Sunday, February 17, 2008

A new drug for alcohol dependency

College campuses are filled with kids who drink for kicks. Statistics suggest that some of these early drinkers will go on to become alcoholics for the feel good, addictive thrill of it all. The majority of adult alcoholics, however, drink to relieve stress and anxiety.

Currently, two drugs are available that are supposed to alter a drinker's response to alcohol in a way that makes ongoing use less appealing. Naltrexone is an opioid receptor blocker believed to prevent the release of dopamine (a feel-good neurotransmitter) that occurs with drinking. A 2006 study reported in JAMA found that naltrexone plus behavior therapy was significantly successful in preventing relapse in abstinent alcoholics. On the other hand, this same study found no benefits from Campral, another drug used for abstinence support. Campral is believed to block the effects of glutamate on brain cells. Glutamate is an activating neurotransmitter which, in some individuals, promotes anxiety and agitation.

So what can be done for alcoholics who drink to calm themselves? Researchers at the U.S. National Institute on Alcohol Abuse and Alcoholism went looking for other substances that would modulate stress reactions in the brain. They pulled LY686017 off the back shelf of drugs tested for depression but discarded for less than perfect efficacy. Ex-alcoholics who scored high on anxiety scales were given LY686017 or placebo, then given questionnaires about just how much they craved alcohol. Those plied with LY686017 were notably less likely to long for a drink.

But these Maryland scientists did not just stop with questionnaires. They subjected the subjects to mock interviews and math tests with scowling assistants in intimidating white coats. Afterwards, the group was tested for levels of the stress hormone cortisol. All subjects also got to sniff and caress a vial of their favorite beverage and were asked just how badly they wanted to drink it. Again, LY686017 triumphed, squelching the hormonal stress reaction as well as the urge to drink.

Says neuroscientist Selena Bartlett of the Ernest Gallo Clinic and Research Center at the University of California, San Francisco, "It feels like we're heading for a sea change for new therapies for alcoholism."


Eric, AKA The Pragmatic Caregiver said...

The *"Ernest Gallo Clinic and Research Center at the University of California, San Francisco"*?

Like, "and Julio"?

What's next? The Carlo Rossi Institute Of Addiction Research? The Night Train Memorial Detox Center?

In all seriousness, though. . .

Substance P is a fascinating neuropeptide. I wouldn't have expected it to be involved with reducing alcohol consumption - the only other agent acting on the substance P receptor that is currently marketed that I'm aware of is Emend, which may keep you from hurling, but doesn't make me enjoy a margarita any less. The halls are littered by Substance B agents that have failed efficacy trials, so this is really interesting.


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