Naltrexone Alone and With Sertraline for the Treatment of Alcohol Dependence in Alaska Natives and Non‐Natives Residing in Rural Settings: A Randomized Controlled Trial

O’Malley, Stephanie S.; Robin, Robert W.; Levenson, Aryeh L.; GreyWolf, Iva; Chance, Lawrence E.; Hodgkinson, Colin A.; Romano, Denise; Robinson, Jane E.; Meandzija, Boris; Stillner, Verner; Wu, Rongqian; Goldman, David

doi:10.1111/j.1530-0277.2008.00682.x

Cited by 88 publications

(99 citation statements)

References 73 publications

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“…In the exploratory analysis of the moderating effect of OPRM1 gene on naltrexone treatment response, a significant increase in emotional well-being was observed among a subgroup of participants with the AA genotype. In line with our data, AA genotype has previously been linked to beneficial treatment response in the treatment of alcoholism [35] . However, several studies report that OPRM1 A118G does not modify the treatment response [36][37][38][39] or that AG / GG genotype is linked to beneficial treatment response to naltrexone [40][41][42] .…”

Section: Discussionsupporting

confidence: 79%

A Randomised, Double-Blind, Placebo-Controlled Trial of As-Needed Naltrexone in the Treatment of Pathological Gambling

Kovanen¹,

Basnet²,

Castrén³

et al. 2015

Eur Addict Res

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Background/Aims: Effective treatment strategies are needed for the treatment of pathological gambling (PG). The efficacy of as-needed naltrexone was assessed in a single-centre, randomised, double-blind, placebo-controlled trial. Methods: The participants (n = 101) received either as-needed placebo or naltrexone (50 mg) and psychosocial support for 20 weeks. The primary outcome measure was the severity of PG assessed by the Yale-Brown Obsessive Compulsive Scale adapted for PG (PG-YBOCS). Secondary gambling-related outcome measures included thoughts/urges and behaviour subscales of PG-YBOCS as well as the highest daily expenditure and gambling frequency. In addition, RAND-36 scales of emotional well-being and social functioning were used as outcomes. The results were analysed using the intention-to-treat principle and linear random effects modelling. Results: No significant treatment group differences were found. In an exploratory analysis, emotional well-being increased in a subgroup of participants with AA genotype of opioid receptor, mu 1 (OPRM1) A118G polymorphism (p = 0.02). Conclusion: Overall, the as-needed naltrexone may not provide substantial additional benefit for PG patients receiving psychosocial support. Replication by larger scale studies is warranted to further evaluate naltrexone administration schedules for the treatment of PG and the role of OPRM1.

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Section: Discussionsupporting

confidence: 79%

A Randomised, Double-Blind, Placebo-Controlled Trial of As-Needed Naltrexone in the Treatment of Pathological Gambling

Kovanen¹,

Basnet²,

Castrén³

et al. 2015

Eur Addict Res

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“…Higher rates of alcohol dependence and associated consequences have been documented among both Native and non-Native Alaskans, with 14% of all Alaskan adults experiencing alcohol abuse or dependence (O'Malley et al, 2008). Although American Indians and Alaska Natives are more likely than any other ethnic group to be abstinent from alcohol, Native people who drink consume greater quantities of alcohol and are more likely to meet Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 2013) criteria for dependence (Beals et al, 2005;Beauvais, 1992;Whitesell, Beals, Big Crow, Mitchell, & Novins, 2012).…”

Section: Introductionmentioning

confidence: 98%

Ethnic Identity, Drinking Motives, and Alcohol Consequences Among Alaska Native and Non-Native College Students

Skewes

Blume

2014

Journal of Ethnicity in Substance Abuse

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This research involves the examination of drinking motives, alcohol consequences, and ethnic identity in a sample of Native and non-Native college student drinkers in Alaska. Although more Alaska Native students are abstinent from alcohol compared to any other ethnic group, Native students who do drink experience greater alcohol consequences and dependence symptoms. Therefore, we attempted to examine the influence of ethnic identity on alcohol consequences in a diverse sample of Native and non-Native students in Alaska. Findings showed that drinking motives, as measured by the Drinking Motives Questionnaire (social, coping, enhancement, and conformity), significantly predicted alcohol consequences after controlling for frequency of monthly binge drinking. In addition, after controlling for depression, binge drinking, and drinking motives, one aspect of ethnic identity (Affirmation, Belonging, and Commitment) was significantly negatively related to alcohol consequences, whereas another aspect of ethnic identity (Ethnic Identity Search) was not. Taken together, these findings suggest that interventions for college student alcohol misuse that target Native students should be culturally grounded and focused on enhancing the Affirmation, Belonging, and Commitment to one's ethnic heritage and should address drinking motives, especially drinking to cope, as a way to reduce alcohol related harm.

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“…OPRM1 genotyping was successful for 92 participants, however, all further analyses were restricted in 75 participants who were 118AA homozygous, of whom 52 were treated with naltrexone as monotherapy or combined therapy. When the eff ect of treatments were compared within this subgroup, the pattern of OPRM1 polymorphism association was similar to the results in the total sample, suggesting that OPRM1 polymorphism is not associated with enhanced response to naltrexone [54]. In 2008, Tidey and colleagues analyzed the association of OPRM1 A118G polymorphism with drink data, urge levels and subjective eff ects on alcohol consumption in 180 heavy drinkers, 63% of whom were alcohol-dependent [55].…”

Section: Introductionmentioning

confidence: 69%

“…Th is study included a total of 25 subjects treated with naltrexone 50mg/day [53]. O'Malley and colleagues have also analyzed the association of OPRM1 A118G polymorphism with naltrexone response in 101 alcohol-dependent Alaskians treated for 16 weeks with placebo, naltrexone 50mg monotherapy or naltrexone 50mg and sertraline 100mg combined therapy [54]. OPRM1 genotyping was successful for 92 participants, however, all further analyses were restricted in 75 participants who were 118AA homozygous, of whom 52 were treated with naltrexone as monotherapy or combined therapy.…”

Section: Introductionmentioning

confidence: 99%

Pharmacogenomics of alcohol addiction: Personalizing pharmacologic treatment of alcohol dependence

Ragia¹,

Manolopoulos²

2014

Hosp Pharm Int Multi J

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SUMMARYAlcohol dependence is a serious psychiatric disorder with harmful physical, mental and social consequences, and a high probability of a chronic relapsing course. The fi eld of pharmacologic treatment of alcohol dependence and craving is expanding rapidly; the drugs that have been found to reduce relapse rates or drinking in alcohol-dependent patients and are approved for treatment of alcohol dependence are naltrexone, acamprosate and disulfi ram, whereas also topiramate appears as a promising therapy. For many patients, however, these treatments are not eff ective. Evidence from a number of diff erent studies suggests that genetic variation is a signifi cant contributor to interindividual variation of clinical presentation of alcohol problems and response to a given treatment. The aim of the present review is to summarize and discuss the fi ndings on the association between gene polymorphisms and the response to alcohol dependence treatment medications. It is anticipated that future implementation of pharmacogenomics in clinical practice will help personalize alcohol dependence drug treatment, and development personalized hospital pharmacology.

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Naltrexone Alone and With Sertraline for the Treatment of Alcohol Dependence in Alaska Natives and Non‐Natives Residing in Rural Settings: A Randomized Controlled Trial

Cited by 88 publications

References 73 publications

A Randomised, Double-Blind, Placebo-Controlled Trial of As-Needed Naltrexone in the Treatment of Pathological Gambling

A Randomised, Double-Blind, Placebo-Controlled Trial of As-Needed Naltrexone in the Treatment of Pathological Gambling

Ethnic Identity, Drinking Motives, and Alcohol Consequences Among Alaska Native and Non-Native College Students

Pharmacogenomics of alcohol addiction: Personalizing pharmacologic treatment of alcohol dependence

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