{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T15:56:44Z","timestamp":1783612604689,"version":"3.55.0"},"reference-count":31,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T00:00:00Z","timestamp":1742169600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100018296","name":"Fort\u00e9 Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100018296","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004047","name":"Karolinska Institutet","doi-asserted-by":"publisher","award":["Dnr 2020\u201302653"],"award-info":[{"award-number":["Dnr 2020\u201302653"]}],"id":[{"id":"10.13039\/501100004047","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Psychiatr Scand"],"published-print":{"date-parts":[[2025,8]]},"abstract":"ABSTRACT<\/jats:title>\n \n Objectives<\/jats:title>\n Despite the high prevalence of alcohol use disorder (AUD), only a minority of patients receive recommended pharmacological treatments, possibly owing to uncertainty about the real\u2010world effectiveness of these medications. Here, we analyzed nationwide, register\u2010based data to investigate the association between approved AUD medications (naltrexone, acamprosate, disulfiram, and nalmefene) and the risk of alcohol\u2010related hospitalizations among individuals with AUD.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n People aged 18\u201364 with a registered first\u2010time diagnosis of AUD between 2009 and 2019 (\n N<\/jats:italic>\n \u2009=\u200993,727) were identified from the Swedish National Patient Register. Cox regression models were used to analyze the association between AUD medication exposure and the risk of alcohol\u2010related hospitalizations.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Exposure to naltrexone (hazard ratio [HR]\u2009=\u20090.80; 95% confidence interval [CI]\u2009=\u20090.73\n \u2013<\/jats:bold>\n 0.87) or disulfiram (HR\u2009=\u20090.83, 95% CI\u2009=\u20090.79\n \u2013<\/jats:bold>\n 0.88) as monotherapy, or a combination of naltrexone\/disulfiram (HR\u2009=\u20090.68, 95% CI\u2009=\u20090.49\n \u2013<\/jats:bold>\n 0.96), or disulfiram\/acamprosate (HR\u2009=\u20090.57 95% CI\u2009=\u20090.44\n \u2013<\/jats:bold>\n 0.74) was significantly associated with a lower risk of alcohol\u2010related hospitalizations compared to periods without exposure to any of these medications. In contrast, no significant associations were observed for acamprosate, nalmefene, or the combination of acamprosate\/naltrexone. Sensitivity analyses in individuals with severe AUD and stratified subgroup analyses by different socioeconomic groups confirmed the robustness of the results.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n Results indicate a significant association between disulfiram and naltrexone monotherapy, as well as the combination of disulfiram with naltrexone or acamprosate, with a lower risk of alcohol\u2010related hospitalizations among individuals with\n AUD<\/jats:styled-content>\n . Low prescription rates suggest that\n AUD<\/jats:styled-content>\n medications are currently underutilized. Increasing the availability of these medications for individuals with\n AUD<\/jats:styled-content>\n could help reduce alcohol\u2010related hospitalizations.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/acps.13802","type":"journal-article","created":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T22:58:28Z","timestamp":1742252308000},"page":"94-103","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Pharmacological Treatments in Alcohol Use Disorder and Risk of Alcohol\u2010Related Hospitalizations: A Register Study"],"prefix":"10.1111","volume":"152","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5962-019X","authenticated-orcid":false,"given":"Patrick","family":"Bach","sequence":"first","affiliation":[{"name":"Department of Clinical Neuroscience Karolinska Institutet Stockholm Sweden"},{"name":"Department of Addictive Behavior and Addiction Medicine Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim Mannheim Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4355-1967","authenticated-orcid":false,"given":"Johan","family":"Franck","sequence":"additional","affiliation":[{"name":"Department of Clinical Neuroscience Karolinska Institutet Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1658-9345","authenticated-orcid":false,"given":"Jonas","family":"H\u00e4llgren","sequence":"additional","affiliation":[{"name":"Department of Clinical Neuroscience Karolinska Institutet Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4209-5728","authenticated-orcid":false,"given":"H\u00e4rje","family":"Widing","sequence":"additional","affiliation":[{"name":"Department of Clinical Neuroscience Karolinska Institutet Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8254-7525","authenticated-orcid":false,"given":"Mika","family":"Gissler","sequence":"additional","affiliation":[{"name":"Department of Data and Analytics Finnish Institute for Health and Welfare Helsinki Finland"},{"name":"Academic Primary Care Centre. Region Stockholm Stockholm Sweden"},{"name":"Department of Molecular Medicine and Surgery Karolinska Institutet Stockholm Sweden"},{"name":"Department of Child Psychiatry Turku University Hospital, Turku University Turku Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8701-4226","authenticated-orcid":false,"given":"Jeanette","family":"Westman","sequence":"additional","affiliation":[{"name":"Academic Primary Care Centre. Region Stockholm Stockholm Sweden"},{"name":"Department of Neurobiology, Care Sciences and Society Karolinska Institutet Stockholm Sweden"},{"name":"Department of Health Care Sciences Marie Cederschi\u00f6ld University Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,3,17]]},"reference":[{"key":"e_1_2_14_2_1","volume-title":"Global Status Report on Alcohol and Health 2018","author":"World Health Organization","year":"2019"},{"key":"e_1_2_14_3_1","volume-title":"Nationella Riktlinjer f\u00f6r V\u00e5rd Och St\u00f6d Vid Missbruk Och Beroende: St\u00f6d f\u00f6r Styrning Och Ledning","author":"Socialstyrelsen P.","year":"2015"},{"key":"e_1_2_14_4_1","volume-title":"Alcohol Use Disorders: The Nice Guideline on the Diagnosis, Assessment and Management of Harmful Drinking and Alcohol Dependence","author":"The National Institute for Health and Care Excellence","year":"2011"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1159\/000522335"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2017.1750101"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD004332.pub2"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD001867.pub2"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1530-0277.2011.01523.x"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euroneuro.2013.02.006"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.15384"},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2022.767506"},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2021.108964"},{"key":"e_1_2_14_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.15502"},{"key":"e_1_2_14_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2016.06.027"},{"key":"e_1_2_14_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2020.108174"},{"key":"e_1_2_14_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102458\u201011\u2010450"},{"key":"e_1_2_14_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.1294"},{"key":"e_1_2_14_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-017-0316-1"},{"key":"e_1_2_14_20_1","doi-asserted-by":"publisher","DOI":"10.1214\/aos\/1176345976"},{"key":"e_1_2_14_21_1","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.1989.10478874"},{"key":"e_1_2_14_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/0021\u20109681(87)90171\u20108"},{"key":"e_1_2_14_23_1","doi-asserted-by":"publisher","DOI":"10.2147\/clep.s282475"},{"key":"e_1_2_14_24_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.3628"},{"key":"e_1_2_14_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.12875"},{"key":"e_1_2_14_26_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0087366"},{"key":"e_1_2_14_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m3934"},{"key":"e_1_2_14_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1530\u20100277.1998.tb04295.x"},{"key":"e_1_2_14_29_1","doi-asserted-by":"publisher","DOI":"10.1177\/11782218221118462"},{"key":"e_1_2_14_30_1","doi-asserted-by":"publisher","DOI":"10.1177\/0193841X0102500202"},{"key":"e_1_2_14_31_1","first-page":"205","volume-title":"Project MATCH Hypotheses: Results and Causal Chain Analyses","author":"DiClemente C. 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