.
The study was designed well, adequate research was completed and the correct
statistical tests were used for the type of data being analyzed (ANOVA)
however, the data could be more clearly defined between the four groups being
analyzed. 

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