Antinausea Cancer Treatment Shows Promise for Alcoholics

Research suggests that a drug used to relieve nausea in cancer patients can help the most difficult-to-treat alcoholics significantly reduce their drinking. Success with the drug ondansetron (Zofran) comes amid growing search for new medications to help treat a disease that affects some 14 million Americans.

In the past half-century, just two drugs have been approved for the treatment of alcoholism, although studies of a number of others are underway. Researchers from the University of Texas Health Science Center in San Antonio reported preliminary results with ondansetron in a recent issue of the Journal of the American Medical Association (284:963-971, 2000).

Effective in Early-Onset Alcoholics

Ondansetron worked in patients with early-onset alcoholism, who represent about 3.5 million of the nation’s alcoholics, said Dr. Bankole Johnson, the psychiatrist who led the study. These alcoholics develop drinking problems before age 25 years and are believed to have a biological predisposition toward alcoholism. They often respond poorly to counseling, exhibit antisocial behavior, and have a high relapse rate.

An imbalance between two chemical messengers in the brain, serotonin and dopamine, is believed to create a craving for alcohol in early-onset alcoholics. Ondansetron’s ability to regulate the serotonin-dopamine interaction may explain why it was effective only in such alcoholics, said Dr. Johnson.

The study involved 271 alcoholics who were given ondansetron twice daily or a placebo for 11 weeks. Weekly behavioral therapy was also included. Three different doses were tested, with the middle dose proving most effective. Alcoholics on that dose had an average of about 1½ drinks daily, compared with nearly 3½ drinks daily for the placebo group. They also abstained from drinking for an average of about 70% of the study days, compared with 50% for the placebo group.

The findings could lead to better ways to treat alcoholism and to tailor treatment to specific types of alcoholics, said Dr. Henry Kranzler of the University of Connecticut in an accompanying JAMA editorial.