title: Fluvoxamine treatment of alcoholic amnestic disorder.
abstract: The serotonin uptake inhibitor fluvoxamine was assessed in treatment of alcohol-induced Korsakoff's syndrome (KS) using fixed (4 weeks, 200 mg/day) or individualized (6 weeks, plasma concentration > or = 400 ng/ml) dosing in randomized placebo-controlled double-blind crossover studies. Cognitive functions and concentrations of the major cerebrospinal fluid (CSF) metabolites of serotonin (5-HIAA), norepinephrine (MHPG), and dopamine (HVA) were determined in abstinent, nondepressed KS patients (aged 45-75), at baseline and placebo (3-4 weeks), and after 3-4 (n = 10) or 6 (n = 4) weeks of fluvoxamine administration. Fluvoxamine decreased CSF 5-HIAA compared to placebo (P < 0.003) without consistent changes in HVA or MHPG. Reductions in 5-HIAA correlated with improvements on the Wechsler Memory Scale Memory Quotient (P < 0.05), independent of effects on attention/vigilance or Beck Depression Inventory scores. Reductions in 5-HIAA correlated with plasma fluvoxamine (P < 0.03) only for fluvoxamine concentrations below 450 ng/ml. These findings suggest improvement of memory consolidation and/or retrieval in patients with Korsakoff's syndrome by fluvoxamine via serotonergic mechanisms.
authors.affiliation: Laboratory of Clinical Studies, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD 20892, USA.
authors.forename: P R
authors.initials: PR
authors.lastname: Martin
authors.forename: B
authors.initials: B
authors.lastname: Adinoff
authors.forename: E
authors.initials: E
authors.lastname: Lane
authors.forename: J M
authors.initials: JM
authors.lastname: Stapleton
authors.forename: G A
authors.initials: GA
authors.lastname: Bone
authors.forename: H
authors.initials: H
authors.lastname: Weingartner
authors.forename: M
authors.initials: M
authors.lastname: Linnoila
authors.forename: M J
authors.initials: MJ
authors.lastname: Eckardt
mesh_terms: D000368:Aged; D000425:Alcohol Amnestic Disorder / Q000188:drug therapy*; D003071:Cognition; D005260:Female; D016666:Fluvoxamine / Q000627:therapeutic use*; D006801:Humans; D006897:Hydroxyindoleacetic Acid / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D006897:Hydroxyindoleacetic Acid; D016666:Fluvoxamine