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This meta\u2010analysis examined\n                      <jats:italic>when<\/jats:italic>\n                      naltrexone and acamprosate are most helpful by testing: (i) the relative efficacy of each medication given its presumed mechanism of action (reducing heavy drinking versus fostering abstinence) and (ii) whether different ways of implementing each medication (required abstinence before treatment, detoxification before treatment, goal of treatment, length of treatment, dosage) moderate its effects.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A systematic literature search identified 64 randomized, placebo\u2010controlled,\n                      <jats:styled-content style=\"fixed-case\">E<\/jats:styled-content>\n                      nglish\u2010language clinical trials completed between 1970 and 2009 focused on acamprosate or naltrexone.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Acamprosate had a significantly larger effect size than naltrexone on the maintenance of abstinence, and naltrexone had a larger effect size than acamprosate on the reduction of heavy drinking and craving. For naltrexone, requiring abstinence before the trial was associated with larger effect sizes for abstinence maintenance and reduced heavy drinking compared with placebo. For acamprosate, detoxification before medication administration was associated with better abstinence outcomes compared with placebo.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In treatment for alcohol use disorders, acamprosate has been found to be slightly more efficacious in promoting abstinence and naltrexone slightly more efficacious in reducing heavy drinking and craving. Detoxification before treatment or a longer period of required abstinence before treatment is associated with larger medication effects for acamprosate and naltrexone respectively.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/j.1360-0443.2012.04054.x","type":"journal-article","created":{"date-parts":[[2012,10,17]],"date-time":"2012-10-17T18:28:30Z","timestamp":1350498510000},"page":"275-293","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":377,"title":["Meta\u2010analysis of naltrexone and acamprosate for treating alcohol use disorders: when are these medications most helpful?"],"prefix":"10.1111","volume":"108","author":[{"given":"Natalya C.","family":"Maisel","sequence":"first","affiliation":[{"name":"Center for Health Care Evaluation VA Palo Alto Health Care System (152MPD) Menlo Park CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet C.","family":"Blodgett","sequence":"additional","affiliation":[{"name":"Center for Health Care Evaluation VA Palo Alto Health Care System (152MPD) Menlo Park CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula L.","family":"Wilbourne","sequence":"additional","affiliation":[{"name":"Center for Health Care Evaluation VA Palo Alto Health Care System (152MPD) Menlo Park CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith","family":"Humphreys","sequence":"additional","affiliation":[{"name":"Center for Health Care Evaluation VA Palo Alto Health Care System (152MPD) Menlo Park CA USA"},{"name":"Department of Psychiatry and Behavioral Sciences Stanford University Stanford School of Medicine Stanford CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John W.","family":"Finney","sequence":"additional","affiliation":[{"name":"Center for Health Care Evaluation VA Palo Alto Health Care System (152MPD) Menlo Park CA USA"},{"name":"Department of Psychiatry and Behavioral Sciences Stanford University Stanford School of Medicine Stanford CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,10,17]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"crossref","unstructured":"Department of Veterans Affairs and Department of Defense.VA\/DoD Clinical Practice Guideline for Management of Substance Use Disorders (SUD). 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