Naltrexone, relapse prevention, and supportive therapy with alcoholics: An analysis of patient treatment matching.

Jaffe, Adam B.; Rounsaville, Bruce J.; Chang, Grace; Schottenfeld, Richard S.; Meyer, Roger E.; O’Malley, Stephanie S.

doi:10.1037/0022-006x.64.5.1044

Cited by 123 publications

(70 citation statements)

References 31 publications

(67 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Exposure to environmental stimuli associated with drinking (such as pictures, smells, and places of ingestion) can strongly stimulate the 'urge' or desire to consume alcohol in alcohol-dependent individuals. In this context, craving for alcohol can be thought of as a useful target for both counseling and pharmacotherapies aimed at reducing alcoholism (Anton, 1999;Flannery et al, 2001;Jaffe et al, 1996). While it appears that craving is accompanied by changes in regional brain activity, what changes and what structures are most sensitive to cue-induced craving are beginning to be clearly elucidated.…”

Section: Discussionmentioning

confidence: 99%

Differential Brain Activity in Alcoholics and Social Drinkers to Alcohol Cues: Relationship to Craving

Myrick

Anton

et al. 2003

Neuropsychopharmacol

471

345

View full text Add to dashboard Cite

Using fMRI, our group previously found that after a sip of alcohol and exposure to alcohol beverage pictures, alcoholics compared to social drinkers had increased differential brain activity in the prefrontal cortex and anterior thalamus. This study extends this earlier work with several improvements including imaging the entire brain (rather than the anterior half previously) and recording craving, while the subjects viewed images within the scanner. In a Philips 1.5 T MRI scanner, 10 nontreatment-seeking alcoholics and 10 age-matched healthy social drinkers were given a sip of alcohol before viewing a 12 min randomized presentation of pictures of alcoholic beverages, nonalcoholic beverages, and two different visual control tasks. During picture presentation, changes in regional brain activity were measured in 15 transverse T2*-weighted blood oxygen level dependent slices. Subjects rated their urge to drink after each picture sequence. After a sip of alcohol, while viewing alcohol cues compared to viewing other beverage cues, the alcoholics, but not social drinkers, reported higher craving ratings and had increased activity in the prefrontal cortex and anterior limbic regions. Brain activity in the left nucleus accumbens, anterior cingulate, and left orbitofrontal cortex significantly correlated with subjective craving ratings in alcohol subjects but not in control subjects. This study suggests, as did our earlier study, that alcoholics and not social drinkers, when exposed to alcohol cues, have increased brain activity in areas that reportedly subserve craving for other addictive substances.

show abstract

Section: Discussionmentioning

confidence: 99%

Differential Brain Activity in Alcoholics and Social Drinkers to Alcohol Cues: Relationship to Craving

Myrick

Anton

et al. 2003

Neuropsychopharmacol

471

345

View full text Add to dashboard Cite

show abstract

“…48,49 Furthermore, treatment with naltrexone, an opiate antagonist, decreases ethanol consumption by alcoholic subjects. [47][48][49][50] Opioid content, biosynthesis, and release are altered after alcohol treatment, although there is considerable disagreement regarding the direction of changes in the activity of the endogenous opioid system by alcohol. 46 We recently showed that Huh.8 cells express -opioid receptor and that morphine enhances HCV RNA expression in these cells (Li Y, unpublished data).…”

Section: Discussionmentioning

confidence: 99%

Alcohol Potentiates Hepatitis C Virus Replicon Expression

Zhang

Lai

et al. 2003

Hepatology

View full text Add to dashboard Cite

H epatitis C virus (HCV) is responsible for the vast majority of cases of transfusion-associated and community-acquired non-A, non-B hepatitis 1,2 and infects an estimated 170 million people worldwide. 3 The seroprevalence of anti-HCV antibody in the United States has been estimated at 1.8%, which corresponds to approximately 4 million people. 4 HCV is the leading cause of chronic viral hepatitis in the United States, 5 and HCV-infected individuals are the major recipients of liver transplantation. HCV, first molecularly cloned in 1989, 1 is a positive-strand RNA virus of the flavivirus family with a genome size of ϳ10 kb, which encodes a number of structural (core, E1, E2, and p7) and nonstructural (NS2, NS3, NS4A, NS4B, NS5A and NS5B) proteins. 6 HCV has at least 6 distinct but related genotypes with more than 50 subtypes, and genotype 1 is the most common in the United States, Europe, and most parts of Asia. HCV typically escapes clearance by the host's immune system and leads to the establishment of a persistent infection in approximately 70% of infected individuals. 7 The consequences of a subset of patients with chronic HCV infection are cirrhosis, liver failure, and hepatocellular carcinoma. 8,9 Treatment of HCV with interferon alfa (IFN-␣) and ribavirin is associated with a sustained response rate of less than 50%. 7,10,11 These limited therapeutic efficacies and the absence of an effective HCV vaccine underscore the importance of research on factors that enhance HCV infection and compromise IFN-␣-based therapy.Alcohol is the most commonly used and abused drug in the United States. Alcohol abuse significantly affects morbidity and mortality from infectious diseases. 12 Alcohol consumption accelerates liver damage, diminishes therapeutic response to IFN-␣, and increases the rate of hepatocellular carcinoma in patients with chronic HCV

show abstract

“…The lack of efficacy of naltrexone in some alcohol-dependent patients has led to investigations that focus on questions regarding which patients are most benefited by this treatment. Indeed, some clinical trials have shown family history to be a predictor of treatment response (Jaffe et al, 1996;Monterosso et al, 2001).…”

Section: Introductionmentioning

confidence: 99%

A Functional Polymorphism of the μ-Opioid Receptor Gene is Associated with Naltrexone Response in Alcohol-Dependent Patients

Oslin

Berrettini

Kranzler

et al. 2003

Neuropsychopharmacol

551

399

View full text Add to dashboard Cite

This study examined the association between two specific polymorphisms of the gene encoding the m-opioid receptor and treatment outcomes in alcohol-dependent patients who were prescribed naltrexone or placebo. A total of 82 patients (71 of European descent) who were randomized to naltrexone and 59 who were randomized to placebo (all of European descent) in one of three randomized, placebo-controlled clinical trials of naltrexone were genotyped at the A +118 G (Asn40Asp) and C +17 T (Ala6Val) SNPs in the gene encoding the m-opioid receptor (OPRM1). The association between genotype and drinking outcomes was measured over 12 weeks of treatment. In subjects of European descent, individuals with one or two copies of the Asp40 allele treated with naltrexone had significantly lower rates of relapse (p ¼ 0.044) and a longer time to return to heavy drinking (p ¼ 0.040) than those homozygous for the Asn40 allele. There were no differences in overall abstinence rates (p ¼ 0.611), nor were there differences in relapse rates or abstinence rates between the two genotype groups among those assigned to placebo. These preliminary results are consistent with prior literature demonstrating that the opioid system is involved in the reinforcing properties of alcohol and that allelic variation at OPRM1 is associated with differential response to a m-receptor antagonist. If replicated, these results would help to identify alcohol-dependent individuals who may be most likely to respond to treatment with naltrexone.

show abstract

Naltrexone, relapse prevention, and supportive therapy with alcoholics: An analysis of patient treatment matching.

Cited by 123 publications

References 31 publications

Differential Brain Activity in Alcoholics and Social Drinkers to Alcohol Cues: Relationship to Craving

Differential Brain Activity in Alcoholics and Social Drinkers to Alcohol Cues: Relationship to Craving

Alcohol Potentiates Hepatitis C Virus Replicon Expression

A Functional Polymorphism of the μ-Opioid Receptor Gene is Associated with Naltrexone Response in Alcohol-Dependent Patients

Contact Info

Product

Resources

About