The need for precise answers for the goals of precision medicine in alcohol dependence to succeed

Abstract

registered reports, increased transparency, and related endeavors [4-6], it will be important to couple carefully the clinically guided hypotheses with appropriate statistical analyses that directly test them.

Response to Letter to Editor (Precision medicine in alcohol dependence: evidence of efficacy and initial support for comparative effectiveness)

“…The letter by Bradford et al [1] gives us an opportunity to add some of those results here. As shown in Fig.…”

“…We thank Bradford et al [1] for a thoughtful commentary on our paper about precision medicine in alcohol dependence [2]. As noted by Bradford et al [1], it is critical to conduct rigorous analyses using pre-registered hypotheses in order to move the field of precision medicine forward. We also contend it is essential to demonstrate that reward/relief drinking moderates the efficacy of medications for alcohol dependence.…”

“…Conversely, a subgroup of patients to whom alcohol acts as negative reinforcer, potentially because of elevations of brain glutamate levels should respond best to a compound known for its antiglutamatergic action (e.g., acamprosate). Moreover, earlier publications reported drug mechanisms and "putative subgroup dysfunction" [1], such as the role of alcohol-cue-induced brain activation in the ventral striatum as a predictor of naltrexone response [4], as well as the acoustic startle response to distinguish between naltrexone and acamprosate responders [5].…”