Abstract
Several pharmacologic treatments for decreasing alcohol consumption and related problems have recently been identified and tested in clinical studies. These developments have been a consequence of increased understanding of the biological mechanisms regulating ethanol intake. Research studies suggest a role for several neurotransmitter systems and hormones in regulating the initiation, maintenance, and cessation of alcohol drinking in animals (NARANJOand SELLERS1992). Recently serotonin, dopamine, and endogenous opioids have been shown to be particularly important in alcohol consummatory behavior (NARANJO and SELLERS 1992; NARANJO et al. 1992c; AMIT and SMITH 1992). Most studies, both preclinical and clinical, have concentrated on a single neurotransmitter system or mechanism, but these independent lines of research will, most likely, be integrated in the future (AMIT and SMITH 1992). The interactions of systems and the potential synergisms of various drugs must be assessed since few medications have a sufficiently potent effect. This paper will review recent clinical research into neuropharmacologic agents and their effects on alcohol consumption. Some of the major findings are summarized in Table 1.
Parts of this manuscript have been published in abstracts and papers by the authors.
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References
American Psychiatric Association (1980) Diagnostic and statistical manual of mental disorders, 3rd edn. Washington DC
American Psychiatric Association (1987) Diagnostic and statistical manual of mental disorders, 3rd edn, revised. Washington DC
Amit Z, Smith BR (1992) Neurotransmitter systems regulating alcohol intake. In: Naranjo CA, Sellers EM (eds) Novel pharmacological interventions for alcoholism. Springer, Berlin Heidelberg New York, pp 161–183
Amit Z, Brown Z, Sutherland A, Rockman G, Gill K (1985) Reduction in alcohol intake in humans as a function of treatment with zimelidine: implications for treatment. In: Naranjo CA, Sellers EM (eds) Research advances in new psychopharmacological treatment for alcoholism. Elsevier Science, Amsterdam, pp 189–198
Benkelfat C, Murphy DL, Hill JL et al. (1991) Ethanollike properties of the serotonergic partial agonist m-chlorophenylpiperazine in chronic alcoholic patients. Arch Gen Psychiatry 48:383
Berg BJ, Volpicelli JR, Alterman AI, O’Brien CP (1992) The relationship of alcohol drinking and endogenous opioids: the opioid compensation hypothesis. In: Naranjo CA, Sellers EM (eds) Novel pharmacological interventions for alcoholism. Springer, Berlin Heidelberg New York, pp 137–141
Boismare F, Daoust M, Moore N et al. (1984) A homotaurine derivative reduces the voluntary ethanol intake by rats: are cerebral GAB A receptors involved? Pharmacol Biochem Behav 21:787–789
Borg V (1983) Bromocriptine in the prevention of alcohol abuse. Acta Psychiatr Scand 68:100–110
Borg V, Weinholt T (1982) Bromocriptine in the treatment of the alcohol withdrawal syndrome. Acta Psychiatr Scand 65:101–111
Bruno F (1989) Buspirone in the treatment of alcoholic patients. Psychopathology 22 [Suppl l]:49–59
Dongier M, Vachon L, Schwartz G (1991) Bromocriptine in the treatment of alcohol dependence. Alcohol Clin Exp Res 15:970–977
Engel JA, Enerback C, Fahlke C et al. (1992) Serotonergic and dopaminergic involvement in ethanol intake. In: Naranjo CA, Sellers EM (eds) Novel pharmacological treatments for alcoholism. Springer, Berlin Heidelberg New York, pp 68–82
Fagius J, Osterman PO, Siden A, Wiholm BE (1985) Guillain-Barre syndrome following zimeldine treatment. Neurol Neurosurg Psychiatry 48:65–69
George SR, Roldan L, Lui A, Naranjo CA (1991) Endogenous opioids are involved in the genetically determined high preference for ethanol consumption. Alcohol Clin Exp Res 15:668–672
George SR, Fan T, Jun Ng G, Naranjo CA (1993) Low endogenous dopamine function in brain predicts high alcohol preference and consumption: reversal by increasing dopamine neurotransmission (abstract). Alcohol Clin Exp Res 17:482
Gorelick DA, Paredes A (1992) Effects of fluoxetine on alcohol consumption in male alcoholics. Alcohol Clin Exp Res 16:261–265
Higgins GA, Lawrin MO, Sellers EM (1992) Serotonin and alcohol consumption. In: Naranjo CA, Sellers EM (eds) Novel pharmacological interventions for alcoholism. Springer, Berlin Heidelberg New York, pp 83–91
Hubbell CL, Reid LD (1990) Opioids modulate rats’ intakes of alcohol beverages. In: Reid LD (ed) Opioids, bulimia and alcohol abuse and alcoholism. Springer, Berlin Heidelberg New York, pp 145–174
Kranzler HR, Meyer RE (1989) An open trial of buspirone in alcoholics. J Clin Psychopharmacol 9:379–380
Krystal JH, Webb E, Cooney N et al. (in press) Specificity of ethanol-like effects elicited by serotonergic and noradrenergic mechanisms: m-CPP and yohimbine effects in recently detoxified alcoholics. Arch Gen Psychiatry
Lader M, Melhuish A, Freka G (1986) The effect of Citalopram in single and repeated doses and with alcohol on physiological and psychological measures in healthy subjects. Eur J Clin Pharmacol 31:183–190
Lawrin MO, Naranjo CA, Sellers EM (1986) Identification and testing of new drugs for modulating alcohol consumption. Psychopharmacol Bull 22:1020–1025
Lemberger L, Rowe H, Bergstrom RF et al. (1985) Effect of fluoxetine on psychomotor performance, physiologic response and kinetics of ethanol. Clin Pharmacol Ther 37:658–664
Lhuintre JP, Moore N, Tran G et al. (1990) Acamprosate appears to decrease alcohol intake in weaned alcoholics. Alcohol Alcohol 25:613–622
McBride WJ, Murphy WJ, Lumeng L, Li T-K (1992) Serotonin and alcohol consumption. In: Naranjo CA, Sellers EM (eds) Novel pharmacological interventions for alcoholism. Springer, Berlin Heidelberg New York, pp 59–67
Meert TF, Janssen PAJ (1991) Ritanserin, a new therapeutic approach for drug abuse, part I: effects on alcohol. Drug Dev Res 24:235–249
Meert TF, Huysmans H, Melis W, Clincke GHC (1993) Ritanserin and other 5-HT agents on alcohol preference and alcohol withdrawal in rats (abstract). College on Problems of Drug Dependence, 55th annual scientific meeting, Toronto, Canada
Monti JM, Alterwain P (1991) Ritanserin decreases alcohol intake in chronic alcoholics. Lancet 337:60
Naranjo CA, Bremner KE (1992a) Clinical pharmacology of serotonin-altering medications for decreasing alcohol consumption. 6th congress of the ISBRA: symposium on role of serotonin in alcohol dependence, Bristol, UK, 22 June 1992. Alcohol Alcohol 27 [Suppl 1]:9
Naranjo CA, Bremner KE (1992b) Evaluation of the effects of serotonin uptake inhibitors in alcoholics: a review. In: Naranjo CA, Sellers EM (eds) Novel pharmacological interventions for alcoholism. Springer, Berlin Heidelberg New York, pp 105–117
Naranjo CA, Bremner KE (1993) Treatment related attenuations of alcohol intake, alcohol dependence (AD) and problems (abstract). Clin Pharmacol Ther 53:176
Naranjo CA, Sellers EM (eds) (1992) Novel pharmacological interventions for alcoholism. Springer, Berlin Heidelberg New York
Naranjo CA, Sellers EM, Kaplan HL et al. (1984a) Acute kinetic and dynamic interactions of zimelidine with ethanol. Clin Pharmacol Ther 36:654–660
Naranjo CA, Sellers EM, Roach CA et al. (1984b) Zimelidine-induced variations in alcohol intake by non-depressed heavy drinkers. Clin Pharmacol Ther 35: 374–381
Naranjo CA, Sellers EM, Sullivan JT et al. (1987) The serotonin uptake inhibitor Citalopram attenuates ethanol intake. Clin Pharmacol Ther 41:266–274
Naranjo CA, Sullivan JT, Kadlec KE et al. (1989) Differential effects of viqualine on alcohol intake and other consummatory behaviors. Clin Pharmacol Ther 46:301–309
Naranjo CA, Kadlec KE, Sanhueza P et al. (1990a) Fluoxetine differentially alters alcohol intake and other consummatory behaviours in problem drinkers. Clin Pharmacol Ther 47:490–498
Naranjo CA, Lane D, Ho-Asjoe M, Lanctöt KL (1990b) A Bayesian assessment of idiosyncratic adverse reactions to new drugs: Guillain-Barre syndrome and zimeldine. J Clin Pharmacol 30:174–180
Naranjo CA, Bremner KE, Lanctöt KL (1992a) Short- and long-term effects of Citalopram (C) combined with a brief psychosocial intervention (BPI) for alcoholism (abstract). Clin Pharmacol Ther 51(2): 168
Naranjo CA, Bremner KE, Poulos CX, Lanctöt KL (1992b) Fluoxetine decreases desire for alcohol (abstract). Clin Pharmacol Ther 51(2): 168
Naranjo CA, George SR, Bremner KE (1992c) Novel neuropharmacological treatments of alcohol dependence. Clin Neuropharmacol 15 [Suppl 1, A]:74A–75A
Naranjo CA, Poulos CX, Bremner KE, Lanctot KL (1992d) Citalopram decreases desirability, liking and consumption of alcohol in alcohol-dependent drinkers. Clin Pharmacol Ther 51:729–739
Naranjo CA, Poulos CX, Umana M, Lanctot KL, Bremner KE (1993) Effects of ritanserin (R) on desire to drink and consummatory behaviors (CB) in heavy alcohol drinkers (abstract). Clin Pharmacol Ther 53:176
O’Malley SS, Jaffe A, Chang G et al. (1992) Naltrexone and coping skills therapy for alcohol dependence: a controlled study. Arch Gen Psychiatry 49:881–887
Pelc I, Le Bon O, Verbanck P et al. (1992) Calcium-acetylhomotaurinate for maintaining abstinence in screened alcoholic patients: a placebo-controlled double-blind multicentre study. In: Naranjo CA, Sellers EM (eds) Novel pharmacological interventions for alcoholism. Springer, Berlin Heidelberg New York, pp 348–352
Reid LD, Hubbell CL (1992) Opioids modulate rats’ propensities to take alcoholic beverages. In: Naranjo CA, Sellers EM (eds) Novel pharmacological interventions for alcoholism. Springer, Berlin Heidelberg New York, pp 121–134
Samson HH, Tolliver GA, Schwarz-Stevens K (1990) Oral ethanol self-administration: a behavioral pharmacologic approach to CNS control mechanisms. Alcohol 7:187–191
Sanchez-Craig M, Wilkinson DA (1987) Theory and methods for secondary prevention of alcohol problems: a cognitively based approach. In: Cox WM (ed) Treatment and prevention of alcohol problems: a resource manual. Academic, New York, pp 287–331
Sellers EM, Naranjo CA, Kadlec K (1987) Do serotonin uptake inhibitors decrease smoking? Observations in a group of heavy drinkers. J Clin Psychopharmacol 7:417–420
Sellers EM, Romach MK, Frecker RC, Higgins GA (1991) Efficacy of the 5-HT3antagonist ondansetron in addictive disorders, In: Racagni G, Brunello N, Fukudo T (eds) Proceedings of the 5th world congress of biological psychiatry, vol 2. Elsevier Science, Amsterdam, pp 894–897
Sellers EM, Higgins GA, Tomkins DM, Romach MK (1992) Serotonin and alcohol drinking. US Government Printing Office, Washington DC, pp 141–145 (NIDA research monograph series 119)
Shaw CA, Sullivan JT, Kadlec KE et al. (1989) Ethanol interactions with serotonin selective and non-selective antidepressants: fluoxetine and amitriptyline. Hum Psychopharmacology 4:113–120
Sullivan JT, Naranjo CA, Shaw CA (1989) Kinetic and dynamic interactions of oral viqualine and ethanol in man. Eur J Clin Pharmacol 36:93–96
Tollefson GD, Montague-Clouse J, Tollefson SL (1992) Treatment of comorbid generalized anxiety in a recently detoxified alcoholic population with a selective serotonergic drug (Buspirone). J Clin Psychopharmacol 12:19–26
Volpicelli JR, Alterman AI, Hayashida M, O’Brien CP (1992) Naltrexone in the treatment of alcohol dependence. Arch Gen Psychiatry 49:876–880
Watson S, Girdlestone D (1993) Receptor nomenclature supplement. Trends Pharmacol Sci 14:21–22
Weiss F, Mitchiner M, Bloom FE, Koob GF (1990) Free-choice responding for ethanol versus water in alcohol preferring (P) and unselected Wistar rats is differentially modified by naloxone, bromocriptine, and methysergide. Psycho-pharmacology 101:178–186
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Naranjo, C.A., Bremner, K.E. (1995). Drugs Attenuating Alcohol Consumption in Humans Through Effects on Various Neurotransmitter Systems. In: Kranzler, H.R. (eds) The Pharmacology of Alcohol Abuse. Handbook of Experimental Pharmacology, vol 114. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-78435-4_15
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