Pharmacotherapy in alcoholism treatment: integrating and understanding the use of serotonin reuptake inhibitors.
Recently, a new area of alcohol-related pharmacotherapy has emerged, namely, the use of drugs which decrease drinking by either decreasing the reinforcing effects of alcohol or by decreasing other CNS-related factors associated with craving and/or motivation to drink. Reinforcement and motivation, as distinct components of drug consumption, might each be therapeutically altered. Evidence suggests that serotonergic systems are involved in aspects of motivation and perhaps also reinforcement, and thus may be important targets for alcohol-related pharmacotherapies. There is a substantial body of animal model literature to support this hypothesis, and recent clinical findings using serotonin reuptake inhibitors (SSRIs) are also supportive. Effective alcoholism treatment strategies with SSRIs should include consideration of the positive and negative impact on reinforcement and motivational factors, through both pharmacological and psychosocial means. In this way, pharmacotherapy with SSRIs will become useful not merely as an adjunctive treatment for alcohol-related disorders, but will become an integral part of the treatment process. Recent indications from clinical trials suggest that this integration may produce a synergistic effect on eventual patient outcome and quality of life.
George
F R
FR
Southwest Institute for Drug and Alcohol Studies, Albuquerque, NM 87190, USA.
D000428:Alcohol Drinking / Q000235:genetics / Q000503:physiopathology / Q000523:psychology; D000437:Alcoholism / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D000818:Animals; D002986:Clinical Trials as Topic; D004195:Disease Models, Animal; D006801:Humans; D009042:Motivation; D051381:Rats; D012054:Reinforcement, Psychology; D012701:Serotonin / Q000502:physiology; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*
D012701:Serotonin; D017367:Selective Serotonin Reuptake Inhibitors