Fluvoxamine and alcoholism

There has been much recent interest in the pharmacological manipulation of alcohol intake and alcohol seeking behaviour. An effective drug treatment could form an important part of a multi-modal treatment programme and could make controlled drinking more of a reality. In animal models the serotonin reuptake inhibitors, including fluvoxamine, have been consistently shown to reduce alcohol consumption, even in alcohol-preferring rat strains. Clinical studies have shown that these specific serotonin reuptake inhibitors may also be useful in significantly reducing the alcohol intake of a group of early stage problem drinkers. Although there are many possible mechanisms, the most likely mechanism to explain this mode of action of these specific serotonin antidepressants is that the serotonin enhancement they produce reduces the positive reinforcement properties of alcohol and thereby produces an anti-craving effect. These studies now need to be replicated, with particular attention being given to those patients who fulfil the criteria of the alcohol dependence syndrome. Such an ongoing study with fluvoxamine will be described.