Research suggests that a drug used to relieve nausea in cancer
patients can help the most difficult-to-treat alcoholics
significantly reduce their drinking. Success with the drug
ondansetron (Zofran) comes amid growing search for new medications to
help treat a disease that affects some 14 million Americans.
In the past half-century, just two drugs have been approved for the
treatment of alcoholism, although studies of a number of others are
underway. Researchers from the University of Texas Health Science
Center in San Antonio reported preliminary results with ondansetron
in a recent issue of the Journal of the American Medical
Association (284:963-971, 2000).
Effective in Early-Onset Alcoholics
Ondansetron worked in patients with early-onset alcoholism, who
represent about 3.5 million of the nations alcoholics, said Dr.
Bankole Johnson, the psychiatrist who led the study. These alcoholics
develop drinking problems before age 25 years and are believed to
have a biological predisposition toward alcoholism. They often
respond poorly to counseling, exhibit antisocial behavior, and have a
high relapse rate.
An imbalance between two chemical messengers in the brain, serotonin
and dopamine, is believed to create a craving for alcohol in
early-onset alcoholics. Ondansetrons ability to regulate the
serotonin-dopamine interaction may explain why it was effective only
in such alcoholics, said Dr. Johnson.
The study involved 271 alcoholics who were given ondansetron twice
daily or a placebo for 11 weeks. Weekly behavioral therapy was also
included. Three different doses were tested, with the middle dose
proving most effective. Alcoholics on that dose had an average of
about 1½ drinks daily, compared with nearly 3½ drinks daily
for the placebo group. They also abstained from drinking for an
average of about 70% of the study days, compared with 50% for the
The findings could lead to better ways to treat alcoholism and to
tailor treatment to specific types of alcoholics, said Dr. Henry
Kranzler of the University of Connecticut in an accompanying JAMA editorial.