Alcoholism's Prozac Moment?

This New Scientist article discusses advances in treating alcoholism using pharmaceuticals.  Such treatments are not used very frequently, though that may change before long.  Here's a sample:

Encouraged by advances in the neuroscience of addiction, positive results from clinical trials and stirrings of interest from big pharma, Heilig and his colleagues are pushing for medication to become a mainstream treatment. Today, the few drugs available to treat alcohol abuse are rarely used outside a small number of specialist centres, but NIAAA's vision is for more and better drugs to be prescribed routinely by psychiatrists and even family doctors.

If they are successful, the result will be alcoholism's "Prozac moment", says Mark Willenbring, NIAAA's head of treatment and recovery research, recalling the time when Prozac revolutionised the way depression was treated following its launch in 1986. By invoking Prozac, however, he will raise both hopes and fears. While it's widely recognised that Prozac and other members of its class - selective serotonin reuptake inhibitors (SSRIs) - have helped to lift the stigma surrounding depression and greatly expanded treatment options, some analyses suggest that their benefits have been exaggerated.

What's more, the pharmaceutical industry's aggressive marketing of SSRIs to ever wider groups of patients, despite evidence that they may sometimes trigger suicidal feelings, has become a major controversy. In this light, could recent advances in developing anti-alcoholism drugs be the first tentative steps towards the medicalisation of social drinking?

Here's some more:

The available drugs for alcoholism are unlikely to be the new Prozac, however. Naltrexone, for instance, which cuts the desire to drink by blocking opioid receptors in the brain's reward system, has two major drawbacks. First, its benefits vary widely between patients, although genetic tests may help predict which people are likely to respond best to the treatment (see "Different drinkers, different drugs").

Naltrexone's biggest stumbling block, however, is that it fails to treat some of the more painful aspects of abstinence. Drinking dampens the brain's response to stress - indeed, many heavy drinkers become hooked on alcohol for this reason alone. The result is that going cold turkey without also calming the brain's stress pathways can be a distressing experience. "People feel just terrible," says George Koob, a specialist in the neurobiology of addiction at the Scripps Research Institute in La Jolla, California. "These individuals are miserable. They have panic attacks."

Targeting these drink-hijacked stress pathways - often without even touching the brain's pleasure circuits - is now the hottest area in alcoholism research. In 2008 a team led by Heilig reported that an experimental drug called LY686017, made by Eli Lilly, suppressed cravings for alcohol in a small group of recently detoxified alcoholics (Science, vol 319, p 1536). The drug is known to block the brain's neurokinin 1 receptor, which is involved in behavioural responses to stress.

Comments

[Carrie]

This is a very interesting article. Thank you so much for posting it. Any advances in alcoholism treatment are a wonderful thing.