Posted by barbaracat on December 11, 2004, at 2:11:07
In reply to Other new meds for alcohol cravings, posted by mikialzed on December 7, 2004, at 10:43:02
I'm doing a serious research on alcohol right now because I have had my last embarassing humliating binge and am committed to stopping. What I've been finding out is that alcohol primarily affects the D2 receptors which do not so much account for the lovely calm feelings (hitting the GABA and opiate receptors take care of that within the first 20 minutes). It's the D2 receptors, or pleasure seeking stimulus, which account for the subsequent craving and which make it so hard to stick with it. Some people are simply genetically deficient in these receptors which revisits the alcoholism as a disease theory. Others burn them out with abuse. Takes about 90 days to regenerate, so if you can hold on that long and you're not genetically deficient...
Some interesting studies where they've bred mice without D2 receptors were poor little mouse boozers, then genetically introduced D2 and they quit on their own - until it wore off.
This doesn't answer your specific question, and I wish I could recall some of the drugs I skimmed past, but in my searching I came across some new promising drugs in the pipeline and some older ones that work on dopamine. You've already tried Wellbutrin. They found it doesn't affect D2 receptors specifically. Unfortunately, the ADHD meds and other stimulants, although they try for dopamine pathways, target D4 and not D2 and that seems to be important. Selegeline (deprenyl) showed promise, so did moclobemide.
Be wary of meds that are dopamine antagonists. Abilify is one. It's an antipsychotic and reduces dopamine. Dopamine is implicated in schizophrenia and psychotic disorders and it seems that if this theory is correct, any dopamine antagonist antipsychotic is not going to be helpful in stopping alcohol craving.
Do a search on alcohol+dopamine and see if anything crops up for further exploration. One word of advice - antabuse will cause many problems, especially if you're taking meds already. It affects an enzyme P-450 that can cause unpredictable med effects and does no good for your liver. I have never taken this nasty sledgehammer approach and truly believe there are better ways. Also, most in-patient facilities generally don't believe in any medications at all and have you rely solely on attending AA and other meetings. Pretty shocking relapse rate.
Some facilities look good for their emphasis on nutritional aspect. I feel any residential facility HAS to address the nutritionally deprived state any alcoholic is in, but it's not enough, unless there's a specific nutrient that targets these pleasure satiation/reward pathways. If I come up with something specific I'll post back. - Barbara
> Does anyone know if there are any new medications for alcoholism besides naltrexone / ReVia®).
> I have heard about Zofran® (generic name: ondansetron) and Topamax® (generic name: topiramate), but i know little about them.
>
> I am ADD & Bipolar taking Wellbutrin SR, Trazadone to sleep, Pemoline, Abilify & was on Strattera, but couldn't handle the medicine taste it left + felt no effect.
>
> I recently lost my job and am extremely anxious, and i started to drink again, which is not helping.
>
> Could someone give me some guidance here?
>
poster:barbaracat
thread:425696
URL: http://www.dr-bob.org/babble/20041206/msgs/427636.html