Pharmaceutical approaches of binge drinking

Area of Science:

• Neuroscience
• Pharmacology
• Addiction Medicine

Background:

• Binge drinking (BD) is characterized as recurrent alcohol abuse and intoxication-seeking behavior in adolescents and young adults.
• Long-term consequences include alcohol dependence, neurodevelopmental disruptions, and alcoholic liver disease.
• Understanding BD requires differentiating psychological dependence (reward system, mesolimbic pathway) from physical dependence (GABA/Glutamate imbalance, Alcohol Withdrawal Syndrome).

Purpose of the Study:

• To classify current and future medications for alcohol addiction based on a dual model of dependence.
• To propose specific therapeutic schemes for treating BD, prioritizing anticraving medications.
• To incorporate harm-reductive, neuroprotective, and hepatoprotective strategies into BD treatment.

Main Methods:

• Literature review and classification of medications targeting psychological and physical dependence.
• Analysis of neurobiological underpinnings of alcohol dependence (mesolimbic pathway, GABA/Glutamate systems).
• Development of therapeutic strategies based on the dual dependence model and clinical specificities of BD.

Main Results:

• Medications for psychological dependence primarily regulate the mesolimbic pathway (anticraving drugs).
• Medications for physical dependence involve GABA agonists and NMDA antagonists.
• Many existing treatments exhibit dual actions on both dependence types.

Conclusions:

• A dual-action approach to pharmacotherapy is crucial for effectively treating binge drinking.
• Prioritizing anticraving medications, alongside harm reduction, neuroprotection, and hepatoprotection, offers a promising therapeutic avenue for BD.
• Future treatments should consider the unique clinical profile of binge drinkers.