Improving clinical outcomes for naltrexone as a management of problem alcohol use

Authors

  • Gary K. Hulse

    Corresponding author
    1. Addiction Medicine, School of Psychiatry & Clinical Neurosciences (M521), The University of Western Australia, Crawley, WA, Australia
    • Correspondence

      Professor Gary Kenneth Hulse M.Bsc PhD, School of Psychiatry & Clinical Neurosciences, The University of Western Australia, Perth, WA 6009, Australia.

      Tel.: +61 8 9346 2280

      Fax: +61 8 9346 3828

      E-mail: gary.hulse@uwa.edu.au

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Abstract

Despite being a relatively effective and safe treatment, the clinical management of alcohol abuse/dependence by oral naltrexone can be compromised due to the patient's non-compliance with daily use of this medication. Over the past decade an increasing body of research has suggested that the use of sustained release depot naltrexone preparations can overcome this issue and deliver improved clinical outcomes. However, at the same time, research findings from diverse areas of pharmacogenetics, neurobiology and behavioural psychology have also been converging to identify variables including genetic markers, patient psychosocial characteristics and drug use history differences, or clusters of these variables that play a major role in mediating the response of alcohol abuse/dependent persons to treatment by naltrexone. While this article does not attempt to review all available data pertaining to an individual alcohol dependent patient's response to treatment by naltrexone, it does identify relevant research areas and highlights the importance of data arising from them. The characterization of clinical markers, to identify those patients who are most likely to benefit from naltrexone and to tailor a more individual naltrexone treatment, will ultimately provide significant benefit to both patients and clinicians by optimizing treatment outcome.

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