From Our 2007 Archives
Quit-Smoking Drug May Curb Alcoholism
Smoking-Cessation Drug Chantix Reduces Drinking in Lab Tests on Alcoholic Rats
Reviewed By Louise Chang, MD
July 10, 2007 -- The quit-smoking drug Chantix may help treat alcoholism, a new study shows.
The Chantix study was conducted on alcoholic rats. But the results were promising, so the researchers plan to start testing Chantix on alcoholism in people this year.
"Eighty-five percent of alcoholics smoke, and drinking and smoking tend to go hand in hand," researcher Selena Bartlett, PhD, tells WebMD.
Bartlett directs the preclinical development group at the University of California, San Francisco's Ernest Gallo Clinic and Research Center.
Bartlett and colleagues report that alcoholic rats halved their alcohol consumption when injected with the active ingredient in Chantix.
"This is not a cure for addiction," says Bartlett. But she notes that Chantix is already on the market for smoking cessation and has been proven safe in people as a quit-smoking drug.
"No one had tried it on alcohol before, and that's what we did, in animals," says Bartlett.
The FDA approved Chantix in May 2006 to help cigarette smokers quit smoking. The drug comes in tablets and is approved for 12 weeks of treatment, though some patients may need to take Chantix for a longer period of time for smoking cessation.
Chantix and Alcoholism Study
Bartlett's team trained rats to drink large amounts of alcohol. That induced alcohol dependence, which is commonly called alcoholism.
The researchers injected varenicline, the active ingredient in Chantix, into some of the alcoholic rats. For comparison, other alcoholic rats didn't get Chantix.
The rats got roughly the same varenicline dose that rats get in nicotine studies. Those doses cut the rats' alcohol consumption by about 50%, Bartlett says.
The results came as a surprise.
Bartlett says she hadn't expected Chantix to be particularly effective in alcoholic rats that weren't also given nicotine. But the drug defied those predictions.
The rats had been drinking heavily for months, notes Bartlett. "This is not something that will just work if you have one or two drinks a week and take the drug. It's not that kind of drug," she predicts.
Chantix didn't affect other rats' taste for plain water or sugary water, the study also shows.
Why would a quit-smoking drug work on alcoholism?
Nicotine and alcohol both affect a certain brain receptor, and Chantix targets that brain receptor, Bartlett explains.
"The bottom line is they're working on similar mechanisms," Bartlett says of nicotine and alcohol. She says she had heard about Chantix about two and a half years ago, when the drug was still in development, and wanted to test it against alcoholism as soon as possible.
The study appears in the early online edition of the journal Proceedings of the National Academy of Sciences.
Chantix is made by the drug company Pfizer, which provided varenicline for the study but didn't fund the lab tests. The researchers note no conflicts of interest.
Alcoholism Experts Weigh In
The Chantix findings "look very promising," Marcus Heilig, MD, PhD, tells WebMD.
Heilig is the clinical director of the National Institute on Alcohol Abuse and Alcoholism (NIAAA). He wasn't involved in Bartlett's lab tests and is working to develop other new alcoholism drugs.
"Lately, neuroscience has been bringing forward a number of interesting new candidate targets, but that's just a fraction of the job," Heilig says.
"There are all these enormous hurdles of bringing molecules forward that will hit those targets and will make it all the way to the clinic. And that's compounded by the fact that industry doesn't necessarily always want to pursue development in this area. Well, here's a compound that's already passed all those hurdles," he says of Chantix.
"We know that it [Chantix] is safe and well tolerated, and that -- combined with the promise of some efficacy for reduction of heavy alcohol drinking -- is enormously encouraging," says Heilig.
However, he says it's very rare to find a drug that's a "magic bullet" against complex, chronic disorders such as alcoholism.
"For complex, chronic disorders, we need a range of therapies and then once we get that range, we need to figure out which patients benefit the most from which [therapies]," says Heilig.
Chantix Not Ready for Alcoholism Treatment
Heilig's NIAAA colleague, Howard Moss, MD, cautions people not to use Chantix for alcoholism treatment yet.
"We eagerly await the clinical trial to see if it actually works in humans," Moss tells WebMD. "I just want to be sure that people understand that they shouldn't just try this on their own."
Bartlett's study "is pretty exciting," says Moss, who is the associate director for clinical and translational research at the National Institute on Alcohol Abuse and Alcoholism.
"But there have been occasions where medications have worked great in animal models but have failed to live up to their promise in humans," says Moss.
In June, Moss and colleagues identified five subtypes of alcoholics -- and reported that more than half of U.S. alcoholics are young adults.
At the time, Moss told WebMD that people who suspect they may have a problem with alcohol to talk about it with their health care provider, since alcohol dependence "must be viewed as a severe disease."
Behavioral Therapy for Alcoholism
Bartlett, Heilig, and Moss note that a drug -- be it Chantix or something else -- isn't likely to be the sole solution to alcoholism.
"We wouldn't want patients to go running to their doctors and say, "Can I have this drug?" because it may not work unless they have behavioral therapy as well," says Bartlett, referring to Chantix.
Each person has a different genetic profile, and "some drugs work better for some people than other drugs," says Bartlett.
Moss puts it this way: "There is no magic bullet yet where we don't need behavioral modification in addition to medications to help people."
Heilig has some advice for people who suspect they may have a problem with alcohol: "Educate yourself and then seek treatment because there are already good treatments to be had."
"I think we need a good mix of very practical, change-oriented and compliance-oriented behavioral therapies and we need good medications," says Heilig.
Overcoming Alcoholism's Stigma
"Alcoholism is still more stigmatized than mental illness, and mental illness is pretty stigmatized," says Bartlett.
Heilig agrees. Alcoholism's stigma is "easing somewhat, but it's still sufficient to keep a large number of people -- the majority -- out of treatment," says Heilig.
Heilig says he would tell people dealing with alcohol problems to "try to see through the stigma and the perception of hopelessness or the perception that it's a character problem that you have to deal with yourself."
"The addicted brain is altered. It's very difficult, even for a person with the best of will, to deal with that on their own," says Heilig.
"On the other hand," Heilig adds, "with adequate help, change can happen and does happen. So that's a message of hope."
SOURCES: Steensland, P. Proceedings of the National Academy of Sciences, week of July 9-13, 2007; early online edition. Selena Bartlett, PhD, director, Preclinical Development Group, Ernest Gallo Clinic and Research Center, University of California, San Francisco. Marcus Heilig, MD, PhD, clinical director, National Institute on Alcohol Abuse and Alcoholism. Howard Moss, MD, associate director for clinical and translational research, National Institute on Alcohol Abuse and Alcoholism.
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