As researchers continue to find medications that will reduce craving in those who are trying to stop drinking, scientists at the University of Texas Health Science Center at San Antonio discovered that the medication ondansetron may be an effective therapy -- especially for patients with early-onset alcohol dependence.
Ondansetron appears to work by acting on serotonin, one of the brain's many neurotransmitters. An imbalance between two chemical messengers in the brain, serotonin and dopamine, is believed to create a craving for alcohol.
In the study, 271 patients with diagnosed alcoholism were randomly selected to receive one of three different doses of either ondansetron or a placebo for 11 weeks.
The ondansetron patients with early-onset alcoholism had fewer drinks per day and reported more days without drinking at all, compared to the other groups in the study. Everyone in the study group also participated in weekly group cognitive behavioral psychotherapy.
Early-Onset Alcoholics
"Dr. Johnson's findings are consistent with a lengthy literature on serotonin dysfunction among early-onset alcoholics," said NIAAA Director Enoch Gordis, M.D. "If confirmed in future studies, they may predict new treatments for a subgroup of patients who often are resistant to behavioral therapies alone.""Early-onset" alcoholics are those who develop problem drinking before age 25, and are believed to have a biological predisposition toward alcoholism, according to researchers. They represent about 3.5 million of the nation's alcoholics, said Dr. Bankole Johnson, a psychiatrist who led the study.
Early-onset alcoholics have a "greater family history of alcoholism, increased propensity for antisocial behaviors, and a more stable and severe disease state than those with late-onset alcoholism," according to the NIAAA.
The early-onset alcoholics historically are not helped by counseling, exhibit anti-social behavior and have a high relapse rate when they attempt to stop drinking.
"The findings could lead to better ways to treat alcoholism and to tailor treatment to specific types of alcoholics," Dr. Henry Kranzler of the University of Connecticut said in the August issue of the Journal of the American Medical Association.
Ondansetron, manufactured by Glaxo Wellcome Inc., is FDA-approved for the treatment of chemotherapy-induced nausea at doses much larger than those used in the alcoholism study. The National Institute on Alcohol Abuse and Alcoholism funded the Texas study.
