Aripiprazole has potential for treating alcohol dependence

“Aripiprazole might ‘shift the balance’ from alcohol being more stimulating to being more sedating,” added Anton. “This has implications for both treatment and side-effect management for people taking this medication, [becoming] a balance of useful versus aversive effects. Most other dopamine-blocking drugs have too many aversive [or side] effects that make them not suitable for treatment of alcohol-use disorders. Aripiprazole might be more tolerated and have less long-term negative effects.”

Kranzler concurred. “Other antipsychotic drugs – such as haloperidol and, olanzapine, which are full dopamine antagonists – reduce the pleasurable effects of alcohol, but they are associated with more adverse effects than aripiprazole is. The list of side effects associated with most medications that exert powerful enough effects to be of value in treating psychosis is long. The ones that occur substantially more commonly than with placebo are headaches, insomnia, nausea, dizziness, and vomiting.”

“Aripiprazole is one of a growing list of medications that are being evaluated for the treatment of alcoholism,” said Anton. “Readers should really see this as preliminary evidence and should be on the lookout for more studies to inform them of the potential treatment utility of aripiprazole by itself or in combination with other medications for alcohol-use disorders.” He suggested that future research test aripiprazole on heavier drinkers and non-treatment-seeking alcoholics under longer-term dosing and natural drinking conditions, and also explore potential genetic predictors of its stimulatory versus sedation effects, with and without alcohol.

“These findings help to demonstrate that alcohol has effects on many different brain chemicals and, as such, that many different treatment approaches for alcohol dependence may be useful,” said Kranzler. “That having been said, it’s unclear whether aripiprazole will be very useful in this effort because its side effects may outweigh its beneficial effects.”

Alcoholism: Clinical & Experimental Research (ACER) is the official journal of the Research Society on Alcoholism and the International Society for Biomedical Research on Alcoholism. Co-authors of the ACER paper, “Effects of Aripiprazole on Subjective and Physiological Responses to Alcohol,” were: Jonathan Covault, Amira Pierucci-Lagha, Grace Chan, Kara Douglas, and Albert J. Arias of the Alcohol Research Center in the Department of Psychiatry; and Cheryl Oncken of the Department of Medicine ... all at the University of Connecticut School of Medicine. The study was funded by Bristol-Myers Squibb Company, and the National Institutes of Health.