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Naltrexone Reduces Craving in Alcohol Dependence
A DGReview of :"Naltrexone decreases craving and alcohol self-administration in alcohol-dependent subjects and activates the hypothalamo-pituitary-adrenocortical axis"
Psychopharmacology
02/28/2002
By David Ball
People who are alcohol dependent can reduce both the desire to drink and the amount consumed by taking the opioid antagonist naltrexone, United States researchers suggest.
Naltrexone may suppress the craving for alcohol, in part, by activating the hypothalamo-pituitary-adrenocortical axis.
The researchers, from Yale University in Connecticut and Rockefeller University in New York, designed the study to determine how naltrexone reduces the risk of relapsing into heavy drinking in alcohol dependent individuals. Eighteen non-treatment-seeking, alcohol-dependent volunteers were randomized to receive either placebo or 50 mg of naltrexone over a six day period. On the sixth day, after baseline assessments of craving and endocrine levels, they were given a priming drink designed to raise blood alcohol levels to 0.03 g/dl. Over the next two hours, the subjects were offered up to eight additional drinks, each designed to raise blood alcohol levels by 0.015 g/dl, or the opportunity to receive US $3 for each drink not consumed.
At baseline, subjects in the naltrexone group had higher cortisol levels and lower levels of craving than did the placebo subjects.While no significant differences were seen in responses to the priming dose, subjects on naltrexone drank fewer drinks and consumed them more slowly. They also reported lower levels of craving throughout the alcohol self-administration.
Higher levels of adrenocorticotropic hormone and cortisol were found in naltrexone than in placebo subjects and levels of cortisol were negatively correlated with intensity of the craving for alcohol. Positive correlations were found with the number of drinks chosen and level of alcohol craving.
There was no difference between the two groups on ratings of nausea, which were low, at any point in the study.
Psychopharmacology 2002, 160: 19-29.
"Naltrexone decreases craving and alcohol self-administration in alcohol-dependent subjects and activates the hypothalamo-pituitary-adrenocortical axis"
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