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Randomized Controlled Trial
. 2013 Nov;51(11):729-35.
doi: 10.1016/j.brat.2013.08.003. Epub 2013 Aug 30.

The effects of venlafaxine and cognitive behavioral therapy alone and combined in the treatment of co-morbid alcohol use-anxiety disorders

Domenic A Ciraulo  1 , David H Barlow, Suzy Bird Gulliver, Todd Farchione, Sandra B Morissette, Barbara W Kamholz, Katherine Eisenmenger, Bonnie Brown, Eric Devine, Timothy A Brown, Clifford M Knapp
Affiliations
Randomized Controlled Trial

The effects of venlafaxine and cognitive behavioral therapy alone and combined in the treatment of co-morbid alcohol use-anxiety disorders

Domenic A Ciraulo et al. Behav Res Ther. 2013 Nov.

Abstract

The effects of the antidepressant venlafaxine (VEN-225 mg daily) and transdiagnostic cognitive behavioral treatment (CBT) alone and in combination on alcohol intake in subjects with co-morbid alcohol use disorders (AUDs) and anxiety disorders were compared. Drinking outcomes and anxiety were assessed for 81 subjects treated for 11 weeks with one of 4 conditions: 1) VEN-CBT, 2) VEN-Progressive Muscle Relaxation therapy (PMR), 3) Placebo (PLC)-CBT and 4) a comparison group of PLC-PMR. For subjects who reported taking at least one dose of study medication, the Time×Group interaction was significant for percent days of heavy drinking and drinks consumed per day. For the measure of percent days heavy drinking, the paired comparison of PLC-CBT versus PLC-PMR group indicated that the PLC-CBT group had greater drinking reductions, whereas other groups were not superior to the comparison group. In Week 11, the proportion of subjects in the PLC-CBT group that had a 50% reduction from baseline in percent days heavy drinking was significantly greater than those in the comparison group. Of the 3 "active treatment" groups only the PLC-CBT group had significantly decreased heavy drinking when contrasted to the comparison group. This finding suggests that the transdiagnostic CBT approach of Barlow and colleagues may have value in the management of heavy drinking in individuals with co-morbid alcoholism and anxiety.

Keywords: Alcoholism; Antidepressants; Anxiety; Cognitive behavioral therapy.

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Figures

Fig.1
Fig.1
Study Flow Diagram
Fig. 2
Fig. 2
Intent to treat data for weekly mean percent days heavy drinking for PLC-CBT and PLC-PMR treatment groups for study weeks included in the analysis, i.e Week 1 (the Placebo Run-In Week) and Weeks 5-12. p=0.01 for the Time × Group interaction for paired comparisons in both the intent to treat analysis and the analysis of data for subjects who used at least one dose of medication.
Fig.3
Fig.3
Mean DASS-A anxiety (subscale scores obtained for Study Weeks 1-11 for each of the treatment groups. VEN-CBT PLC-CBT VEN-PMR PLC-PMR
See this image and copyright information in PMC

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