The impact of anti-craving medication on cue reactivity and abstinence in patients undergoing alcohol detoxification: some preliminary evidence from a retrospective event-related potentials study.

RATIONALE: While medications such as acamprosate, baclofen, or naltrexone have shown promising effects in the treatment of alcohol use disorder (AUD), meta-analyses have yielded conflicting findings regarding their efficacy. This retrospective study examined whether alcohol cue reactivity and its neural correlates could serve as protective factors against relapse in AUD inpatients receiving pharmacological treatment during a three-week detoxification program.

METHOD: Fifty-eight inpatients diagnosed with AUD undergoing a three-weeks detoxification program were selected. These patients received either acamprosate (n = 21), naltrexone (n = 21), or baclofen (n = 16) during their stay. They completed an event-related potential cue-reactivity task at the beginning (T0) and end (T1) of the program. Follow-up data on relapse were collected up to two months post- discharge.

RESULTS: The Log-Rank (Mantel-Cox) test ([Formula: see text] (2) = 5.84; p =.059) revealed a marginally significant difference in survival distributions between medications. A significant difference emerged between baclofen and acamprosate groups ([Formula: see text] (1) = 4.73; p =.030), with slower return to alcohol use in the baclofen group. No other significant difference emerged between the acamprosate and naltrexone groups or between the naltrexone and baclofen groups (p >.05). Only the baclofen group showed a significant reduction in oddball P3 amplitude between T0 and T1 (p =.002), suggesting decreased neural cue reactivity.

CONCLUSION: A reduction in neural cue reactivity, observed exclusively in the baclofen group, may act as a protective factor against early relapse in AUD. However, this study was underpowered, and findings should be interpreted cautiously until confirmed in larger prospective investigations.