Few pharmacotherapies are
available for alcoholism. Numerous studies indicate the involvement of the
opioid-endorphin system in mediating the reinforcing effects of alcohol via
dopaminergic neurons. The opioid antagonist naltrexone was found to be
effective in alcohol treatment and the European Medicines Agency has now
approved the mu-opioid antagonist und partial kappa agonist nalmefene. Areas
covered:
This article presents background information on the chemistry of nalmefene and pre-clinical and clinical findings. The three relevant Phase III studies, all of which followed a harm-reduction, "as needed" approach and found reduced alcohol consumption with nalmefene 18 (20) mg, are discussed in detail.
Expert opinion: The integration of the "as needed" approach into conventional psychosocial alcohol therapies may be challenging but offers the opportunity to reach otherwise not treated patients. Nalmefene is the first medication to be approved specifically in this indication and seems to be most suitable for patients with alcohol misuse or a rather low physical dependence on alcohol who do not require immediate detoxification or inpatient treatment.
Although a categorical distinction between patients who want to stop heavy drinking or drinking at all over time may be somewhat hypothetical, nalmefene offers new treatment options to patients with alcohol use disorder.
This article presents background information on the chemistry of nalmefene and pre-clinical and clinical findings. The three relevant Phase III studies, all of which followed a harm-reduction, "as needed" approach and found reduced alcohol consumption with nalmefene 18 (20) mg, are discussed in detail.
Expert opinion: The integration of the "as needed" approach into conventional psychosocial alcohol therapies may be challenging but offers the opportunity to reach otherwise not treated patients. Nalmefene is the first medication to be approved specifically in this indication and seems to be most suitable for patients with alcohol misuse or a rather low physical dependence on alcohol who do not require immediate detoxification or inpatient treatment.
Although a categorical distinction between patients who want to stop heavy drinking or drinking at all over time may be somewhat hypothetical, nalmefene offers new treatment options to patients with alcohol use disorder.
Purchase full article at: http://goo.gl/f9ej1w
By:
- 1 Department of Psychiatry and Psychotherapy , Ludwig Maximilian University , Munich , Germany.
- 2 Privatklinik Meiringen , Meiringen , Switzerland.
- Expert Opin Pharmacother. 2016 Jan 25.
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