Effects of naltrexone and nalmefene on subjective response to alcohol among non-treatment-seeking alcoholics and social drinkers
Abstract
BACKGROUND: Despite the relative success of opiate antagonist medication within controlled clinical trials for alcoholism, laboratory studies have not fully examined potential mechanisms for their efficacy in alcohol-dependent persons. The present study evaluated the impact of naltrexone and nalmefene on craving and subjective effects after a moderate alcohol dose among non-treatment-seeking alcoholics (n = 125) and social drinkers (n = 90). METHODS: Participants were randomly assigned to receive placebo, naltrexone (titrated to 50 mg/day), or nalmefene (titrated to 40 mg/day) for seven days before an alcohol challenge clinical laboratory session. During the clinical laboratory session, a drink of alcohol (0.4 mg/kg for men, 0.34 mg/kg for women) was provided in a bar-like setting. The effects of the alcohol dose on subjective craving, stimulation, and sedation were measured before having free access to alcohol. RESULTS: Alcoholics reported higher levels of craving than social drinkers before and after the drink as well as higher levels of alcohol-induced stimulation. Both opiate antagonist medications suppressed initial increases in craving and stimulation. CONCLUSIONS: These findings demonstrate that both naltrexone and nalmefene are associated with reduced alcohol-induced craving and stimulation among alcoholics who are not actively attempting to reduce drinking. These data provide insights into potential mechanisms that may underlie opiate antagonists' effects in the context of treatment.
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Altering euphoric and pleasurable effects of alcohol is hypothesized to underlie in part the efficacy of opioid receptor antagonists, including naltrexone and nalmefene.
“The findings may have relevance to medication development, as altering euphoric and pleasurable effects of alcohol would be important targets for novel treatments and are hypothesized to underlie in part the efficacy of opioid receptor antagonists, including naltrexone and nalmefene(67–76).”
From A Prospective 5-Year Re-examination of Alcohol Response in Heavy Drinkers Progressing in Alcohol Use Disorder (2016) · cites this paper as [68]
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Pharmacogenetics of Addiction Therapy
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- Authors
- Drobes, D. J., Anton, R. F., Thomas, S. E., & Voronin, K.
- Affiliations
- Medical University of South Carolina (US)
- Corresponding author
- Drobes, David J.
- Venue
- Alcoholism Clinical and Experimental Research
- Publisher
- Wiley
- Published
- 2004-09
- Volume
- 28
- Issue
- 9
- Pages
- 1362-1370
- ISSN
- 0145-6008 (ISSN-L)
- 1530-0277
- OpenAlex
- W2032321294
- Cited by
- 140
- References
- 47
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2023: 7 · 2022: 5 · 2021: 4 · 2020: 4 · 2019: 6 · 2018: 5 · 2017: 9 · 2016: 10 · 2015: 16 · 2014: 7 · 2013: 8 · 2012: 8
- FWCI
- 3.58
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Alcoholism Clinical and Experimental Research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Alcohol Abuse and Alcoholism (P50AA010761)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Keywords
- naltrexone, nalmefene, opioid antagonists, alcohol craving, subjective effects of alcohol, alcoholism, social drinkers
- MeSH terms
- Adult, Aged, Alcohol Drinking, Alcoholism, Analysis of Variance, Female, Humans, Male, Middle Aged, Naltrexone, Behavior, Addictive
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