Abstract
Serotonergic agents remain an important area of pharmacologic study as treatments for alcoholism. Selective serotonin reuptake inhibitors (SSRIs) do not appear to be efficacious at treating a heterogeneous alcoholic group. SSRIs may, however, possess utility in treating later-onset alcoholics and alcoholism that is complicated by co-morbid major depression. The 5-HT(1A) partial agonist, buspirone, does not appear to be an efficacious treatment for alcoholics without co-morbid disease. Buspirone may, however, possess some utility in treating alcoholics with co-morbid anxiety disorder. Ritanserin, a 5-HT(2) antagonist, does not appear to be an efficacious treatment for alcoholism at pharmacologically relevant clinical doses. Ondansetron, a 5-HT(3) antagonist, is an efficacious and promising medication for the treatment of earlier-onset alcoholism. The differential treatment effect of SSRIs and ondansetron among various subtypes of alcoholics is intriguing. Future research is needed to more clearly understand the biopsychosocial differences that typify a particular alcoholic subtype. This type of understanding could develop our ability to make reasonable predictions as to what alcoholic subtype would respond best to a particular serotonergic agent, which could then be provided.
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