Aripiprazole for relapse prevention and craving in alcohol use disorder: current evidence and future perspectives.
BACKGROUND
Among other approaches, the modulation of the dopaminergic pathway has been advocated in the therapeutic management of Alcohol Use Disorders (AUD). A potential avenue toward the modulation of the dopaminergic pathway across varying substance disorders seems to be provided by aripiprazole, a second-generation antipsychotic characterized by a peculiar pharmacodynamics signature.


METHODS
In this review, the authors provided a qualitative synthesis and a critical perspective on the efficacy of aripiprazole in relapse prevention and craving in AUD. A systematic search was carried out through MEDLINE/Embase/PsycINFO/Cochrane Library from inception until September 2015, combining free terms and MESH headings for the topics of AUD and aripiprazole as following: (((Alcohol use Disorder) OR (Alcohol use)) AND aripiprazole).


CONCLUSIONS
Based both on a qualitative synthesis and a critical interpretation of the evidence, the authors submit that aripiprazole would promote alcohol abstinence and reduce the alcohol seeking behaviour possibly via dopaminergic and serotoninergic modulations at the fronto-subcortical circuits underpinning alcohol reward and craving, impulsive behaviour as well as reduce alcohol-related anxiety/low mood and anhedonia. However, due to the lack of published studies, a conclusive statement about any direct effect of aripiprazole in the prevention of craving and/or alcohol consumption is not possible.
a Department of Neuroscience, Imaging and Clinical Science , University of 'G. D'Annunzio' , Chieti , Italy.|b School of Life and Medical Sciences , University of Hertfordshire , Herts , UK.
Giovanni
G
Martinotti
b School of Life and Medical Sciences , University of Hertfordshire , Herts , UK.|c Villa S. Giuseppe Hospital, Hermanas Hospitalarias , Ascoli Piceno , Italy.|d Polyedra Research, Polyedra , Teramo , Italy.|e Department of Psychiatry and Neuropsychology , Maastricht University , Maastricht , Netherlands.
Laura
L
Orsolini
d Polyedra Research, Polyedra , Teramo , Italy.|f New York State Psychiatric Institute , Columbia University , New York , NY , USA.
Michele
M
Fornaro
c Villa S. Giuseppe Hospital, Hermanas Hospitalarias , Ascoli Piceno , Italy.|d Polyedra Research, Polyedra , Teramo , Italy.|e Department of Psychiatry and Neuropsychology , Maastricht University , Maastricht , Netherlands.
Roberta
R
Vecchiotti
a Department of Neuroscience, Imaging and Clinical Science , University of 'G. D'Annunzio' , Chieti , Italy.|d Polyedra Research, Polyedra , Teramo , Italy.|g NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment , Hospital 'G. Mazzini' , Teramo , Italy.
Domenico
D
De Berardis
h Laboratory of Molecular Psychiatry and Psychopharmacotherapeutics, Section of Psychiatry, Department of Neuroscience , University School of Medicine 'Federico II' , Naples , Italy.
Felice
F
Iasevoli
i Addiction Research and Human Pharmacology Groups, Neurosciences Research Program , IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Institute of Neuropsychiatry and Addictions , Barcelona , Spain.
Marta
M
Torrens
a Department of Neuroscience, Imaging and Clinical Science , University of 'G. D'Annunzio' , Chieti , Italy.
Massimo
M
Di Giannantonio
D000428:Alcohol Drinking / Q000517:prevention & control; D000437:Alcoholism / Q000188:drug therapy* / Q000523:psychology; D000818:Animals; D014150:Antipsychotic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D000068180:Aripiprazole / Q000494:pharmacology / Q000627:therapeutic use*; D066249:Craving / Q000187:drug effects; D006801:Humans; D007175:Impulsive Behavior / Q000187:drug effects; D012201:Reward; D055502:Secondary Prevention / Q000379:methods
D014150:Antipsychotic Agents; D000068180:Aripiprazole
Alcohol; alcohol addiction; alcohol dependence; alcohol use disorder; aripiprazole; craving