kaytedidnt:

The drug ondansetron (Zofran) appears to help some alcoholics–those whose drinking problem began when they are 25 or younger–cut back or stop drinking, according to a new report.

“This study demonstrates and provides hope for individuals with early-onset alcoholism,” the study’s lead author, Dr. Bankole A. Johnson, of the University of Texas Health Science Center in San Antonio, told Reuters Health in an interview. “Treatment to help them is available,” he said. Johnson explained that alcoholism that begins at an early age tends to be more severe than alcoholism that starts later in life. Treatment is often more difficult in people whose alcoholism begins early, who are more likely to be biologically predisposed to alcoholism.

But Johnson’s team found that ondansetron, which was developed to relieve nausea and vomiting caused by chemotherapy, helps people with early-onset alcoholism drink less often or even quit. Over the course of 11 weeks, alcoholics taking the drug were abstinent 40% more often than those taking a placebo (an inactive pill), the researchers report in the August 23/30 issue of The Journal of the American Medical Association. Those taking the drug also drank less than half as much as those taking the placebo. But the drug did not help people whose alcoholism started later in life, according to the report.

The study included 271 people, average age 40, who were diagnosed with alcoholism. At the start of the study, study participants were not required to abstain from alcohol, but all said that they would like to quit drinking. For 1 week, all participants took a placebo each day. For the next 11 weeks, they were randomly assigned to taking a low, medium or high dose of the drug, or to continue taking the placebo. Everyone in the study also participated in group therapy.

Glaxo Wellcome provided the drug used in the study. In his comments to Reuters Health, Johnson said that ondansetron works by regulating dopamine, a brain chemical involved in feelings of pleasure. By reducing the release of dopamine, the drug takes some of the fun out of drinking, he explained.

“(Drinkers) don’t get the same buzz or thrill” from alcohol, according to Johnson, so “it’s not worth drinking.”

Interestingly, in people with less severe alcoholism, which tends to develop later in life, drugs called selective serotonin reuptake inhibitors (SSRIs), which have the opposite effects of medications like ondansetron, have been shown to reduce drinking.

Earlier this year, Johnson and colleagues published a preliminary study suggesting that another drug, naltrexone, “boosts” the effects of ondansetron when used in combination. But this finding needs to be confirmed in future studies, Johnson explained. He also noted that it is uncertain how long alcoholics will need to take ondansetron or other such drugs to stay sober.

Even though the Food and Drug Administration approved naltrexone for the treatment of alcoholism, prescriptions of the drug have been lower than expected, perhaps because physicians underdiagnose alcoholism or are pessimistic about the odds of curing the condition, Dr. Henry R. Kranzler, of the University of Connecticut Health Center in Farmington, notes in an accompanying editorial. And when doctors do diagnose alcoholism, they most commonly advise patients to join Alcoholics Anonymous, some of whose members may be opposed to using medications to treat alcoholism, Kranzler adds.

But new studies that prove the effectiveness of medications to treat alcoholism “promise to add alcohol dependence to that group of behavior disorders that can be effectively diagnosed and treated,” he writes.