Naltrexone is one of four oral medications approved by the U.S. Food and Drug Administration (FDA) for the treatment of alcoholism.
A recent large multicenter research study of alcohol dependence supported by the National Institute of Alcoholism and Alcohol Abuse (NIAAA), the COMBINE Study, suggested that naltrexone produced a modest but significant benefit but another FDA-approved medication, acamprosate, was ineffective. Perhaps consistent with its modest effects in COMBINE, naltrexone is not widely prescribed in the treatment of alcoholism. Yet, clinicians report that naltrexone may have significant benefits for individual patients. To make naltrexone a more useful medication, it would be important to begin to identify groups of patients who might be more or less likely to show a significant clinical benefit from naltrexone prescription and to understand the causes of differential naltrexone efficacy. A new study that will appear in the September 15th issue of Biological Psychiatry suggests that alcohol dependent individuals with a family history of alcohol dependence may be more likely than alcohol dependent individuals without a family history of alcohol dependence to reduce their drinking in the laboratory when prescribed naltrexone.
Krishnan-Sarin and colleagues at the NIAAA Center for the Translational Neuroscience of Alcoholism studied alcohol consumption in the laboratory by alcohol-dependent individuals who were not seeking treatment. The participants were studied in the laboratory after 6 days of treatment with 0 mg (placebo), 50 mg, or 100 mg of naltrexone. The authors discovered that naltrexone decreased drinking in those with a family history of alcoholism and this effect was greatest with the highest naltrexone dose. However, it increased drinking in those without a family history of alcoholism and this effect was greatest at the highest naltrexone dose.