Pharmacogenetically driven treatments for alcoholism: are we there yet?

CNS Drugs
Albert Arias, R Andrew Sewell

Abstract

Pharmacogenetic analyses of treatments for alcohol dependence attempt to predict treatment response and side-effect risk for specific medications. We review the literature on pharmacogenetics relevant to alcohol dependence treatment, and describe state-of-the-art methods of pharmacogenetic research in this area. Two main pharmacogenetic study designs predominate: challenge studies and treatment-trial analyses. Medications studied include US FDA-approved naltrexone and acamprosate, both indicated for treating alcohol dependence, as well as several investigational (and off-label) treatments such as sertraline, olanzapine and ondansetron. The best-studied functional genetic variant relevant to alcoholism treatment is rs1799971, a single-nucleotide polymorphism in exon 1 of the OPRM1 gene that encodes the μ-opioid receptor. Evidence from clinical trials suggests that the presence of the variant G allele of rs1799971 may predict better treatment response to opioid receptor antagonists such as naltrexone. Evidence from clinical trials also suggests that several medications interact pharmacogenetically with variation in genes that encode proteins involved in dopaminergic and serotonergic neurotransmission. Variation in the DRD4 gene, ...Continue Reading

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Citations

Jul 25, 2013·CNS Drugs·Mark J Niciu, Albert J Arias
Jul 3, 2015·Brain Sciences·Joan Y Holgate, Selena E Bartlett
Dec 20, 2013·Depression and Anxiety·Mark J NiciuCarlos A Zarate
Apr 15, 2014·The American Journal on Addictions·Albert J AriasIsmene L Petrakis
Mar 30, 2018·Frontiers in Physiology·Rajeswari KoyyadaStefano O Casalotti
Nov 19, 2013·The World Journal of Biological Psychiatry : the Official Journal of the World Federation of Societies of Biological Psychiatry·Eri HashimotoToshikazu Saito

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