Investigational therapies for the pharmacological treatment of alcoholism

Abstract

Introduction: Alcohol dependence is one of the most important psychiatric disorders leading to enormous harm in individuals and indeed within society. Yet, although alcohol dependence is a disease of significant importance, the availability of efficacious pharmacological treatment is still limited.

Areas covered: The current review focuses on neurobiological pathways that are the rationale for recent preclinical and clinical studies testing novel compounds that could be used as treatments for alcohol dependence. These neurobiological mechanisms include the: glutamatergic, dopaminergic and GABA mediated pathways as well as neuroendocrine systems. There is also an interest in the approaches for influencing chromatin structure.

Expert opinion: There are several compounds in Phase I and Phase II clinical studies that have produced potentially useful results for the treating alcoholism. Further evaluation is still necessary, and the implementation of Phase III studies will help to elucidate the usefulness of these compounds. It is important that personalized approaches (e.g., pharmacogenomics) are investigated in these later studies, as the efficacy of different compounds may vary substantially between subgroups of patients.

Keywords:

• alcohol dependence
• heavy drinking
• Phase II studies
• preclinical studies

Acknowledgements

The content of this review is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Declaration of interest

T Hillemacher has received grants and honoraria from Lundbeck, Merz, Bristol-Myers-Squibb, Servier, AstraZeneca and Otsuka Pharmaceutical Co., Ltd. A Heberlein has received grants from Bristol-Myers-Squibb/Otsuka and Elli Lilly & Co. L Leggio’s work is supported by the Division of Intramural Clinical and Biological Research of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and the Intramural Research Program of the National Institute on Drug Abuse (NIDA). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

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