Clinical Application of Findings from Animal Research on Alcohol Self-Administration and Dependence

Overview

Preceding chapters have reviewed progress made in the understanding of the basic mechanisms of action of alcohol and preclinical evidence suggesting the involvement of a number of neurotransmitter and neuropeptide systems in the modulation of ethanol¹ self-administration, dependence, and tolerance. The aim of this chapter is to integrate some of these experimental findings with the clinical manifestations of alcohol abuse and dependence and to discuss their application to the development of pharmacotherapies for treatment of these disorders. It is impossible to review all the important research developments of the past several years, and we will therefore focus on those areas with direct and current relevance to the management of alcoholism. In particular, self-administration studies and their pharmacologic manipulation will be emphasized.

Since the ideal initial requirement for clinical studies of medications to alter alcohol consumption is that there should be extensive preclinical pharmacology with the compounds, we will selectively review those drugs which have been systematically evaluated preclinically and as a result showed clinical promise. The ensuing clinical work will then be described. In addition, several issues are emerging with important clinical implications, for example, comorbid psychiatric disorders in alcohol abusers. They underscore the need for new approaches to investigate clinically driven concepts in laboratory animals. These will be reviewed briefly.