title: Varenicline and neuronal nicotinic acetylcholine receptors: a new approach to the treatment of co-occurring alcohol and nicotine addiction?
abstract: OBJECTIVE
  Alcohol and nicotine dependence are serious public health problems worldwide. They are associated with substantial morbidity and mortality, as well as adverse social effects and increased healthcare costs. Although efficacious treatments are available for these disorders, additional therapeutic options are required to ensure greater treatment utilization. In this paper, we describe the empirical basis on which varenicline, a nicotinic partial agonist approved for smoking cessation, may also have utility in the treatment of alcohol addiction.
  
  
  METHODS
  We sought to identify papers examining nicotine dependence, alcohol dependence, smoking, alcohol, and varenicline for possible inclusion in the present review. We identified over 600 papers through Pubmed/Medline, PsychINFO, and Google Scholar. We found 12 papers taking into consideration the following criteria: original language English, varenicline effect on alcohol consumption.
  
  
  RESULTS
  Animal studies have shown that varenicline reduces alcohol consumption. Two recent studies showed that varenicline also reduces alcohol consumption in humans. Both nicotine and alcohol interact with α4β2 and α3β4 nicotinic acetylcholine (ACh) receptors located in the ventral tegmental area of the brain, inducing dopamine (DA) release at the nucleus accumbens. Varenicline binds to nicotinic ACh receptors, where it has partial agonist effects, producing a moderate and constant level of DA release both in the mesolimbic pathway and in the prefrontal cortex.
  
  
  CONCLUSIONS
  Through these effects, varenicline may reduce alcohol craving, seeking, and consumption, in addition to promoting smoking cessation. Additional studies are needed to confirm the efficacy of varenicline in the treatment of alcohol dependence.
authors: Department of Clinical Medicine, Sapienza-University of Rome, Italy.
authors: Roberto
authors: R
authors: Nocente
authors: Mario
authors: M
authors: Vitali
authors: Giuseppe
authors: G
authors: Balducci
authors: Domenico
authors: D
authors: Enea
authors: Henry R
authors: HR
authors: Kranzler
authors: Mauro
authors: M
authors: Ceccanti
mesh_terms: D000437:Alcoholism / Q000150:complications* / Q000188:drug therapy; D000818:Animals; D001552:Benzazepines / Q000627:therapeutic use*; D006801:Humans; D018722:Nicotinic Agonists / Q000627:therapeutic use*; D011810:Quinoxalines / Q000627:therapeutic use*; D014029:Tobacco Use Disorder / Q000150:complications* / Q000188:drug therapy; D000068580:Varenicline
chemical_list: D001552:Benzazepines; D018722:Nicotinic Agonists; D011810:Quinoxalines; D000068580:Varenicline