Substance use disorders among older adults: A review of randomized controlled pharmacotherapy trials

Table 1 Summary of included studies

Study	Number of participants	Age in yr	Setting	Comparators	Duration in wk
Oslin et al[7], 1997	44	50-70	Veterans affairs	Naltrexone vs placebo	12
Oslin et al[8], 2005	74	≥ 55	Outpatient	Naltrexone + sertraline vs placebo + sertraline	12

Table 2 Quality of included studies

Study	Randomization	Similar groups initially?	Equal treatment?	Analyzed groups in which they were randomized	Objective/ “blind” treatments?	Overall quality of study
Oslin et al[7]	Yes	Yes	Yes	Yes	Yes	Good
Oslin et al[8]	Yes	Yes	Yes	Yes	Yes	Good

Table 3 Results summary from included studies

Name of study	Outcomes	Tolerability	Limitations
Oslin et al[7]	(1) Those who drank alcohol was 1.9% of days for the naltrexone group vs 6.5% of days in the placebo group, P = 0.275; (2) The relapse rates were 25% in all clinical subjects; 14.3% in the naltrexone group vs 34.8% in the placebo group, P = 0.117; (3) Those who sampled alcohol and relapsed: 3 of 6 in the naltrexone group vs 8 of 8 in the placebo group, P = 0.024; (4) There were no differences in the abstinence rates between the two groups, P = 0.659; (5) There were no differences in prolonging abstinence between the two groups, P = 0.532	(1) Most common side effects were sleep disturbances and anxiety; (2) For naltrexone, the common side effects were depression, sedation, and constipation; (3) For placebo, the common side effects were memory lapse, asthma attack, “fleeting thoughts”, and frequent urination; (4) None of the subjects dropped out of study due to medication effects	(1) There were a small number of subjects; (2) The method of assessment was self-report
Oslin et al[8]	(1) Those who relapsed on alcohol use was 35.1% in the naltrexone group vs 32.4% in placebo group, OR: 1.25, P = 0.690; (2) Those who were abstinent from alcohol use was 43.2% in the naltrexone group vs 54.1% in the placebo group, OR: 1.34, P = 0.575; (3) Those individuals in whom the depression had remitted was 51.4% in the naltrexone group vs 54.1% in the depression group, OR: 1.40, P = 0.537; (4) Overall improvement was noted in 40.5% of individuals in the naltrexone group vs 43.2% in the depression group, OR: 1.40, P = 0.537	(1) Common adverse events noted during treatment included; 58.1% headache, 51.4% anxiety, 41.9% nausea, 39.2% decreased sexual functioning, 24.3% vomiting; (2) The occurrence of adverse effects was not different between the two groups; (3) The symptoms were not related to the completion of the trial or to the adherence with the medication	(1) There were a small number of veterans and were mainly male; (2) The method of assessment was self-report; (3) The outcomes measured were dually dependent on depression remission and the lack of relapse on alcohol

OR: Odds ratio.