Another in combination with BPI sessions at weeks

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Last updated: August 19, 2019

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

            The 99 subjects were enrolled into thestudy 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 beingrandomized into two groups. The intervention group, further subdivided intomales and females, received 40 mg citalopram every night at 8 pm in combinationwith BPI sessions at weeks 2, 4, 8, and 12; while the control group, alsodivided by sex, received the same treatment but with a placebo pill.

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Two-fourhours after the 8 pm dose, each subject was required to give a urine samplethat was analyzed for riboflavin and ethanol concentrations to confirm the useof alcohol and medication consumption. Subjects selected individual alcoholgoals of either moderation or abstinence and were monitored for non-alcoholicdrinks, alcoholic drinks, and tobacco use. The primary outcome measured was the percentchange from baseline in drinks consumed per day, the secondary outcome measuredwas the percent change from baseline in drinks consumed per drinking day, andthe third and last outcome measured was percent total days of abstinence relativeto baseline.2 The outcome differences between sexes were analyzedusing a 2-way ANOVA test while Duncan’s post hoc was used to analyze thespecific group differences due to the unequal sample size of men to women.Depression, anxiety, and alcohol problems were considered covariates. Baselinemeasurements concluded women consumed a statistically significant less amountof alcohol than men and were assessed to have higher anxiety levels.

There wereno significant differences between men and women in alcohol cravings or levelof alcohol dependence.             Only one statistical significantoutcome was concluded from this study, men receiving citalopram showed astatistically significant reduction in alcoholic drinks per day than womenreceiving citalopram (p=0.045). No significance was found in reduction ofdrinks per drinking day between sexes, abstinent days between sexes, or placebogroups between sexes. Though both men and women receiving citalopram did havegreater reductions in alcohol consumption in comparison to those in the placebogroup, it was not statistically significant.             The final conclusion to this studyimplies that citalopram might be more efficacious in treating men for alcoholabuse than women, because of the lack of data in this area, further studiesshould be completed to confirm this. In future studies, more care should betaken in selecting the study population.

Although the treatment groups were adequatelyrandomized, more information is needed to extrapolate this data, like sampleethnicities. Also, as stated in the introduction, many women who abuse alcoholalso suffer from depression, only using non-depressed women in this study mayalso limit the external validity.3 Whether power was met was not addressed and the failureto meet statistical significance could be the result of the small sample size.The study was designed well, adequate research was completed and the correctstatistical tests were used for the type of data being analyzed (ANOVA)however, the data could be more clearly defined between the four groups beinganalyzed. 

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