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Fine-tuning naltrexone treatment for alcoholics

  • In 1994, the Food and Drug Administration approved naltrexone for the treatment of alcoholism.
  • It has since proven to be highly effective for many in recovery, but it does not work for everyone.
  • A recent study has found that individual metabolism may be a factor in naltrexone's effectiveness.
  • Its effectiveness can, in turn, be partially determined by measuring blood levels for naltrexone and its major metabolite, 6-beta-naltrexol.

The 1994 approval of naltrexone by the federal Food and Drug Administration was a milestone in the treatment of alcoholism. Naltrexone is a medication that decreases the rewarding effects of drinking and reduces the craving for alcohol that often leads people to relapse. Yet despite its effectiveness for many recovering alcoholics, it does not work for everyone. A study in the September issue of Alcoholism: Clinical & Experimental Research has found that, first, naltrexone's effectiveness may be influenced by individual metabolism, and second, this may be detected by measuring blood levels for the medication's major metabolite, 6-beta-naltrexol.

"Determining blood levels may be useful for patients who are not helped by the standard naltrexone dose," explained Mary E. McCaul, associate professor at Johns Hopkins University School of Medicine and lead author of the study. "This study demonstrates the importance of adjusting naltrexone dosage to ensure than an adequate blood level of 6-beta-naltrexol is achieved. If an individual does not achieve a therapeutic effect at the standard naltrexone dose of 50 milligrams per day, he or she may want to discuss a dose increase with the prescribing physician."

McCaul explained that drugs can have agonist and/or antagonist properties. Agonists activate a receptor to achieve their effect. Antagonists block the receptor from being activated by another endogenous (produced within the organism) or exogenous (produced outside the organism) chemical, bu
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Contact: Mary E. McCaul, Ph.D.
betsymc@jhmi.edu
410-955-5439
Alcoholism: Clinical & Experimental Research
13-Sep-2000


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