Alcoholism (alcohol abuse and dependence) is a chronic disorder affecting both brain and behavior that has worldwide public health consequences.
Primary goals for alcoholism pharmacotherapy include mitigating withdrawal, maintaining abstinence and reducing the severity of relapse, usually in combination with behavioral treatment or self-help groups.
Currently, only three medications for the treatment of alcoholism are approved for use in the USA—disulfiram, acamprosate and naltrexone—and the efficacy of each is modest at best.
In this context, the recent Cochrane Review of the use of gamma-hydroxybutyrate (GHB) for the treatment of alcoholism is a welcome addition to the literature ( Leone et al., 2010). The Cochrane Collaboration is a group of >27,000 volunteers in >90 countries who prepare, maintain and make accessible systematic reviews of the effects of healthcare interventions tested in randomized controlled trials (RCTs), with the goal of helping clinicians to make well-informed decisions about health care. Cochrane Reviews have a reputation for stringent assessment methods and generally cautious conclusions.
In this case, the authors conclude that, despite some limitations, there is enough evidence to recommend GHB's use both for treating alcohol withdrawal and for preventing relapse. In fact, they argue that GHB is more effective than either naltrexone or disulfiram, the current mainstays in alcoholism pharmacotherapy.
Primary goals for alcoholism pharmacotherapy include mitigating withdrawal, maintaining abstinence and reducing the severity of relapse, usually in combination with behavioral treatment or self-help groups.
Currently, only three medications for the treatment of alcoholism are approved for use in the USA—disulfiram, acamprosate and naltrexone—and the efficacy of each is modest at best.
In this context, the recent Cochrane Review of the use of gamma-hydroxybutyrate (GHB) for the treatment of alcoholism is a welcome addition to the literature ( Leone et al., 2010). The Cochrane Collaboration is a group of >27,000 volunteers in >90 countries who prepare, maintain and make accessible systematic reviews of the effects of healthcare interventions tested in randomized controlled trials (RCTs), with the goal of helping clinicians to make well-informed decisions about health care. Cochrane Reviews have a reputation for stringent assessment methods and generally cautious conclusions.
In this case, the authors conclude that, despite some limitations, there is enough evidence to recommend GHB's use both for treating alcohol withdrawal and for preventing relapse. In fact, they argue that GHB is more effective than either naltrexone or disulfiram, the current mainstays in alcoholism pharmacotherapy.
GHB, or as a pharmaceutical product, sodium oxybate, is a pharmacologically intriguing short-chain fatty acid structurally similar to the inhibitory neurotransmitter gamma-aminobutyric acid (GABA) and is approved for treatment of alcoholism in Italy. GHB is a weak agonist at the inhibitory GABA B receptor and a potent agonist at the newly characterized …
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Request Reprint E-Mail: ismene.petrakis@yale.edu
