Studies of the treatment of alcohol dependence are often limited by their short duration. Because alcohol dependence is a long-term condition with a high chance of relapse, studies that only last for a few weeks or months may present an incomplete picture. Additionally, not all people with alcohol addiction are the same. The differences between certain population subtypes can have a strong effect on long-term outcomes.
For instance, research has shown a significant link between the age of onset for alcohol dependence and the likelihood of effective treatment and abstinence. Early-onset alcoholism, which is evident in those who begin drinking heavily at 25 or younger, generally have a more difficult time gaining the upper hand on alcoholism. Likewise, certain genes have also been associated with an increased chance for alcohol dependence.
A recent study published in the journal Alcoholism: Clinical and Experimental Research looked at the duration of effects after the end of a placebo-controlled trial. During the trial, late-onset alcoholics responded better to Zoloft (sertraline), while early-onset alcoholics responded better to placebo. Study authors then performed 3- and 6-month follow-ups with the participants. After three months, the beneficial effects of Zoloft continued to be seen within a portion of the late-onset group. However, at six months all significant study effects had diminished.
Genetics also contributed to the effectiveness of treatment, both during and after the study. It’s believed that a particular gene plays a pivotal role in the transport of serotonin, with potential effects on both for the effectiveness of psychotropic medications and the likelihood of developing a substance abuse disorder. Carriers of the gene that predisposes one to alcohol dependence showed no follow-up benefits, regardless of whether the individual developed early onset or late onset alcoholism.
In contrast, those carrying the nonalcoholic genes had better results at follow-up, but these gains were largely erased by the time six months had elapsed. Interestingly, those with the predisposing gene actually had a worse response to Zoloft than placebo during the trial period, a finding with large consequences.
Effective treatment of alcohol dependence continues to be a significant public health challenge. Identifying the genetic and behavioral subtypes of alcoholism has been an important step toward more useful approaches to the condition. The current study adds to the pile of evidence that Zoloft, as well as similar drugs, can be effective for moderating individual drinking habits. Maintaining those benefits over the long haul is the next key challenge.
- Alcoholism and alcohol abuse – PubMed Health. (n.d.). National Center for Biotechnology Information. Retrieved August 3, 2012, from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001940/
- Kranzler, H., Armeli, S., & Tennen, H. (2012). Post-Treatment Outcomes in a Double-Blind, Randomized Trial of Sertraline for Alcohol Dependence. Alcoholism: Clinical and Experimental Research, 36(4), 739-744.
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