This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citing articles on ISI (2)  • Contact me when this article is cited  Related Content  • Related articles  • Similar articles in JAMA  Topic Collections  • Substance Abuse/ Alcoholism  • Drug Therapy, Other  • Alert me on articles by topic

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

To the Editor: Since alcoholic patients represent an extremely heterogeneous population, the design of the COMBINE Study¹ was selective, with a goal of striving for high internal validity at the expense of generalizability. The selection process a priori favored patients for whom completing the trial was expected. Of the 4965 potential patients screened, only 1383 were enrolled. Abstinence, an inclusion requirement, was achieved by about 92% without prior inpatient detoxification. Patients were abstinent before onset of study treatment, and a large proportion remained abstinent throughout. Since both placebo response (78% days abstinent) and data completeness (94% with complete drinking data) are extraordinarily high for alcohol-dependent patients, the COMBINE Study may have targeted a subpopulation of such patients with a low need for a specific relapse prevention treatment. Consequently, even though the percent days abstinent for both naltrexone and acamprosate was in the range reported by previous studies that combined and . . . [Full Text of this Article]

Falk Kiefer, MD
falk.kiefer@zi-mannheim.de

Karl Mann, MD
Department of Addictive Behavior and Addiction Medicine
Central Institute of Mental Health
University of Heidelberg
Mannheim, Germany

RELATED ARTICLES

Pharmacotherapy and Behavioral Intervention for Alcohol Dependence
Jeffrey M. Jonas and Sylvie Chabac
JAMA. 2006;296(14):1727.
EXTRACT | FULL TEXT  

Pharmacotherapy and Behavioral Intervention for Alcohol Dependence—Reply
Raymond F. Anton, William R. Miller, Stephanie S. O’Malley, Allen Zweben, and James D. Hosking
JAMA. 2006;296(14):1728-1729.
EXTRACT | FULL TEXT  

Combined Pharmacotherapies and Behavioral Interventions for Alcohol Dependence: The COMBINE Study: A Randomized Controlled Trial
Raymond F. Anton, Stephanie S. O’Malley, Domenic A. Ciraulo, Ron A. Cisler, David Couper, Dennis M. Donovan, David R. Gastfriend, James D. Hosking, Bankole A. Johnson, Joseph S. LoCastro, Richard Longabaugh, Barbara J. Mason, Margaret E. Mattson, William R. Miller, Helen M. Pettinati, Carrie L. Randall, Robert Swift, Roger D. Weiss, Lauren D. Williams, Allen Zweben, and for the COMBINE Study Research Group
JAMA. 2006;295(17):2003-2017.
ABSTRACT | FULL TEXT