Microsoft word - information for prescribing naltrexone july 27.doc
Information for Prescribing Naltrexone
The patient carrying this letter to you would like your support in a highly effective treatment for
alcoholism: it is called TSM and has a 78% cure rate. It requires a prescription for naltrexone.
The FDA approved naltrexone in 1995 for use in the treatment of alcohol dependence. Important new
evidence has been obtained since then about how to use naltrexone much more effectively.
First, a dual double-blind clinical trial1 showed that the usual protocol of having patients take
naltrexone while abstinent is not effective. To be effective, naltrexone and alcohol must be in the system
concurrently. Therefore, naltrexone must always be taken one hour before consuming alcohol. The resulting
mechanism of extinction then gradually reduces craving and drinking over several months, and produces a
natural detoxification - thus avoiding the distress and complications of rapid withdrawal. The result has been
replicated and is consistent with findings from nearly all of the 82 clinical trials conducted to date.2
Second, it is now clear that naltrexone can be prescribed by doctors without an accompanying
program of intensive counselling. Naltrexone was originally approved by the FDA as an adjunct
within comprehensive programs of alcoholism treatment. The results of Project Combine
the largest clinical trial in the alcohol field, showed, however, that naltrexone was effective
without the need for intensive counselling where patients are treated in general medical settings.3
The bottom line is that TSM has proven to be far more successful than any other treatment for
alcoholism on the market to date, and your patient is keen to try this method.
Detailed information can be found in Dr. Roy Eskapa’s book, The Cure for Alcoholism
instructions to physicians, can be downloaded on the internet at: www.TheCureForAlcoholism.com - Click on
‘About the Book’ Chapter 17 – ‘For Medical Professionals’
Additional documentation may be requested by emailing: [email protected]
National Institute for Health and Welfare (THL)
Head of the National Anxiety Association
Information for Prescribing Naltrexone
1 Heinälä, P., Alho, H., Kiianmaa, K., Lönnqvist, J., Kuoppasalmi, K., and Sinclair, J.D. (2001).
Targeted use of Naltrexone without prior detoxification in the treatment of alcohol dependence: A
factorial double-blind placebo-controlled trial. Journal of Clinical Psychopharmacology, 21(3):
2 Sinclair, J. D. (2001) Evidence about the use of Naltrexone and for different ways of using it in the
treatment of alcoholism. Alcohol and Alcoholism
36: 2-10; Sinclair, D. and F.Fantozzi (2004)
Relapse prevention with extinction . In: Relapse prevention in the treatment of alcohol dependence. Personalit Dipendenze
10 (fasc.II): 219-243.
3 Anton RF, O’Malley, SS Ciraulo DC, Cisler RA. Couper D, Donovan DM, Gastfriend DR, Hosking
JD, Johnson BA, LoCastro JS, Longabaugh R, Mason BJ, Mattson ME, Miller WR, Pettinati HM,
Randall CL, Swift R, Weiss RD, Williams LD, Zweben AZ, for the COMBINE Study Research
Group (2006) Combined pharmacotherapies and behavioral interventions for alcohol dependence:
The COMBINE Study: A Randomized Controlled Trial JAMA. 2006;295:2003-2017
4 Eskapa, R (2008) The Cure for Alcoholism.
Dallas: Ben Bella Books, 320 pages – Several chapters
may be downloaded at www.TheCureForAlcoholism.com - click on ‘About the Book’
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