Genotyping and the treatment of alcohol dependence

Feb 8 2008

Inherited genetic makeup often plays a role in determining the risk level for certain diseases, including alcoholism.

Now new evidence-based research also shows a correlation between genotyping and the treatment of alcohol dependence.

Investigators participating in the National Institute on Alcohol Abuse and Alcoholism's 2001-2004 Combined Pharmacotherapies and Behavioral Interventions for Alcohol Dependence Study (COMBINE Study) have discovered a direct correlation between patients with the Asp40 allele, a variation of the receptor gene OPRM1, and the drug naltrexone. Patients with this variant gene responded positively to the drug that blocks opiate receptors in the brain thereby reducing gratification from alcohol. Not only did patients who were treated with naltrexone and have the Asp40 gene variant go without harmful drinking for a longer period of time, but they also consumed fewer beverages on the days they did drink.

"For the first time we might have a 'personalized medical treatment' for alcoholism," said Raymond Anton, M.D., COMBINE Study principal investigator and director of the Center for Drug and Alcohol Programs at the Medical University of South Carolina (MUSC). "Discovery that a common genetic trait predicts treatment response to a commonly used medication should enhance its effectiveness and helps focus alcohol treatment in a cost-effective manner."

These findings provide a viable solution for the 15 to 25 percent of the population that carry the Asp40 allele. Alcohol counseling did not have the same affect as the drug, therefore researchers conclude genotyping is most beneficial without the therapy.

Gene variant carriers of all ethnicities who took naltrexone were more likely than their counterparts to have a good clinical result. However, since the study had more Caucasian participants, the results for this group are the most reliable.

About MUSC

Founded in 1824 in Charleston, The Medical University of South Carolina is the oldest medical school in the South. Today, MUSC continues the tradition of excellence in education, research, and patient care. MUSC educates and trains more than 3,000 students and residents, and has nearly 10,000 employees, including 1,300 faculty members. As the largest non-federal employer in Charleston, the university and its affiliates have collective annual budgets in excess of $1.3 billion. MUSC operates a 600-bed medical center, which includes a nationally recognized Children's Hospital and a leading Institute of Psychiatry. For more information on academic information or clinical services.