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Personalized Treatment of Alcohol Dependence

  • Substance Use and Related Disorders (JR McKay, Section Editor)
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Abstract

Pharmacogenetic and adaptive treatment approaches can be used to personalize care for alcohol-dependent patients. Preliminary evidence shows that variation in the gene encoding the μ-opioid receptor moderates the response to naltrexone when used to treat alcohol dependence. Studies have also shown moderating effects of variation in the gene encoding the serotonin transporter on response to serotonergic treatment of alcohol dependence. Adaptive algorithms that modify alcohol treatment based on patients’ progress have also shown promise. Initial response to outpatient treatment appears to be a particularly important in the selection of optimal continuing care interventions. In addition, stepped-care algorithms can reduce the cost and burden of treatment while maintaining good outcomes. Finally, matching treatment to specific problems present at intake or that emerge during treatment can also improve outcomes. Although all of these effects require replication and further refinement, the future of personalized care for alcohol dependence appears bright.

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Acknowledgments

Related work by the authors is supported by grants K24 AA13736 (to HRK) and K24 DA029062 and P01 AA016821 (to JRM) from the National Institutes of Health.

Disclosure

H. R. Kranzler: consulting fees from Alkermes, Gilead, GlaxoSmithKline, Lilly, Lundbeck, Pfizer, Roche, Sanofi-Aventis, and Solvay; research support from Merck; and honoraria from the American College of Neuropsychopharmacology’s Alcohol Clinical Trials Initiative (ACTIVE), which was supported by Lilly, Janssen, Schering Plough, Lundbeck, Alkermes, GlaxoSmithKline, Abbott, and Johnson & Johnson; J. R. McKay: consulting fees from Human Service Center.

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Authors and Affiliations

  1. Center for Studies of Addiction, Department of Psychiatry, Perelman School of Medicine of the University of Pennsylvania, 3900 Chestnut Street, Philadelphia, PA, 19104-6178, USA

    Henry R. Kranzler

  2. Center for Studies of Addiction, Department of Psychiatry, Perelman School of Medicine of the University of Pennsylvania, 3440 Market Street, Suite 370, Philadelphia, PA, 19104, USA

    James R. McKay

  3. Philadelphia Veterans Affairs Medical Center, 3900 Woodland St., Philadelphia, PA, 19104, USA

    Henry R. Kranzler & James R. McKay

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Correspondence to Henry R. Kranzler.

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Kranzler, H.R., McKay, J.R. Personalized Treatment of Alcohol Dependence. Curr Psychiatry Rep 14, 486–493 (2012). https://doi.org/10.1007/s11920-012-0296-5

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