Drug to Treat Nausea Also May Help Alcoholics Stop Drinking
Although Zofran affects the brain's serotonin levels, it works in an opposite way from widely prescribed antidepressants that affect the serotonin system, known as SSRIs, such as Prozac (fluoxetine), Zoloft (sertraline), and Paxil (paroxetine), Johnson says.
"A few years ago, when we learned that these genetically predisposed alcoholics had a deficiency in serotonin, it was widely believed the SSRIs like Prozac would help these people stop drinking, but that has not proven to be the case," Johnson says. "That's why our findings are so exciting. This serotonin interaction seems to help."
Although Zofran is widely available, it can be expensive, with a 30-day supply of the 4 mg tablets ranging from about $450 to more than $600, according to an informal survey of pharmacies across the country.
About three-fourths of the patients enrolled in the San Antonio study received varying doses of the drug and the others received a placebo. Johnson says those patients receiving Zofran reported that they had a decreased craving for alcohol, and that drinking did not give them the same "rush" as it had in the past. All of the patients, regardless of whether they were given the drug or a placebo, received behavioral therapy.
The alcoholics who took Zofran stayed away from alcohol 70% of the time, compared to 50% of the time for those who took a placebo.
Gomez, who still does not know whether he received Zofran or the placebo, says his drive to drink was definitely diminished during the 12-week study. He attributes much of this to the group therapy sessions he attended religiously during that time, but he says the medication could have played a large part. He has not had a drink in more than a year.
"I spent 30 days in a Maryland treatment center back in the late 1980s, and I came out of there with the idea that if I was going to keep drinking, I had to cut down," he says. "So I worked my way down to 10 or 12 beers a day, and I thought I was doing good. When I joined this study, my counselor asked me what I wanted to achieve, and I said it might be nice to get down to a six-pack a day. But little by little, I realized that I couldn't just cut back. I had to quit."
It is not clear how big a role drug therapy played in Gomez's recovery, but all those interviewed agreed that it is likely to play a big role in the treatment of alcoholism and drug addiction in the future.
"Over the next decade, we are going to see more and more medications aimed at treating substance abuse," Henry R. Kranzler, MD, tells WebMD. "I think it is similar to where we were with cigarettes back in 1991, when the nicotine patch was approved. Since that time, we have seen a substantial decline in smoking, and with the availability of these new drugs, we may see a substantial impact on alcoholism over the next 10 years." Kranzler wrote an editorial accompanying the study.