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Varenicline reduces alcohol self-administration in heavy-drinking smokers.

Abstract：

BACKGROUND:Alcohol and tobacco dependence are highly comorbid disorders, with preclinical evidence suggesting a role for nicotinic acetylcholine receptors (nAChRs) in alcohol consumption. Varenicline, a partial nicotinic agonist with high affinity for the alpha4beta2 nAChR receptor, reduced ethanol intake in rodents. We aimed to test whether varenicline would reduce alcohol consumption and alcohol craving in humans. METHODS:This double-blind, placebo-controlled investigation examined the effect of varenicline (2 mg/day vs. placebo) on alcohol self-administration using an established laboratory paradigm in non-alcohol-dependent heavy drinkers (n = 20) who were daily smokers. Following 7 days of medication pretreatment, participants were first administered a priming dose of alcohol (.3 g/kg) and subjective, and physiologic responses were assessed. A 2-hour alcohol self-administration period followed during which participants could choose to consume up to 8 additional drinks (each .15 g/kg). RESULTS:Varenicline (.5 +/- SE = .40) significantly reduced the number of drinks consumed compared to placebo (2.60 +/- SE = .93) and increased the likelihood of abstaining from any drinking during the self-administration period. Following the priming drink, varenicline attenuated alcohol craving and reduced subjective reinforcing alcohol effects (high, like, rush, feel good, intoxicated). Adverse events associated with varenicline were minimal and, when combined with alcohol, produced no significant effects on physiologic reactivity, mood, or nausea. CONCLUSIONS:This preliminary investigation demonstrated that varenicline significantly reduced alcohol self-administration and was well tolerated, alone and in combination with alcohol in heavy-drinking smokers. Varenicline should be investigated as a potential treatment for alcohol use disorders.

journal_name

Biol Psychiatry

journal_title

Biological psychiatry

authors

McKee SA,Harrison EL,O'Malley SS,Krishnan-Sarin S,Shi J,Tetrault JM,Picciotto MR,Petrakis IL,Estevez N,Balchunas E

doi

10.1016/j.biopsych.2009.01.029

subject

Has Abstract

pub_date

2009-07-15 00:00:00

pages

185-90

issue

eissn

0006-3223

issn

1873-2402

pii

S0006-3223(09)00112-7

journal_volume

pub_type

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Varenicline reduces alcohol self-administration in heavy-drinking smokers.