Pharmacologically induced alcohol craving in treatment seeking alcoholics correlates with alcoholism severity, but is insensitive to acamprosate
Autor: | David T. George, Erick Singley, Julie Usala, John C. Umhau, Christopher B. Geyer, Melanie L. Schwandt, Markus Heilig |
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Rok vydání: | 2011 |
Předmět: |
Adult
Male Taurine Acamprosate media_common.quotation_subject Population Craving Anxiety Pharmacology Severity of Illness Index Piperazines Placebos Alcohol-Induced Disorders Nervous System Double-Blind Method mental disorders medicine meta-Chlorophenylpiperazine Humans Treatment Failure education media_common education.field_of_study Yohimbine Adrenergic alpha-2 Receptor Antagonists Middle Aged Abstinence Serotonin Receptor Agonists Alcoholism Psychiatry and Mental health Anesthesia Alcohol Deterrents Female Original Article medicine.symptom Psychology medicine.drug |
Zdroj: | Neuropsychopharmacology. 36:1178-1186 |
ISSN: | 1740-634X 0893-133X |
Popis: | Modulation of alcohol craving induced by challenge stimuli may predict the efficacy of new pharmacotherapies for alcoholism. We evaluated two pharmacological challenges, the α(2)-adrenergic antagonist yohimbine, which reinstates alcohol seeking in rats, and the serotonergic compound meta-chlorophenylpiperazine (mCPP), previously reported to increase alcohol craving in alcoholics. To assess the predictive validity of this approach, the approved alcoholism medication acamprosate was evaluated for its ability to modulate challenge-induced cravings. A total of 35 treatment seeking alcohol dependent inpatients in early abstinence were randomized to placebo or acamprosate (2997 mg daily). Following two weeks of medication, subjects underwent three challenge sessions with yohimbine, mCPP or saline infusion under double blind conditions, carried out in counterbalanced order, and separated by at least 5 days. Ratings of cravings and anxiety, as well as biochemical measures were obtained. In all, 25 subjects completed all three sessions and were included in the analysis. Cravings were modestly, but significantly higher following both yohimbine and mCPP challenge compared with saline infusion. The mCPP, but not yohimbine significantly increased anxiety ratings. Both challenges produced robust ACTH, cortisol and prolactin responses. There was a significant correlation between craving and the degree of alcoholism severity. Acamprosate administration did not influence craving. Both yohimbine and mCPP challenges lead to elevated alcohol craving in a clinical population of alcoholics, and these cravings correlate with alcoholism severity. Under the experimental conditions used, alcohol cravings induced by these two stimuli are not sensitive to acamprosate at clinically used doses. |
Databáze: | OpenAIRE |
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