Prospects for pharmacotherapies to treat alcohol use disorder: an update on recent human studies

Curr Opin Psychiatry. 2019 Jul;32(4):255-265. doi: 10.1097/YCO.0000000000000519.

Abstract

Purpose of review: The aim of this study was to provide an update on medication development efforts for alcohol use disorder (AUD) by reviewing recently published (past 2 years) human studies that evaluated medications' effects on alcohol-related outcomes.

Recent findings: Forty-five publications were found suitable for this review. A variety of compounds have been tested in the past 2 years as potential pharmacological options for AUD, including medications that act on multiple targets (topiramate, aripiprazole, quetiapine), calcium channels (gabapentin), gamma-Aminobutyric acid receptors (baclofen, diazepam), glutamate receptors (ifenprodil, memantine, glycine), nicotinic acetylcholine receptors (varenicline, mecamylamine), α1 adrenergic receptors (prazosin, doxazosin), neuroendocrine pathways (oxytocin, a vasopressin receptor 1b antagonist, a ghrelin receptor inverse agonist) and others (samidorphan, ibudilast, N-acetylcysteine, citoline). Important findings and limitations regarding the effects of these medications on alcohol-related outcomes are discussed.

Summary: There is a critical need to increase the armamentarium of medications for AUD. Human laboratory studies may help screen and prioritize promising targets and compounds before running large clinical trials. Given the complexity of AUD and the heterogeneity of afflicted patients, future studies should also investigate potential moderators and predictors of response to each pharmacological intervention.

Publication types

  • Research Support, N.I.H., Intramural
  • Review

MeSH terms

  • Adrenergic alpha-1 Receptor Antagonists / therapeutic use
  • Alcohol-Related Disorders / drug therapy*
  • Cholinergic Agonists / therapeutic use
  • GABA Modulators / therapeutic use
  • GABA-B Receptor Agonists / therapeutic use
  • Humans
  • Nicotinic Agonists / therapeutic use
  • Treatment Outcome

Substances

  • Adrenergic alpha-1 Receptor Antagonists
  • Cholinergic Agonists
  • GABA Modulators
  • GABA-B Receptor Agonists
  • Nicotinic Agonists