Unexpected Results with an Anti-Alcohol Drug

Naltrexone is commonly used to treat alcoholism, and it has been described as being very helpful. But a new study suggests that not all people respond the same way to the drug. There are two areas of uncertainty: first, where the genetic make-up of the person can produce a paradoxical reaction, and second, where an unmotivated person takes the drug.

Scientists at Brown University, Rhode Island, report that, in heavy-drinking volunteers, those possessing a particular gene called SNP respond to 10 days of naltrexone dosing with an increased desire for alcohol – just the reverse of the desired effect. They were asked to rate their urge to drink on being presented with their favorite alcoholic beverage on a scale from 0 to 10. Out of the 90 subjects, those who carried the SNP gene scored 5, compared with 2.5 scores for those on placebo. Interestingly, those without the SNP gene scored about 3.5 whether they received naltrexone or placebo. In other words, naltrexone didn’t have the desired effect in these subjects, either.

Earlier studies have shown that naltrexone clearly works in a clinical setting. The scientists conclude that the principal difference in their study is that the subjects were heavy drinkers who were not particularly desirous of giving up their ways, while in the clinical studies leading to the drug’s approval, all the volunteers wanted to stop drinking.

These findings show that there’s often more to learn before one just ‘takes a pill’. Let the patient beware!