Cited by 152Substance Abuse Treatment and OutcomesNeurotransmitter Receptor Influence on BehaviorAlcohol Consumption and Health Effects

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Medication Treatment of Different Types of Alcoholism

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Johnson, Bankole A.·2010·American Journal of Psychiatry

DOI 10.1176/appi.ajp.2010.08101500PMC PMC2939449

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Abstract

Alcoholism remains a serious cause of morbidity and mortality despite progress through neurobiological research in identifying new pharmacological strategies for its treatment. Drugs that affect neural pathways that modulate the activity of the cortico-mesolimbic dopamine system have been shown to alter drinking behavior, presumably because this dopaminergic system is closely associated with rewarding behavior. Ondansetron, naltrexone, topiramate, and baclofen are examples. Subtyping alcoholism in adults into an early-onset type, with chronic symptoms and a strong biological predisposition to the disease, and a late-onset type, typically brought on by psychosocial triggers and associated with mood symptoms, may help in the selection of optimal therapy. Emerging adults with binge drinking patterns also might be aided by selective treatments. Although preliminary work on the pharmacogenetics of alcoholism and its treatment has been promising, the assignment to treatment still depends on clinical assessment. Brief behavioral interventions that encourage the patient to set goals for a reduction in heavy drinking or abstinence also are part of optimal therapy.

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Boas, G. R. V., Zamboni, C. G., Peretti, M. C., Correia, D., Rueda, A. V. L., Camarini, R., Godard, A. L. B., & Boerngen-Lacerda, R. (2012) · Pharmacology Biochemistry and Behavior · doi:10.1016/j.pbb.2012.04.011 · Cited by 21
Effects of naltrexone on alcohol drinking patterns and extinction of alcohol seeking in baboons
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“1999) and/or decreasing motivation to drink (Johnson et al. 2004; Johnson 2010), although specific effects on urges to drink in clinical trials are unclear.”
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Orrù, A., Fujani, D., Cassina, C., Conti, M., Clemente, A. D., & Cervo, L. (2012) · Psychopharmacology · doi:10.1007/s00213-012-2672-6 · Cited by 20
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“The idea that certain medications may be more or less effective for certain types of drinkers has been proposed (Johnson, 2010).”
Background
Multidisciplinary View of Alcohol Use Disorder: From a Psychiatric Illness to a Major Liver Disease
Gitto, S., Golfieri, L., Caputo, F., Grandi, S., & Andreoné, P. (2016) · Biomolecules · doi:10.3390/biom6010011 · Cited by 20
“A substantial heterogeneity can be found among patients with AUD regarding age of onset, kind of drinking (continuous or binge), alcohol metabolism (worst in females) and presence or absence of associated psychiatric disorder [12].”
Background
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Schlaff, G., Walter, H., & Lesch, O. (2011) · Europe PMC (PubMed Central) · Cited by 20
Alcoholism and Substance Abuse
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Are Some Alcohol Use Disorder Criteria More (or Less) Externalizing than Others? Distinguishing Alcohol Use Symptomatology from General Externalizing Psychopathology
McDowell, Y. E., Verges, A. J., & Sher, K. J. (2019) · Alcoholism Clinical and Experimental Research · doi:10.1111/acer.13952 · Cited by 19
“In recent years, researchers have focused on identifying AUD subgroups with shared pathophysiology who may be more likely to respond to certain medications to improve medication efficacy (e.g., Johnson, 2010).”
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Holt, S. R., & Tobin, D. G. (2018) · Medical Clinics of North America · doi:10.1016/j.mcna.2018.02.008 · Cited by 17
Acute and chronic administration of a low-dose combination of topiramate and ondansetron reduces ethanol’s reinforcing effects in male alcohol preferring (P) rats.
Moore, C. F., Lycas, M. D., Bond, C. W., Johnson, B. A., & Lynch, W. J. (2014) · Experimental and Clinical Psychopharmacology · doi:10.1037/a0035215 · Cited by 17
“, serotonin, glutamate, GABA), this combination has potential for a promising treatment, particularly for early onset alcoholics (Johnson, 2008; Johnson, 2010).”
Self-citation
Pharmacological Treatments for Alcohol Use Disorder: Considering the Role of Sex and Gender
Kirsch, D. E., Belnap, M. A., Burnette, E. M., Grodin, E. N., & Ray, L. A. (2024) · Current Addiction Reports · doi:10.1007/s40429-023-00535-x · Cited by 16
“To that end, a major goal is to further identify subgroups of treatment responders and possible factors that mediate pharmacotherapy treatment response [9].”
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Soufia, M., Plaze, M., Gueguen, B., Demigneux, G., Olié, J., & Raphaël Gaillard, B. (2010) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0b013e3181fb7b97 · Cited by 16
Multiday administration of ivermectin is effective in reducing alcohol intake in mice at doses shown to be safe in humans
Yardley, M. M., Neely, M. N., Huynh, N., Asatryan, L., Louie, S. G., Alkana, R. L., & Davies, D. L. (2014) · Neuroreport · doi:10.1097/wnr.0000000000000211 · Cited by 16
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Long-term Management of Alcoholic Liver Disease
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Alcohol Abuse and Dependence
O’Connor, P. G. (2012) · Elsevier eBooks · doi:10.1016/b978-1-4377-1604-7.00032-4 · Cited by 13
Cocaine reverses the naltrexone-induced reduction in operant ethanol self-administration: The effects on immediate-early gene expression in the rat prefrontal cortex
Echeverry‐Alzate, V., Tuda-Arízcun, M., Bühler, K., Santos, Á., Giné, E., Olmos, P., Gorriti, M. Á., Huertas, E., de Fonseca, F. R., & López‐Moreno, J. A. (2012) · Neuropharmacology · doi:10.1016/j.neuropharm.2012.06.010 · Cited by 12
“), two clinically approved medications to treat binge ethanol consumption, ethanol abuse and dependence and to prevent relapse (Fuller and Gordis, 2001; Johnson, 2010; Mason, 2003; O'Brien et al., 1996; Spanagel and Zieglgänsberger, 1997).”
Cannabis Use Disorders
Duncan, P. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781139025515.013 · Cited by 12
Alcohol and UK recreational divers: consumption and attitudes.
Dowse, M. S. L., Cridge, C., Shaw, S. R., & Smerdon, G. R. (2012) · PubMed · Cited by 11
Amino-Terminal Pro-B-Type Brain Natriuretic Peptide: Screening for Cardiovascular Disease in the Setting of Alcoholism
Höfer, P., Syeda, B., Bergler-Klein, J. K., Friedrich, F., Lesch, O., Vyssoki, B., Binder, T. M., & Walter, H. (2011) · Alcohol and Alcoholism · doi:10.1093/alcalc/agr027 · Cited by 10
“It is evident that different subgroups, even if the subtype classification of alcoholism remains controversial, need different therapy approaches, concerning medical withdrawal and relapse prevention treatment (Johnson, 2010; Lesch et al., 2011).”
Background
Analysis of alcohol use disorders from the Nathan Kline Institute—Rockland Sample: Correlation of brain cortical thickness with neuroticism
Zhao, Y., Zheng, Z., & Castellanos, F. X. (2016) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2016.10.040 · Cited by 10
“To reduce deleterious health impacts and the associated economic loss, mechanistic understanding of AUD pathogenesis is required for developing more effective strategies for AUD prevention and treatment (Johnson, 2010; Litten et al., 2015; Reilly et al., 2014; Zahr et al., 2011).”
Background
Low-dose ondansetron: A candidate prospective precision medicine to treat alcohol use disorder endophenotypes
Johnson, B. A., Alho, H., Addolorato, G., Lesch, O. M., Chick, J., Liu, L., & Schuyler, V. (2024) · European Journal of Internal Medicine · doi:10.1016/j.ejim.2024.06.001 · Cited by 9
Self-citation
Disulfiram: An Anticraving Substance?
Müller, C. A., & Banas, R. (2011) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2010.10070943 · Cited by 10
Design of a randomized controlled trial examining the efficacy of oxytocin to enhance alcohol behavioral couple therapy
Flanagan, J. C., Joseph, J. E., Nietert, P. J., Back, S. E., & McCrady, B. S. (2019) · Contemporary Clinical Trials · doi:10.1016/j.cct.2019.05.002 · Cited by 8
Should the Reorganization of Addiction-Related Research Across All the National Institutes of Health Be Structural?-The Devil Is Truly in the Details
Johnson, B. A., Messing, R. O., Charness, M. E., Crabbe, J. C., Goldman, M. S., Harris, R. A., Kranzler, H. R., Mitchell, M. C., Nixon, S. J., Riley, E. P., et al. (2011) · Alcoholism Clinical and Experimental Research · doi:10.1111/j.1530-0277.2011.01493.x · Cited by 7
“…and alcohol activate similar reward pathways and that cannabinoid receptors may be associated with the reinforcing effects of alcohol (SUAA Working Group, 2010), it has not been proven that targeting cannabinoid signaling is an efficacious strategy for treating alcohol dependence (Johnson, 2010b).”
Self-citation
Pharmacologically-mediated reactivation and reconsolidation blockade of the psychostimulant-abuse circuit: A novel treatment strategy
Lee, T. H., Szabo, S. T., Fowler, J. C., Mannelli, P., Mangum, O. B., Beyer, W. F., Patkar, A. A., & Wetsel, W. C. (2012) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2012.01.021 · Cited by 6
“Ondansetron has also shown to be useful in the treatment of alcohol withdrawal (Johnson, 2010).”
Response to Skodol Letter
Shedler, J., Beck, A. T., Fonagy, P., Gabbard, G. O., Kernberg, O. F., Michels, R., & Westen, D. (2011) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2010.10101466r · Cited by 6
Substance Use Disorders
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Treatments for Alcohol Dependence: Rethinking the Role of Comorbidity and Clinical Subtypes
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Introduction to the Special Issue “Pharmacotherapies for the Treatment of Alcohol Abuse and Dependence” and a Summary of Patents Targeting other Neurotransmitter Systems
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Abstinence dans l’alcoolodépendance : approche critique et actualisée des recommandations nationales de 2001
Rolland, B., Laprévote, V., Geoffroy, P. A., Guardia, D., Schwan, R., & Cottencin, O. (2012) · La Presse Médicale · doi:10.1016/j.lpm.2012.02.038 · Cited by 4
“boire (traitements anticraving), devra également s’intégrer à une médecine personnalisée du patient alcoolodépendant [29].”
Alcoholism: The Self-Reinforcing Feedback Loop
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Health Psychology in Australia
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Alcoholism and Substance Abuse
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What Can General Medical Providers Do for Hospitalized Patients with Alcohol Dependence After Discharge?
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Alcoholism and Sleep
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Authors: Johnson, B. A.
Affiliations: University of Virginia (US)
Corresponding author: Johnson, Bankole A.
ORCID: Johnson, Bankole A.
Venue: American Journal of Psychiatry
Publisher: American Psychiatric Association Publishing
Published: 2010-06-01
Volume: 167
Issue: 6
Pages: 630-639
ISSN: 0002-953X (ISSN-L)
1535-7228
DOI: 10.1176/appi.ajp.2010.08101500
PMC: PMC2939449
OpenAlex: W2142440641
Cited by: 151
References: 72
Citations by year: 2026: 1 · 2025: 1 · 2024: 4 · 2023: 4 · 2021: 2 · 2020: 23 · 2019: 11 · 2018: 3 · 2017: 10 · 2016: 8 · 2015: 10 · 2014: 10 · 2013: 11 · 2012: 31
FWCI: 14.89
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: American Journal of Psychiatry (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: National Institute on Alcohol Abuse and Alcoholism (R01AA010522, R01AA013964, R01AA014628, U10AA011776, R01AA012964)
National Center for Research Resources (M01RR000847, M01-RR 00847)
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: alcoholism, pharmacological treatment of alcoholism, dopaminergic system, ondansetron, naltrexone, topiramate, baclofen, early-onset alcoholism, late-onset alcoholism, binge drinking, pharmacogenetics, brief behavioral intervention, abstinence
MeSH terms: Topiramate, Adult, Aged, Alcohol Deterrents, Alcoholism, Baclofen, Chronic Disease, Depressive Disorder, Female, Fructose, Humans, Hypothalamo-Hypophyseal System, Limbic System, Male, Naltrexone, Pituitary-Adrenal System, Ondansetron, Prefrontal Cortex, Receptors, Dopamine D2, Receptors, GABA, Young Adult

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