Naltrexone Pharmacogenetics in Alcohol-dependent Patients

Abstract

<p>Naltrexone is an opioid receptor antagonist, approved by the Food and Drug Administration (FDA) for alcohol addiction, on the basis of two double-blind, placebo-controlled trials. Naltrexone reduces risk for relapse to heavy drinking (at daily doses of 50 to 100 mg orally), as demonstrated in more than 20 double-blind, placebo controlled trials. Naltrexone is not often prescribed for the treatment of alcohol addiction, in part because compliance with chronic oral dosing is difficult to maintain. This barrier may be diminished by the introduction of an injectable-depot naltrexone, also FDA approved for alcohol addiction.</p> <h4>ABOUT THE AUTHOR</h4> <p>Wade Berrettini, MD, PhD, is Karl E. Rickels Professor, Center for Neurobiology and Behavior, Department of Psychiatry, University of Pennsylvania School of Medicine.</p> <p>Address correspondence to: Wade Berrettini, MD, PhD, Room 2206, 125 S. 31st St., Philadelphia, PA 19104; or email <a href="mailto:wadeb@mail.med.upenn.edu">wadeb@mail.med.upenn.edu</a>.</p> <p>Dr. Berrettini has disclosed no relevant financial relationships.</p> <p>Supported in part by grants from the VISN 4 MIRECC Philadelphia Veterans Affairs Medical Center and National Institute of Drug Abuse Grant P60 DA 11835.</p> <h4>EDUCATIONAL OBJECTIVES</h4> <ol> <li>Identify that naltrexone reduces risk to relapse for heavy drinking but does not influence abstinence, according to results from more than 20 double-blind, placebo-controlled trials.</li> <li>Summarize the nature of the A118G variant on mu opioid receptor function, both in vitro and in vivo.</li> <li>Cite that Food and Drug Administration (FDA) requirements for restricting indications to specific genotypes for naltrexone will require multiple complex clinical trials.</li> </ol>