Genetic markers have been identified that could help identify alcohol-dependent patients for whom the drug acamprosate may be beneficial. The researchers behind the study, from the Mayo Clinic in Rochester, MN – publish their findings in the journal Translational Psychiatry.
Acamprosate is commonly prescribed as part of alcohol recovery treatment. The drug works by restoring the chemical imbalances in the brain that occur when someone who is alcohol dependent quits drinking.
Along with counseling and behavior modification support, acamprosate is used to to help people who have recently given up drinking continue to abstain from alcohol. However, the drug may not be beneficial to people who have already quit drinking and undergone detoxification or people who are addicted to other drugs as well as alcohol.
The Mayo Clinic team recruited participants enrolled in community-based alcohol recovery programs who were being treated with acamprosate.
The researchers studied the association between genetic variations and the length of sobriety among the alcohol-dependent patients.
Taking into account environmental and physiological factors, the team found that patients with the genetic variant allele rs2058878 located in the GRIN2B gene stayed sober for more days than patients with another variant of this allele.
The researchers say these findings support previous studies suggesting that N-Methyl-D-aspartate receptors play a role in the effectiveness of acamprosate.
Dr. Victor Karpyak, Mayo Clinic psychiatrist and lead author of the article, says:
“This association finding is a first step towards development of a pharmacogenetic test allowing physicians to choose appropriate treatment for specific subgroups of alcohol-dependent patients.
We believe that individualized treatment selection will eliminate the need for trial-and-error approaches and improve treatment efficacy in patients with alcohol use disorders.”
Dr. Karpyak adds that more studies are needed in order to establish the importance of genetic variants and how they influence the effectiveness of acamprosate over the long term.
In May of this year, researchers of a study published in JAMA conducted a systematic review of 120 studies examining the effectiveness of medications to treat alcohol use disorders. They found that acamprosate and oral naltrexone had the strongest evidence for decreasing alcohol consumption.
- Alcohol use disorders result in 3-fold increased rates of early death
- Less than 10% of alcohol-dependent patients receive medication to assist in reducing consumption
- The longest-standing alcohol use disorder medication, disulfiram, has been prescribed since the 1950s, but evidence on its effectiveness is mixed.
However, a previous systematic review in 2011 focusing specifically on acamprosate found that the drug showed only “moderate benefit” in trials when used in combination with non-drug therapies.
Examining data from 24 randomized controlled trials, with a combined total of 6,915 alcohol-dependent patients, the researchers – from the University of Munich, Germany – found that acamprosate prevented relapse in every 1 in 9 patients and increased the number of alcohol-free days by an average of 3 days per month.
According to that study, patients who took acamprosate had an 86% risk of returning to drinking, compared with patients who took a placebo.
Lead researcher Susanne Rösner commented:
“Acamprosate is certainly no magic bullet, but it is a safe and effective treatment for patients who are trying to stop drinking. The benefits we have seen in these trials are small. However, we must remember that these are additional benefits on top of those from other non-drug therapies.”