Naltrexone helps drunks. But not everyone

Women and mutants easily quit drinking
Ilya Shcheglov, STRF.ru  

In the treatment of alcoholism, a great difficulty is a decrease in the patient's desire to take a new dose of alcohol. In the case of formed alcoholism, the desire to experience the euphoria accompanying alcoholic intoxication again is the main reason for "breakdowns" even after high–quality treatment.

There are few drugs aimed at reducing the "craving for alcohol". One of the most effective is naltrexone. The mechanism of its action is associated with the blockade of opioid receptors of the mu type in the brain. Normally, these receptors are involved in pain suppression and stress reduction reactions. Many types of drugs, including alcohol, are able to bind with them and cause a person to feel pleasure and euphoria. By blocking the receptors, naltrexone neutralizes these effects, alcohol "ceases to act", and the patient gradually loses the desire to take alcohol.

However, as recently established by Canadian scientists from McGill University, naltrexone does not help everyone. It is effective in the treatment of women and people with a mutation in the OPRM1 gene encoding the mu type opioid receptor. The results of the work will be published in the June issue of the journal Alcoholism: Clinical & Experimental Research, but are already available on its website (Elaine Setiawan et al., The Effect of Naltrexone on Alcohol's Stimulant Properties and Self-Administration Behavior in Social Drinkers: Influence of Gender and Genotype).

We are talking about a specific mutation – A118G, in which adenine is replaced by guanine at a certain place in the OPRM1 gene. At the same time, in the receptor encoded by this gene, asparagine changes to aspartic acid. With this mutation, fewer opioid receptors of the mu type are produced, but a quantitative decrease is accompanied by an increase in their response to various pharmacological agents. For people with such a mutation, the risk of becoming addicted to alcohol is higher, but, as it turned out, naltrexone treatment is more effective for them.

The authors investigated the effect of naltrexone in 40 volunteers (20 men and 20 women) with domestic drunkenness aged 18 to 50 years for six days. All the subjects were genotyped to find out if there was an A118G mutation. After a course of naltrexone, the participants in the experiment received one dose of their preferred alcoholic beverage, after which they were informed that they could get another portion. It turned out that most women and carriers of this mutation refused to "continue the banquet" after treatment.

The authors believe that the results obtained are very important for the "personalization" of alcoholism treatment. "By collaborating, researchers and doctors could predict in advance from which type of treatment the patient will receive the maximum benefit," the EurekAlert portal (Certain populations may benefit most from alcohol–dependence treatment naltrexone) quotes the lead author of the work Marco Leyton.

Portal "Eternal youth" http://vechnayamolodost.ruFriday, 25.03.2011