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V D Pisani

Publications and source records attributed to V D Pisani.

13 recordsLinked to original sources
PubMed1993

The relative contributions of medication adherence and AA meeting attendance to abstinent outcome for chronic alcoholics.

Our preliminary studies of the efficacy of lithium carbonate therapy for alcoholism under double-blind, placebo-controlled conditions demonstrated that alcoholics who took their assigned medication (lithium or placebo) for the first 6 months after discharge from an inpatient rehabilitation program were more likely to abstain from any alcohol use for 18 months following discharge than were alcoholics who took their medication erratically or not at all. Attendance at Alcoholics Anonymous (AA) meetings was also associated with medication adherence. We applied a structural equation model to data on the relationships between medication adherence, AA meeting attendance and abstinent outcome to clarify whether medication adherence or AA meeting attendance better explains the positive-outcome "adherence effect" we observed. Both medication adherence and AA meeting attendance evidenced direct and independent influences on abstinent outcome: medication adherence showed a small direct influence, and AA meeting attendance showed a much larger, independent influence.

Adult↗
PubMed1987

A double-blind, placebo-controlled trial of lithium carbonate therapy for alcoholism.

The efficacy of lithium carbonate as a treatment for alcoholism was examined in a double-blind, placebo-controlled study of 104 men and women meeting DSM-III criteria for alcohol dependence. Subjects entered the study during inpatient treatment and were subsequently followed up for 12 months. Survival analysis disclosed essentially three categories of treatment response: one for noncompliant subjects (0% to 7% abstinent), one for compliant subjects not attaining therapeutic serum lithium levels (31% to 44% abstinent), and one for compliant subjects with therapeutic serum levels (67% abstinent). Two findings led us to believe that therapeutic serum levels of lithium were associated with better outcome over and above a behavioral compliance effect. First, in a dose-response analysis, serum lithium levels and abstinence rates were not linearly associated. Second, all subjects who started lithium carbonate therapy as inpatients were significantly less likely to relapse to drinking during the first month than were placebo-compliant subjects. There was no evidence that depressed alcoholics showed a better treatment response than nondepressed alcoholics or that lithium had any significant impact on the mood or social adjustment of alcoholics. Although the sample size and the difficulties of ascertaining placebo compliance caution against drawing firm conclusions, the data add further support to the hypothesis that lithium has an effect on drinking behavior not related to the treatment of affective symptoms.

Adult↗
PubMed1984

Evaluation of lithium therapy for alcoholism.

The efficacy of lithium therapy for alcoholism was examined in 84 alcoholic volunteers admitted for rehabilitation. Subjects were randomly assigned to a lithium or placebo treatment condition for 18 months, and were reinterviewed monthly to document their compliance, drinking status, and mood. Two separate factors contributed to abstinent outcome: therapeutic serum lithium levels (greater than or equal to 0.4 mEq/L) and medication compliance. Recommendations are proposed for studying compliance effects in future treatment studies.

Adult↗