Abstract
Despite a number of approved medications for alcohol use disorder (AUD), this chronic relapsing disease still produces a considerable global burden, with both health-related and financial consequences. While clinical trials are a critical step in drug development, human laboratory studies provide the field with means of screening pharmacotherapy for more nuanced aspects of AUD. Specifically, studies employing alcohol administration techniques (e.g., alcohol challenge and self-administration) are able to investigate potential drugs with respect to their ability to alter various responses to alcohol administration or alter alcohol consumption in laboratory settings. This chapter reviews methodological designs and provides updates from alcohol administration studies used to screen for potential AUD pharmacotherapy over the past decade. These recent studies have supported the efficacy of approved drugs, identified some promising novel drugs, and investigated other drugs that appear ineffective in AUD treatment. Yet, few drugs are explored using the different variants of alcohol administration methods, and using the different methods has provided inconsistent results for the same drug. Future research would aid advancement in the field by testing medication with various methodologies and refining recently developed techniques.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
APA (2013) Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Publishing, Washington, DC
NIAAA (2017) Alcohol facts and statistics. National Institute of Health. https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-facts-and-statistics
Peacock A, Leung J, Larney S, Colledge S, Hickman M, Rehm J, Giovino GA, West R, Hall W, Griffiths P, Ali R, Gowing L, Marsden J, Ferrari AJ, Grebely J, Farrell M, Degenhardt L (2018) Global statistics on alcohol, tobacco and illicit drug use: 2017 status report. Addiction 113(10):1905–1926
Hasin DS, Grant BF (2015) The National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) Waves 1 and 2: review and summary of findings. Soc Psychiatry Psychiatr Epidemiol 50:1609–1640
WHO (2014) Global status report on alcohol and health. WHO, Geneva
Franck J, Jayaram-Lindstrom N (2013) Pharmacotherapy for alcohol dependence: status of current treatments. Curr Opin Neurobiol 23:692–699
Litten RZ, Egli M, Heilig M, Cui C, Fertig JB, Ryan ML, Falk DE, Moss H, Huebner R, Noronha A (2012) Medications development to treat alcohol dependence: a vision for the next decade. Addict Biol 17:513–527
U.S. Department of Health and Human Services, Food and Drug Administration, Center for Drug Evaluation and Research (CDER) (2015) Alcoholism: developing drugs for treatment guidance for industry. FDA. https://www.fda.gov/downloads/drugs/guidancecomplianceregulatoryinformation/guidances/ucm433618.pdf
EMA (2010) Guideline on the development of medicinal products for the treatment of alcohol dependence. EMA. http://www.ema.europa.eu/docs/en_GB/document_library/Scientific_guideline/2010/03/WC500074898.pdf
Heilig M, Egli M (2006) Pharmacological treatment of alcohol dependence: target symptoms and target mechanisms. Pharmacol Ther 111:855–876
McGonigle P, Ruggeri B (2014) Animal models of human disease: challenges in enabling translation. Biochem Pharmacol 87:162–171
Bujarski S, Ray LA (2016) Experimental psychopathology paradigms for alcohol use disorders: applications for translational research. Behav Res Ther 86:11–22
Engel JA, Jerlhag E (2014) Alcohol: mechanisms along the mesolimbic dopamine system. Prog Brain Res 211:201–233
Koob GF (1992) Neural mechanisms of drug reinforcement. Ann N Y Acad Sci 654:171–191
Spanagel R, Weiss F (1999) The dopamine hypothesis of reward: past and current status. Trends Neurosci 22:521–527
Weiss F, Lorang MT, Bloom FE, Koob GF (1993) Oral alcohol self-administration stimulates dopamine release in the rat nucleus accumbens - genetic and motivational determinants. J Pharmacol Exp Ther 267:2550–2258
Boileau I, Assaad JM, Pihl RO, Benkelfat C, Leyton M, Diksic M, Tremblay RE, Dagher A (2003) Alcohol promotes dopamine release in the human nucleus accumbens. Synapse 49:226–231
Thiruchselvam T, Wilson AA, Boileau I, Le Foll B (2017) A preliminary investigation of the effect of acute alcohol on dopamine transmission as assessed by [(11) C]-(+)-PHNO. Alcohol Clin Exp Res 41:1112–1119
Urban NB, Kegeles LS, Slifstein M, Xu X, Martinez D, Sakr E, Castillo F, Moadel T, O’Malley SS, Krystal JH, Abi-Dargham A (2010) Sex differences in striatal dopamine release in young adults after oral alcohol challenge: a positron emission tomography imaging study with [(1)(1)C]raclopride. Biol Psychiatry 68:689–696
Yoder KK, Constantinescu CC, Kareken DA, Normandin MD, Cheng TE, O’Connor SJ, Morris ED (2007) Heterogeneous effects of alcohol on dopamine release in the striatum: a PET study. Alcohol Clin Exp Res 31:965–973
Hietala J, West C, Syvälahti E, Någren K, Lehikoinen P, Sonninen P, Ruotsalainen U (1994) Striatal D2 dopamine receptor binding characteristics in vivo in patients with alcohol dependence. Psychopharmacology 116:285–290
Volkow ND, Wang GJ, Telang F, Fowler JS, Logan J, Jayne M, Ma Y, Pradhan K, Wong C (2007) Profound decreases in dopamine release in striatum in detoxified alcoholics: possible orbitofrontal involvement. J Neurosci 27:12700–12706
Der-Avakian A, Markou A (2012) The neurobiology of anhedonia and other reward-related deficits. Trends Neurosci 35:68–77
Vengeliene V, Bilbao A, Molander A, Spanagel R (2008) Neuropharmacology of alcohol addiction. Br J Pharmacol 154:299–315
Skinner MD, Lahmek P, Pham H, Aubin HJ (2014) Disulfiram efficacy in the treatment of alcohol dependence: a meta-analysis. PLoS One 9:e87366
Srisurapanont M, Jarusuraisin N (2002) Opioid antagonists for alcohol dependence. Cochrane Database Syst Rev (2):CD001867–CD001867
Johnson BA, Ait-Daoud N (2000) Neuropharmacological treatments for alcoholism: scientific basis and clinical findings. Psychopharmacology 149:327–344
Clapp P (2012) Current progress in pharmacologic treatment strategies for alcohol dependence. Expert Rev Clin Pharmacol 5:427–435
Niciu MJ, Arias AJ (2013) Targeted opioid receptor antagonists in the treatment of alcohol use disorders. CNS Drugs 27:777–787
Consensus A (2016) Medications for alcohol use disorder. Am Fam Physician 93:457–465
Litten RZ, Wilford BB, Falk DE, Ryan ML, Fertig JB (2016) Potential medications for the treatment of alcohol use disorder: an evaluation of clinical efficacy and safety. Subst Abus 37:286–298
Aubin HJ, Daeppen JB (2013) Emerging pharmacotherapies for alcohol dependence: a systematic review focusing on reduction in consumption. Drug Alcohol Depend 133:15–29
Walker BM, Zorrilla EP, Koob GF (2011) Systemic kappa-opioid receptor antagonism by nor-binaltorphimine reduces dependence-induced excessive alcohol self-administration in rats. Addict Biol 16:116–119
Mann K, Torup L, Sorensen P, Gual A, Swift R, Walker B, van den Brink W (2016) Nalmefene for the management of alcohol dependence: review on its pharmacology, mechanism of action and meta-analysis on its clinical efficacy. Eur Neuropsychopharmacol 26:1941–1949
Mason BJ, Salvato FR, Williams LD, Ritvo EC, Cutler RB (1999) A double-blind, placebo-controlled study of oral nalmefene for alcohol dependence. Arch Gen Psychiatry 56:719–724
Gual A, He Y, Torup L, van den Brink W, Mann K, ESENSE 2 Study Group (2013) A randomised, double-blind, placebo-controlled, efficacy study of nalmefene, as-needed use, in patients with alcohol dependence. Eur Neuropsychopharmacol 23:1432–1442
Mann K, Bladstrom A, Torup L, Gual A, van den Brink W (2013) Extending the treatment options in alcohol dependence: a randomized controlled study of as-needed nalmefene. Biol Psychiatry 73:706–713
De Witte P, Littleton J, Parot P, Koob G (2005) Neuroprotective and abstinence-promoting effects of acamprosate. CNS Drugs 19:517–537
Jonas DE, Amick HR, Feltner C, Bobashev G, Thomas K, Wines R, Kim MM, Shanahan E, Gass CE, Rowe CJ, Garbutt JC (2014) Pharmacotherapy for adults with alcohol use disorders in outpatient settings: a systematic review and meta-analysis. JAMA 311:1889–1900
CSAT (2009) Incorporating alcohol pharmacotherapies into medical practice. Substance Abuse and Mental Health Services Administration (US), Rockville, MD
Krishnan-Sarin S, Krystal JH, Shi J, Pittman B, O’Malley SS (2007) Family history of alcoholism influences naltrexone-induced reduction in alcohol drinking. Biol Psychiatry 62:694–697
Anton RF (2008) Genetic basis for predicting response to naltrexone in the treatment of alcohol dependence. Pharmacogenomics 9:655–658
Oslin DW, Leong SH, Lynch KG, Berrettini W, O’Brien CP, Gordon AJ, Rukstalis M (2015) Naltrexone vs placebo for the treatment of alcohol dependence: a randomized clinical trial. JAMA Psychiat 72:430–437
King AC, De Wit H, McNamara PJ, Cao D (2011) Rewarding, stimulant, and sedative alcohol responses and relationship to future binge drinking. Arch Gen Psychiatry 68:389–399
N.I.H (2014) Alcohol use disorder: a comparison between DSM-IV and DSM-5. NIH, Bethesda, MD
Watson PE (1989) Total body water and blood alcohol levels: updating the fundamentals. In: Crow KE, Batt RD (eds) Human metabolism of alcohol, vol 1. CRC Press, Boca Raton, pp 41–55
Brick J (2006) Standardization of alcohol calculations in research. Alcohol Clin Exp Res 30:1276–1287
Verplaetse TL, Pittman BP, Shi JM, Tetrault JM, Coppola S, McKee SA (2016) Effect of varenicline combined with high-dose alcohol on craving, subjective intoxication, perceptual motor response, and executive cognitive function in adults with alcohol use disorders: preliminary findings. Alcohol Clin Exp Res 40:1567–1576
Khemiri L, Steensland P, Guterstam J, Beck O, Carlsson A, Franck J, Jayaram-Lindstrom N (2015) The effects of the monoamine stabilizer (-)-OSU6162 on craving in alcohol dependent individuals: a human laboratory study. Eur Neuropsychopharmacol 25:2240–2251
Childs E, Roche DJ, King AC, de Wit H (2012) Varenicline potentiates alcohol-induced negative subjective responses and offsets impaired eye movements. Alcohol Clin Exp Res 36:906–914
Ray LA, Courtney KE, Ghahremani DG, Miotto K, Brody A, London ED (2014) Varenicline, low dose naltrexone, and their combination for heavy-drinking smokers: human laboratory findings. Psychopharmacology 231:3843–3853
Miranda R Jr, MacKillop J, Monti PM, Rohsenow DJ, Tidey J, Gwaltney C, Swift R, Ray L, McGeary J (2008) Effects of topiramate on urge to drink and the subjective effects of alcohol: a preliminary laboratory study. Alcohol Clin Exp Res 32:489–497
Haass-Koffler CL, Leggio L, Davidson D, Swift RM (2015) Effects of idazoxan on alcohol pharmacokinetics and intoxication: a preliminary human laboratory study. Alcohol Clin Exp Res 39:594–602
Hammarberg A, Jayaram-Lindstrom N, Beck O, Franck J, Reid MS (2009) The effects of acamprosate on alcohol-cue reactivity and alcohol priming in dependent patients: a randomized controlled trial. Psychopharmacology 205:53–62
Plebani JG, Oslin DW, Lynch KG (2011) Examining naltrexone and alcohol effects in a minority population: results from an initial human laboratory study. Am J Addict 20:330–336
Covault J, Pond T, Feinn R, Arias AJ, Oncken C, Kranzler HR (2014) Dutasteride reduces alcohol’s sedative effects in men in a human laboratory setting and reduces drinking in the natural environment. Psychopharmacology 231:3609–3618
Evans SM, Bisaga A (2009) Acute interaction of baclofen in combination with alcohol in heavy social drinkers. Alcohol Clin Exp Res 33:19–30
Zimmermann US, O’Connor S, Ramchandani VA (2013) Modeling alcohol self-administration in the human laboratory. Curr Top Behav Neurosci 13:315–353
Ray LA, Hutchison KE (2004) A polymorphism of the mu-opioid receptor gene (OPRM1) and sensitivity to the effects of alcohol in humans. Alcohol Clin Exp Res 28:1789–1795
Ray LA, Bujarski S, Chin PF, Miotto K (2012) Pharmacogenetics of naltrexone in Asian Americans: a randomized placebo-controlled laboratory study. Neuropsychopharmacology 37:445–455
Roche DJ, Yardley MM, Lunny KF, Louie SG, Davies DL, Miotto K, Ray LA (2016) A pilot study of the safety and initial efficacy of ivermectin for the treatment of alcohol use disorder. Alcohol Clin Exp Res 40:1312–1320
Ray LA, Bujarski S, Shoptaw S, Roche DJ, Heinzerling K, Miotto K (2017) Development of the neuroimmune modulator ibudilast for the treatment of alcoholism: a randomized, placebo-controlled, human laboratory trial. Neuropsychopharmacology 42:1776–1788
Ray LA, Chin PF, Heydari A, Miotto K (2011) A human laboratory study of the effects of quetiapine on subjective intoxication and alcohol craving. Psychopharmacology 217:341–351
Moallem N, Ray LA (2012) Quetiapine improves response inhibition in alcohol dependent patients: a placebo-controlled pilot study. Pharmacol Biochem Behav 100:490–493
O’Malley SS, Krishnan-Sarin S, Farren C, Sinha R, Kreek MJ (2002) Naltrexone decreases craving and alcohol self-administration in alcohol-dependent subjects and activates the hypothalamo-pituitary-adrenocortical axis. Psychopharmacology 160:19–29
Penetar DM, Toto LH, Farmer SL, Lee DY, Ma Z, Liu Y, Lukas SE (2012) The isoflavone puerarin reduces alcohol intake in heavy drinkers: a pilot study. Drug Alcohol Depend 126:251–256
Penetar DM, Toto LH, Lee DY, Lukas SE (2015) A single dose of kudzu extract reduces alcohol consumption in a binge drinking paradigm. Drug Alcohol Depend 153:194–200
McKee SA, O’Malley SS, Shi J, Mase T, Krishnan-Sarin S (2008) Effect of transdermal nicotine replacement on alcohol responses and alcohol self-administration. Psychopharmacology 196:189–200
Verplaetse TL, Pittman BP, Shi JM, Tetrault JM, Coppola S, McKee SA (2016) Effect of lowering the dose of varenicline on alcohol self-administration in drinkers with alcohol use disorders. J Addict Med 10:166–173
McKee SA, Harrison EL, O’Malley SS, Krishnan-Sarin S, Shi J, Tetrault JM, Picciotto MR, Petrakis IL, Estevez N, Balchunas E (2009) Varenicline reduces alcohol self-administration in heavy-drinking smokers. Biol Psychiatry 66:185–190
Roberts W, McKee SA (2018) Effects of varenicline on cognitive performance in heavy drinkers: dose-response effects and associations with drinking outcomes. Exp Clin Psychopharmacol 26:49–57
Roberts W, Verplaetse TL, Moore K, Oberleitner L, Picciotto MR, McKee SA (2017) Effects of varenicline on alcohol self-administration and craving in drinkers with depressive symptoms. J Psychopharmacol 31:906–914
Faessel HM, Smith BJ, Gibbs MA, Gobey JS, Clark DJ, Burstein AH (2006) Single-dose pharmacokinetics of varenicline, a selective nicotinic receptor partial agonist, in healthy smokers and nonsmokers. J Clin Pharmacol 46:991–998
Farokhnia M, Schwandt ML, Lee MR, Bollinger JW, Farinelli LA, Amodio JP, Sewell L, Lionetti TA, Spero DE, Leggio L (2017) Biobehavioral effects of baclofen in anxious alcohol-dependent individuals: a randomized, double-blind, placebo-controlled, laboratory study. Transl Psychiatry 7:e1108
Leggio L, Zywiak WH, McGeary JE, Edwards S, Fricchione SR, Shoaff JR, Addolorato G, Swift RM, Kenna GA (2013) A human laboratory pilot study with baclofen in alcoholic individuals. Pharmacol Biochem Behav 103:784–791
Sarid-Segal O, Knapp CM, Burch W, Richardson MA, Bahtia S, DeQuattro K, Afshar M, Richambault C, Sickels L, Devine E, Ciraulo DA (2009) The anticonvulsant zonisamide reduces ethanol self-administration by risky drinkers. Am J Drug Alcohol Abuse 35:316–319
Anton RF, Schacht JP, Voronin KE, Randall PK (2017) Aripiprazole suppression of drinking in a clinical laboratory paradigm: influence of impulsivity and self-control. Alcohol Clin Exp Res 41:1370–1380
Voronin K, Randall P, Myrick H, Anton R (2008) Aripiprazole effects on alcohol consumption and subjective reports in a clinical laboratory paradigm--possible influence of self-control. Alcohol Clin Exp Res 32:1954–1961
Kenna GA, Zywiak WH, Swift RM, McGeary JE, Clifford JS, Shoaff JR, Fricchione S, Brickley M, Beaucage K, Haass-Koffler CL, Leggio L (2014) Ondansetron and sertraline may interact with 5-HTTLPR and DRD4 polymorphisms to reduce drinking in non-treatment seeking alcohol-dependent women: exploratory findings. Alcohol 48:515–522
George DT, Herion DW, Jones CL, Phillips MJ, Hersh J, Hill D, Heilig M, Ramchandani VA, Geyer C, Spero DE, Singley ED, O’Malley SS, Bishai R, Rawlings RR, Kunos G (2010) Rimonabant (SR141716) has no effect on alcohol self-administration or endocrine measures in nontreatment-seeking heavy alcohol drinkers. Psychopharmacology 208:37–44
Vatsalya V, Gowin JL, Schwandt ML, Momenan R, Coe MA, Cooke ME, Hommer DW, Bartlett S, Heilig M, Ramchandani VA (2015) Effects of varenicline on neural correlates of alcohol salience in heavy drinkers. Int J Neuropsychopharmacol 18:pyv068
Zimmermann US, Mick I, Vitvitskyi V, Plawecki MH, Mann KF, O’Connor S (2008) Development and pilot validation of computer-assisted self-infusion of ethanol (CASE): a new method to study alcohol self-administration in humans. Alcohol Clin Exp Res 32:1321–1328
Ramchandani VA, Bolane J, Li TK, O’Connor S (1999) A physiologically-based pharmacokinetic (PBPK) model for alcohol facilitates rapid BrAC clamping. Alcohol Clin Exp Res 23:617–623
Muller CA, Geisel O, Banas R, Heinz A (2014) Current pharmacological treatment approaches for alcohol dependence. Expert Opin Pharmacother 15:471–481
Ray LA, Oslin DW (2009) Naltrexone for the treatment of alcohol dependence among African Americans: results from the COMBINE Study. Drug Alcohol Depend 105:256–258
Litten RZ, Ryan ML, Fertig JB, Falk DE, Johnson B, Dunn KE, Green AI, Pettinati HM, Ciraulo DA, Sarid-Segal O, Kampman K, Brunette MF, Strain EC, Tiouririne NA, Ransom J, Scott C, Stout R, NCIG Study Group (2013) A double-blind, placebo-controlled trial assessing the efficacy of varenicline tartrate for alcohol dependence. J Addict Med 7:277–286
Miranda R Jr, MacKillop J, Treloar H, Blanchard A, Tidey JW, Swift RM, Chun T, Rohsenow DJ, Monti PM (2016) Biobehavioral mechanisms of topiramate’s effects on alcohol use: an investigation pairing laboratory and ecological momentary assessments. Addict Biol 21:171–182
Lukas SE, Penetar D, Su Z, Geaghan T, Maywalt M, Tracy M, Rodolico J, Palmer C, Ma Z, Lee DY (2013) A standardized kudzu extract (NPI-031) reduces alcohol consumption in nontreatment-seeking male heavy drinkers. Psychopharmacology 226:65–73
Martinotti G, Di Nicola M, Di Giannantonio M, Janiri L (2009) Aripiprazole in the treatment of patients with alcohol dependence: a double-blind, comparison trial vs. Naltrexone. J Psychopharmacol 23:123–129
Anton RF, Kranzler H, Breder C, Marcus RN, Carson WH, Han J (2008) A randomized, multicenter, double-blind, placebo-controlled study of the efficacy and safety of aripiprazole for the treatment of alcohol dependence. J Clin Psychopharmacol 28:5–12
Colombo G, Agabio R, Fa M, Guano L, Loche A, Reali R, Gessa GL (1998) Reduction of voluntary ethanol intake in ethanol-preferring sP rats by the cannabinoid antagonist SR-141716. Alcohol Alcohol 33:126–130
Soyka M, Koller G, Schmidt P, Lesch OM, Leweke M, Fehr C, Gann H, Mann KF, ACTOL Study Investigators (2008) Cannabinoid receptor 1 blocker rimonabant (SR 141716) for treatment of alcohol dependence: results from a placebo-controlled, double-blind trial. J Clin Psychopharmacol 28:317–324
Bacio GA, Lunny KF, Webb JN, Ray LA (2014) Alcohol use following an alcohol challenge and a brief intervention among alcohol-dependent individuals. Am J Addict 23:96–101
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer Science+Business Media, LLC, part of Springer Nature
About this protocol
Cite this protocol
Chukwueke, C.C., Le Foll, B. (2019). The Human Laboratory and Drug Development in Alcohol Use Disorder: Recent Updates. In: Kobeissy, F. (eds) Psychiatric Disorders. Methods in Molecular Biology, vol 2011. Humana, New York, NY. https://doi.org/10.1007/978-1-4939-9554-7_12
Download citation
DOI: https://doi.org/10.1007/978-1-4939-9554-7_12
Published:
Publisher Name: Humana, New York, NY
Print ISBN: 978-1-4939-9553-0
Online ISBN: 978-1-4939-9554-7
eBook Packages: Springer Protocols