scholarly journals Interaction of Heavy Drinking Patterns and Depression Severity predicts Efficacy of Quetiapine Fumarate XR in lowering Alcohol Intake in Alcohol Use Disorder Patients

2020 ◽  
Author(s):  
Vatsalya Vatsalya ◽  
Maiying Kong ◽  
Luis M. Marsano ◽  
Zimple D Kurlawala ◽  
Kan V Chandras ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Alcohol Use Disorder ◽  
Alcohol Intake ◽  
Rating Scale ◽  
Heavy Drinking ◽  
Depression Symptoms ◽  
Drinking Patterns ◽  
Quetiapine Fumarate ◽  
Heavy Alcohol ◽  
Depression Ratings

Background: Shared etiological pathways of dopamine and serotonin neurotransmission play a central role in heavy alcohol intake and exacerbation in the symptoms of depression. We investigated the role of depression ratings and patterns of heavy drinking on the treatment efficacy of Quetiapine fumarate XR in lowering alcohol intake in alcohol use disorder (AUD) patients. Methods: One hundred and eight male and female heavy drinking AUD patients in the age range of 18 to 64 yrs. received 12 weeks of active treatment. Participants were grouped by the severity grading of depression using Montgomery Asberg Depression Rating Scale (MADRS) (clinically relevant≥8 [CR], clinically non-relevant≤7 [CNR]) at baseline. Drinking history and depression ratings were assessed at the patients visits. Results: Heavy drinking days (HDD) and total drinks (TD) were significantly fewer in CR patients at the treatment end. A true positive response in AUROC analysis supported the lowering of TD in CR patients. The number of drinking days (NDD) and average drinks per drinking day (AvgD) were lower in the CNR patients at treatment-end. Significant associations with increasing effect sizes were observed for all the heavy drinking measures (HDD, TD, NDD and AvgD) and MADRS scores by the end of the treatment course. Conclusions: Baseline elevated depressive symptoms could likely predict the course of heavy alcohol drinking during the treatment, and efficacy outcome of a treatment. AUD patients with baseline clinically significant depression had a progressive lowering in heavy drinking markers significantly corresponding to the lowering of depression symptoms by the end of treatment with Quetiapine fumarate XR.

scholarly journals Interaction of Heavy Drinking Patterns and Depression Severity Predicts Efficacy of Quetiapine Fumarate XR in Lowering Alcohol Intake in Alcohol Use Disorder Patients

2020 ◽  
Vol 14 ◽  
pp. 117822182095518
Author(s):  
Vatsalya Vatsalya ◽  
Maiying Kong ◽  
Luis M Marsano ◽  
Zimple Kurlawala ◽  
Kan V Chandras ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Alcohol Use Disorder ◽  
Alcohol Intake ◽  
Rating Scale ◽  
Heavy Drinking ◽  
Depression Symptoms ◽  
Drinking Patterns ◽  
Quetiapine Fumarate ◽  
Heavy Alcohol ◽  
Depression Ratings

Background: Shared etiological pathways of dopamine and serotonin neurotransmission play a central role in heavy alcohol intake and exacerbation in the symptoms of depression. We investigated the treatment efficacy of Quetiapine fumarate extended release (XR) in lowering alcohol intake in alcohol use disorder (AUD) patients indicated by the shared alleviation of depression ratings and patterns of heavy drinking. Methods: Hundred and eight male and female heavy drinking AUD patients in the age range of 18 to 64 years. participated in a randomized clinical trial (RCT) to receive 12 weeks of quetiapine XR or placebo (N = 115). Participants were sub-grouped by the severity grading of depression using Montgomery-Asberg Depression Rating Scale (MADRS) (clinically relevant ⩾8 [CR], clinically non-relevant ⩽7 [CNR]) at baseline in both the groups. Drinking history and depression ratings were assessed at the patients’ visits. Results: Heavy drinking days (HDD) and total drinks (TD) were significantly fewer in CR patients at the treatment end. A true positive response in AUROC analysis supported the lowering of TD in CR patients. The number of drinking days (NDD) and average drinks per drinking day (AvgD) were lower in the CNR patients at treatment-end. Significant associations with increasing effect sizes were observed for all the heavy drinking measures (HDD, TD, NDD, and AvgD) and MADRS scores by the end of the treatment course. Conclusions: Baseline elevated depressive symptoms could likely predict the course of heavy alcohol drinking during the treatment, and efficacy outcome of a treatment. AUD patients with baseline clinically significant depression had a progressive lowering in heavy drinking markers significantly corresponding to the lowering of depression symptoms by the end of treatment with Quetiapine fumarate XR. ClinicalTrials.gov: NCT#0049862 ( https://clinicaltrials.gov/ct2/show/NCT00498628?term=litten&draw=2&rank=3 )

Nalmefene against alcohol use disorder: A report of one case

2017 ◽  
Vol 41 (S1) ◽  
pp. s866-s866
Author(s):  
M. Juncal Ruiz ◽  
O. Porta Olivares ◽  
L. Sánchez Blanco ◽  
R. Landera Rodríguez ◽  
M. Gómez Revuelta ◽  
...  
Keyword(s):  
Alcohol Consumption ◽  
Alcohol Use ◽  
Opioid Receptor ◽  
Treatment Option ◽  
Withdrawal Syndrome ◽  
Alcohol Use Disorder ◽  
Alcohol Intake ◽  
Family Relationship ◽  
Heavy Drinking ◽  
Alcohol Withdrawal Syndrome

IntroductionAlcohol consumption represents a significant factor for mortality in the world: 6.3% in men and 1.1% in women. Alcohol use disorder is also very common: 5.4% in men and 1.5% in women. Despite its high frequency and the seriousness of this disorder, only 8% of all alcohol-dependents are ever treated. One potentially interesting treatment option is oriented toward reducing alcohol intake.AimsTo describe one case who has improved his alcohol consumption after starting treatment with nalmefene, an opioid receptor antagonist related to naltrexone.MethodsA 35-year-old male with alcohol use disorder since 2001 came to our consult in November 2015. He was in trouble with his family and he had a liver failure. We offer a new treatment option with nalmefene 18 mg to reduce alcohol consumption.ResultsBefore to start nalmefene he drank 21 drinks/week. Six-month later, he decreased alcohol intake until 5 drinks/week with better family relationship and liver function. After starting nalmefene he complained of nausea, so we recommend to take the middle of the pill for next 7 days. After this time he returned to take one pill with good tolerance and no more side effects or withdrawal syndrome.ConclusionsNalmefene appears to be effective and safe in reducing heavy drinking and in preventing alcohol withdrawal syndrome due to its opioid receptor antagonism. This case suggests nalmefene is a potential option to help patients, who do not want or cannot get the abstinence, in reducing their alcohol consumption.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Predictors of Symptom Course in Alcohol Use Disorder

2020 ◽  
Author(s):  
William Conlin ◽  
Kenneth J. Sher ◽  
Alvaro Vergés ◽  
Michaela Hoffman ◽  
Douglas Steinley
Keyword(s):  
Family History ◽  
Alcohol Consumption ◽  
Alcohol Use ◽  
Alcohol Use Disorder ◽  
Heavy Drinking ◽  
Epidemiological Survey ◽  
Future Research ◽  
Heavy Alcohol ◽  
Heavy Alcohol Consumption ◽  
History Of

Objective: Alcohol Use Disorder (AUD) has traditionally been viewed as a chronic, progressive, relapsing disorder (Jellinek, 1960; National Institute on Drug Abuse, 2018). However, little is known about the course of individual AUD criteria. To the extent that individual symptoms represent the focus of some treatments (e.g., withdrawal, craving), understanding the course of specific symptoms, and individual differences in symptom course, can inform treatment efforts and future research directions.Method: The current study examined 34,653 participants form Wave 1 (2001-2002) and Wave 2 (2003-2004) of the National Epidemiological Survey on Alcohol and Related Conditions (NESARC; Grant, Moore, & Kaplan, 2003; Grant, Kaplan, and Stinson, 2005), using logistic regression to analyze the extent to which AUD symptom course is predicted by heavy alcohol consumption, family history of alcoholism, and lifetime diagnosis of Conduct Disorder. Results: The course of all AUD symptoms was significantly influenced by all four external criteria, with the magnitude of the prediction varying across different symptoms and different aspects of course. Conclusion: The strength of the relationship appeared to be related to the theoretical proximity of a given predictor to AUD symptomatology, with heavy drinking being the strongest and family history of AUD being the weakest. The course of all AUD symptoms was strongly associated with the prevalence of the given symptom in the overall sample. Future work should include examining the interchangeability of AUD symptoms and considering heavy alcohol consumption as a criterion for AUD diagnosis.

mTORC and PKCε in Regulation of Alcohol Use Disorder

2020 ◽  
Vol 20 (17) ◽  
pp. 1696-1708 ◽  
Author(s):  
Athirah Hanim ◽  
Isa Naina Mohamed ◽  
Rashidi M. Pakri Mohamed ◽  
Srijit Das ◽  
Norefrina Shafinaz Md Nor ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Alcohol Use Disorder ◽  
Alcohol Intake ◽  
Potential Role ◽  
Synaptic Proteins ◽  
Cellular Mechanisms ◽  
Kinase C ◽  
Protein Kinase C Epsilon ◽  
Seeking Behavior

Alcohol use disorder (AUD) is characterized by compulsive binge alcohol intake, leading to various health and social harms. Protein Kinase C epsilon (PKCε), a specific family of PKC isoenzyme, regulates binge alcohol intake, and potentiates alcohol-related cues. Alcohol via upstream kinases like the mammalian target to rapamycin complex 1 (mTORC1) or 2 (mTORC2), may affect the activities of PKCε or vice versa in AUD. mTORC2 phosphorylates PKCε at hydrophobic and turn motif, and was recently reported to be associated with alcohol-seeking behavior, suggesting the potential role of mTORC2-PKCε interactions in the pathophysiology of AUD. mTORC1 regulates translation of synaptic proteins involved in alcohol-induced plasticity. Hence, in this article, we aimed to review the molecular composition of mTORC1 and mTORC2, drugs targeting PKCε, mTORC1, and mTORC2 in AUD, upstream regulation of mTORC1 and mTORC2 in AUD and downstream cellular mechanisms of mTORCs in the pathogenesis of AUD.

scholarly journals Heavy alcohol consumption in individuals with HIV infection: Effects on neuropsychological performance

2005 ◽  
Vol 11 (1) ◽  
pp. 70-83 ◽  
Author(s):  
JOHANNES C. ROTHLIND ◽  
TANYA M. GREENFIELD ◽  
ANNE V. BRUCE ◽  
DIETER J. MEYERHOFF ◽  
DEREK L. FLENNIKEN ◽  
...  
Keyword(s):  
Alcohol Consumption ◽  
Alcohol Use ◽  
Executive Functioning ◽  
Hiv Infection ◽  
Synergistic Effects ◽  
Heavy Drinking ◽  
Heavy Alcohol ◽  
Heavy Drinkers ◽  
Heavy Alcohol Use ◽  
Active Alcohol

Higher rates of alcohol use have been reported in HIV+ individuals compared to the general population. Both heavy alcohol use and HIV infection are associated with increased risk of neuropsychological (NP) impairment. We examined effects of heavy active alcohol use and HIV on NP functioning in a large sample of community-residing HIV+ individuals and HIV− controls. The four main study groups included 72 HIV− light/non-drinkers, 70 HIV− heavy drinkers (>100 drinks per month), 70 HIV+ light/non-drinkers, and 56 HIV+ heavy drinkers. The heavy drinking group was further subdivided to assess effects of the heaviest levels of active alcohol use (>6 drinks per day) on NP functioning. A comprehensive NP battery was administered. Multivariate analysis of covariance was employed to examine the effect of HIV and alcohol on NP functioning after adjusting for group differences in age and estimated premorbid verbal intellectual functioning. The analyses identified main effects of heavy drinking and HIV on NP function, with greatest effects involving the contrast of HIV+ heavy drinkers and the HIV− light drinkers. Synergistic effects of heaviest current drinking and HIV infection were identified in analyses of motor and visuomotor speed. Supplementary analyses also revealed better NP function in the HIV+ group with antiretroviral treatment (ART) and lower level of viral burden, a finding that was consistent across levels of alcohol consumption. Finally, heavy alcohol use and executive functioning difficulties were associated with lower levels of self-reported medication adherence in the HIV+ group. The findings suggest that active heavy alcohol use and HIV infection have additive adverse effects on NP function, that they may show synergistic effects in circumstances of very heavy active alcohol use, and that heavy drinking and executive functioning may mediate health-related behaviors in HIV disease. (JINS, 2005, 11, 70–83.)

A 6-Month Randomized Trial of a Smartphone Application, UControlDrink, in Aiding Recovery in Alcohol Use Disorder

2021 ◽  
pp. 1-12
Author(s):  
Conor Farren ◽  
Aoife Farrell ◽  
Aisling Hagerty ◽  
Cliodhna McHugh
Keyword(s):  
Alcohol Use ◽  
Text Messaging ◽  
Alcohol Use Disorder ◽  
Positive Impact ◽  
Controlled Trial ◽  
Intervention Group ◽  
Heavy Drinking ◽  
Smartphone Application ◽  
Smartphone App ◽  
Control Group

<b><i>Background and Aims:</i></b> Alcohol use disorder (AUD) is a substantial problem, causing early death and great economic burden. Research has highlighted the potential positive impact of technological interventions, such as smartphone applications (app) in treatment of AUD. The aim of this study was to explore the effectiveness of a smartphone app, incorporating computerized cognitive behavioural therapy and text messaging support, on alcohol outcomes over 6 months in a post-rehabilitation setting. <b><i>Methods:</i></b> A total of 111 participants with AUD were recruited into this randomized controlled trial, following completion of a 30-day rehabilitation programme. The intervention group (<i>n</i> = 54) used the smartphone app “UControlDrink” (UCD) over 6 months with treatment as usual (TAU), and the control group (<i>n</i> = 57) received TAU. All subjects suffered from AUD as the primary disorder, with other major psychiatric disorders excluded. All intervention subjects used the UCD smartphone app in the treatment trial, and all subjects underwent TAU consisting of outpatient weekly support groups. Drinking history in the previous 90 days was measured at baseline and at 3- and 6-month follow-ups. Additional measurements were made to assess mood, anxiety, craving, and motivation. Results were analysed using intention-to-treat analyses. <b><i>Results:</i></b> Retention in the study was 72% at 3 months and 52% at 6 months. There was a significant reduction in heavy drinking days in the intervention group relative to TAU over the 6 months, <i>p</i> &#x3c; 0.02. <b><i>Conclusions:</i></b> The UCD smartphone app demonstrates a significant benefit to reducing heavy drinking days over a 6-month post-rehabilitation period in AUD.

scholarly journals Make Mission Impossible Feasible: The Experience of a Multidisciplinary Team Providing Treatment for Alcohol Use Disorder to Homeless Individuals

2020 ◽  
Vol 55 (5) ◽  
pp. 547-553
Author(s):  
Tommaso Dionisi ◽  
Carolina Mosoni ◽  
Giovanna Di Sario ◽  
Claudia Tarli ◽  
Mariangela Antonelli ◽  
...  
Keyword(s):  
Alcohol Consumption ◽  
Alcohol Use ◽  
Clinical Evaluation ◽  
Treatment Program ◽  
Alcohol Use Disorder ◽  
Alcohol Intake ◽  
Multidisciplinary Treatment ◽  
Social Reintegration ◽  
Multidisciplinary Treatment Program ◽  
Glutamyl Transpeptidase

Abstract Aim People experiencing homelessness are often excluded from treatment programs for alcohol use disorder (AUD). The goal of this study was to describe the impact of a multidisciplinary treatment program on alcohol consumption and social reintegration in individuals with AUD experiencing homelessness. Methods Thirty-one individuals with AUD experiencing homelessness were admitted to an inpatient unit for 5–6 days for clinical evaluation and to treat potential alcohol withdrawal syndrome. A group of volunteers, in collaboration with the Community of Sant’Egidio, provided social support aimed to reintegrate patients. After inpatient discharge, all patients were followed as outpatients. Alcohol intake (number drinks/day), craving and clinical evaluation were assessed at each outpatient visit. Biological markers of alcohol use were evaluated at enrollment (T0), at 6 months (T1) and 12 months (T2). Results Compared with T0, patients at T1 showed a significant reduction in alcohol consumption [10 (3–24) vs 2 (0–10); P = 0.015] and in γ-glutamyl-transpeptidase [187 (78–365) vs 98 (74–254); P = 0.0021]. The reduction in alcohol intake was more pronounced in patients with any housing condition [10 (3–20) vs 1 (0–8); P = 0.008]. Similarly, compared with T0, patients at T2 showed significant reduction in alcohol consumption [10 (3–24) vs 0 (0–15); P = 0.001], more pronounced in patients with any housing condition [10 (3–20) vs 0 (0–2); P = 0.006]. Moreover, at T2 patients showed a significant reduction in γ-glutamyl-transpeptidase [187 (78–365) vs 97 (74–189); P = 0.002] and in mean cell volume [100.2 (95–103.6) vs 98.3 (95–102); P = 0.042]. Conclusion Patients experiencing homelessness may benefit from a multidisciplinary treatment program for AUD. Strategies able to facilitate and support their social reintegration and housing can improve treatment outcomes.

Effects of CYP2D6 activity on the efficacy and safety of mirtazapine in patients with depressive disorders and comorbid alcohol use disorder

2019 ◽  
Vol 97 (8) ◽  
pp. 781-785 ◽  
Author(s):  
M.S. Zastrozhin ◽  
V.Y. Skryabin ◽  
V.V. Smirnov ◽  
E.A. Grishina ◽  
K.A. Ryzhikova ◽  
...  
Keyword(s):  
Alcohol Use ◽  
High Performance ◽  
Alcohol Use Disorder ◽  
Depressive Disorders ◽  
Rating Scale ◽  
Correlation Coefficients ◽  
Inverse Correlation ◽  
Efficacy And Safety ◽  
Cyp2d6 Activity ◽  
Scale Scores

The objective of the study was to investigate the effects of CYP2D6 activity on the efficacy and safety of mirtazapine in patients with depressive disorders and comorbid alcohol use disorder who received mirtazapine. The study included 109 Russian patients who received mirtazapine at a dose of 30.0 [15.0; 45.0] mg per day. Genotyping of CYP2D6*4 (1846G > A, rs3892097) was performed using real-time polymerase chain reaction with allele-specific hybridization. The activity of CYP2D6 was evaluated by determining the concentration of endogenous substrate of the enzyme and its urinary metabolite — pinoline to 6-hydroxy-1,2,3,4-tetrahydro-beta-carboline ratio, using high-performance liquid chromatography – mass spectrometry. The statistically significant differences between the scores on the Hamilton Depression Rating Scale (HAMD) in patients with different genotypes were revealed by day 16: (GG) 5.0 [3.0; 6.0], (GA) 1.5 [1.0; 3.2] (p < 0.001), and for the The UKU Side Effects Rating Scale (UKU): (GG) 6.0 [6.0; 7.0], (GA) 8.5 [8.0; 10.0] (p < 0.001). The calculation of correlation coefficients between the differences in scale scores and metabolic rate showed the presence of statistically significant weak inverse correlation with the efficacy indicator evaluated by HAMD (r = −0.278, p < 0.05), but not by UKU (r = 0.274, p > 0.05). This study demonstrated that an increased CYP2D6 activity reduces the efficacy of treatment with mirtazapine.

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