Use of serotonin selective pharmacotherapy in the treatment of alcohol dependence

This study presents a review of existing human studies that examine the role of serotonin [5-hydroxytryptamine (5-HT)] selective agents in the treatment of alcohol dependence. Findings of abnormally low 5-HT levels in many alcohol-dependent patients led investigators to explore the use of 5-HT selective pharmacotherapy in the treatment of alcoholism. Several studies reported that the administration of 5-HT selective pharmacological agents to alcohol-dependent patients effectively reduced alcohol intake, although results have been relatively modest. The most recent study by Kranzler et al. (Am. J. Psychiatry 152:391-397, 1995) found no added benefit over cognitive-behavioral treatment. However, the original relationship between the presence of alcohol dependence and low 5-HT levels in the brains of patients with alcoholism was predicated on subtypes of alcohol dependence. Research has suggested that 5-HT plays an important role in some forms of alcoholism that may be genetically or developmentally mediated. Thus, additional studies are needed to determine if treatment with 5-HT selective agents is viable therapeutic option for alcoholism, specifically in types of alcohol-dependent patients who are most likely to benefit from treatment with 5-HT selective pharmacotherapy.