DNA highly-promising predictor for successful treatment of alcoholics
14 July 2006
According to Dutch researcher Wendy Ooteman, the biological and genetic characteristics of alcoholics can predict which drugs will best suppress the desire to drink. Naltrexone and acamprosate are drugs that are supposed to suppress the desire for a drink. The researcher investigated which patient characteristics were responsible for predicting the drug that would work best.
Alcoholics have an overwhelming urge to drink. That desire not only facilitates alcohol addiction but also ensures that the habit is difficult to kick. There are two drugs that can suppress this longing for alcohol: naltrexone works via the reward system in the brain and acamprosate via the stress system. However, they do not work for everybody. The question was whether patient characteristics can predict which drug works best for which patient.
Temptation
One hundred and fifty-six alcoholics were
willing to participate in Ootemans' study. The participants’ desire to drink
was aroused by, for example, placing a glass of their favourite drink on the
table. Meanwhile they were posed questions about their urge for a drink and
their physical reactions were measured, such as heart rate and sweat
production. Genetic characteristics were also determined. After a month of
treatment with naltrexone, acamprosate or a placebo the effect of clinical,
physiological or genetic differences on the success of the treatment was
examined.
Genetic indications
Clinical patient characteristics
were found to be a poor predictor of whether someone would respond best to
acamprosate or naltrexone. Biological and genetic characteristics could,
however, predict this. People who started to sweat profusely during the
experiment, responded better to acamprosate, whereas people who sweated less
profusely responded better to naltrexone. Further genes which code for certain
receptors in the brain predicted which drug would be successful for a patient. In particular, the genes that code for the mu-opioid receptor, the dopamine D2
receptor and a gaba receptor were found to be good predictors. This might be
because these genes are closely associated with the causes of addiction.
Further research
The question is whether these same
results will be found if longer term relapse is examined. It is expected that
in particular the highly-promising genetic characteristics will be used for a
more effective allocation of alcoholics to different treatments.
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For further information please contact:
- Wendy Ooteman (Amsterdam Institute for Addiction Research, Universiteit van Amsterdam)
- t: + 31 (0)6 1254 8665, w_ooteman@hotmail.com
- The doctoral thesis will be defended on 7 July 2006
- Supervisors Prof. Wim van den Brink and Prof. Roel Verheul
