Abstract
Preclinical studies, using various models, have consistently shown that serotonin uptake inhibitors (SUI) decrease alcohol consumption in rats in a dose-related manner. Similarly, in four (zimeldine, citalopram, viqualine, fluoxetine) short-term (2 to 4 weeks of treatment) randomized, double–blind studies, patients with moderate dependence on alcohol showed a dose-dependent decrease in alcohol consumption. Number of drinks decreased from baseline by averages of 15% to 20%, with some subjects showing a 60% decrease. The effect on alcohol consumption is not due to toxicity, antianxiety or antidepressant effects of SUI or to aversive interactions with alcohol. Side effects have generally been mild and few. Subjects who correctly believed that they received a SUI did not respond differently than those who believed they received placebo, so expectation was not responsible for SUI effects. SUI (e.g. citalopram) decrease the desire and liking for alcohol as well as consumption. Changes in these variables correlated, suggesting a possible mechanism of action. SUI seem to have a differential effect on addictive behaviors since cigarette smoking did not decrease and consumption of nonalcoholic beverages was unaltered. Slight weight losses were observed, probably due to decreased appetite and food intake, since variations in alcohol intake were not correlated with changes in body weight. SUI are one of the most promising psychopharmacological agents available for treating alcoholics. They may act by decreasing desire to drink and the reinforcing properties of alcohol making them uniquely suitable for relapse prevention strategies. Evaluation of their long-term effects in conjunction with behavioral interventions continues.
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Naranjo, C.A., Bremner, K.E. (1992). Evaluation of the Effects of Serotonin Uptake Inhibitors in Alcoholics: A Review. In: Naranjo, C.A., Sellers, E.M. (eds) Novel Pharmacological Interventions for Alcoholism. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-2878-3_9
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DOI: https://doi.org/10.1007/978-1-4612-2878-3_9
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