title: Pharmacogenetics of alcohol use disorders and comorbid psychiatric disorders.
abstract: Alcohol use disorders (AUDs) represent a significant health burden worldwide. Currently, there are three medications approved by the U.S. Food and Drug Administration for the treatment of AUDs, and other drugs are being prescribed off-label for this purpose. However, response rates for pharmacologic treatment are low, and extant research suggests that treatment effects may partially depend on genetic factors. Personalized medicine, or using a patient's genetics and/or personal history to determine efficacy of treatment prior to prescription, is an emerging tool that will help clinicians treat their patients more effectively and safely. This review systematically discusses current findings from AUD pharmacotherapy trials examining disulfiram, acamprosate, naltrexone, the injectable naltrexone, and topiramate. Furthermore, it presents pharmacogenetics findings associated with these medications in an attempt to further the field of personalized medicine. Research from trials examining AUDs and comorbid major depressive disorder and anxiety disorders is also presented, and pharmacogenetic findings for these treatments are discussed. Lastly, the authors comment on the present and future states of the field of personalized medicine for AUD.
authors.affiliation: Laboratory of Clinical Genomics and Experimental Therapeutics, National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, MD, USA.
authors.forename: Sarah G
authors.initials: SG
authors.lastname: Helton
authors.affiliation: Laboratory of Clinical Genomics and Experimental Therapeutics, National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, MD, USA. Electronic address: falk.lohoff@nih.gov.
authors.forename: Falk W
authors.initials: FW
authors.lastname: Lohoff
mesh_terms: D000077443:Acamprosate; D000427:Alcohol Deterrents / Q000627:therapeutic use; D019973:Alcohol-Related Disorders / Q000188:drug therapy* / Q000453:epidemiology; D001008:Anxiety Disorders / Q000188:drug therapy* / Q000453:epidemiology; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000453:epidemiology; D004221:Disulfiram / Q000627:therapeutic use; D005632:Fructose / Q000031:analogs & derivatives / Q000627:therapeutic use; D006801:Humans; D009271:Naltrexone / Q000627:therapeutic use; D010597:Pharmacogenetics; D057285:Precision Medicine / Q000379:methods / Q000639:trends*; D013654:Taurine / Q000031:analogs & derivatives / Q000627:therapeutic use; D000077236:Topiramate; D014481:United States
chemical_list: D000427:Alcohol Deterrents; D000077236:Topiramate; D013654:Taurine; D005632:Fructose; D009271:Naltrexone; D000077443:Acamprosate; D004221:Disulfiram
keywords: Alcohol dependence; Genetics; Personalized medicine; Pharmacotherapy; Psychiatric comorbidity; Treatment response