Medications acting on the dopaminergic system in the treatment of alcoholic patients.
An extensive literature supports the role of dopamine in the development and maintenance of alcohol dependence. Yet the organization of brain dopamine is complex, with multiple dopamine receptor subtypes and distinct effects on reinforcement, craving, motivation and behavior. Several modestly effective pharmacological treatments for alcoholism, including naltrexone, baclofen and ondansetron, affect dopaminergic systems indirectly. Direct dopamine antagonists, including tiapride, quetiapine, ondansetron and clozapine have been shown to be somewhat effective in reducing alcohol consumption in controlled clinical trials. The partial dopamine agonist, aripiprazole has shown mixed efficacy. Dopaminergic medications can have significant side effects. A better understanding of how dopamine affects the various aspects of addictive behavior may lead to more effective medications.
Swift
Robert
R
Brown University Center for Alcohol and Addiction Studies, 121 South Main Street, Room 404, Providence, RI 02903, USA. Robert_Swift@brown.edu
D000428:Alcohol Drinking / Q000517:prevention & control; D000437:Alcoholism / Q000188:drug therapy* / Q000503:physiopathology; D000818:Animals; D016739:Behavior, Addictive / Q000188:drug therapy; D001921:Brain / Q000378:metabolism; D018849:Controlled Clinical Trials as Topic; D004298:Dopamine / Q000378:metabolism*; D015259:Dopamine Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D018492:Dopamine Antagonists / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D011954:Receptors, Dopamine / Q000187:drug effects / Q000378:metabolism
D015259:Dopamine Agents; D018492:Dopamine Antagonists; D011954:Receptors, Dopamine; D004298:Dopamine