From the Guidelines
Currently, there are no approved genetic treatments specifically for alcoholism, and the most effective current treatments combine FDA-approved medications like naltrexone, acamprosate, or baclofen with behavioral therapies. While research has identified genetic factors that contribute to alcohol use disorder, such as variations in genes that affect alcohol metabolism (ADH and ALDH) and neurotransmitter systems (GABA, glutamate, dopamine), targeted genetic therapies remain experimental 1. The medications work by either reducing cravings, creating unpleasant reactions to alcohol, or restoring neurotransmitter balance.
Treatment Options
- Naltrexone (50mg daily) is an opioid receptor antagonist that decreases the concentration of dopamine in the brain and dampens activation of the reward pathway by alcohol, thereby decreasing excessive drinking and recurrence rates and increasing abstinence duration in patients with alcohol dependence 1.
- Acamprosate (666mg three times daily) reduces the withdrawal effects of and the craving for alcohol, and is effective at maintaining abstinence in alcohol-dependent patients following withdrawal 1.
- Baclofen, a GABAB receptor agonist, has been shown to be effective in maintaining abstinence in patients with liver cirrhosis, and may be a viable option for patients with alcoholic liver disease (ALD) 1.
Behavioral Therapies
Behavioral therapies, such as cognitive behavioral therapy, social skills training, and coping skills training, can help individuals with alcohol use disorder to develop coping skills and strategies to maintain abstinence 1. Brief interventions, such as motivational interviewing and counseling, can also be effective in reducing risky drinking behavior and risk of ALD 1.
Personalized Medicine
Genetic testing may help identify individuals at higher risk for alcoholism or predict medication response, but this approach is still developing 1. Personalized medicine based on genetic profiles shows promise for the future but isn't yet standard practice. Anyone struggling with alcohol use disorder should seek comprehensive treatment from healthcare providers who can develop an individualized plan combining appropriate medications, counseling, and support groups rather than waiting for genetic treatments to become available.
From the FDA Drug Label
There is no information in the provided drug labels that directly supports the answer to the question about genetic treatments for alcohol use disorder (AUD).
The FDA drug label does not answer the question.
From the Research
Genetic Treatments for Alcohol Use Disorder (AUD)
The following genetic treatments for AUD have been identified in various studies:
- Naltrexone, an opioid antagonist, has been shown to aid in reducing alcohol consumption 2, 3, 4, 5
- Acamprosate, a putative glutamate receptor antagonist, supports abstinence 2, 3, 5
- Disulfiram, an aldehyde dehydrogenase inhibitor, is used as a second-line treatment approach 5
- Topiramate, gabapentin, ondansetron, varenicline, baclofen, and sodium oxybate are off-label medications that have shown potential in treating AUD 5
Genetic Predictors of Treatment Response
Research has identified several genetic predictors of treatment response, including:
- The mu-opioid receptor gene (OPRM1) Asp40 allele, which predicts naltrexone response 4
- Single nucleotide polymorphisms (SNPs) in the BRE gene, which are associated with time until relapse to heavy drinking (THR) 3
- Intergenic SNPs, which are associated with medication-specific outcomes, such as naltrexone THR and acamprosate time until relapse to any drinking (TR) 3
- The PTPRD gene, which has been implicated in addiction phenotypes and is associated with naltrexone response 3
Precision Medicine Approach
A precision medicine approach, which involves tailoring treatment to an individual's genetic profile, may be useful in improving treatment outcomes for AUD 2, 6