Hazardous drinking and alcohol use disorders

Nature Reviews Disease Primers, Год журнала: 2022, Номер 8(1)

Опубликована: Дек. 22, 2022

Язык: Английский

---

The glucagon-like peptide-1 (GLP-1) analogue semaglutide reduces alcohol drinking and modulates central GABA neurotransmission

JCI Insight, Год журнала: 2023, Номер 8(12)

Опубликована: Май 16, 2023

Growing evidence indicates that the glucagon-like peptide-1 (GLP-1) system is involved in neurobiology of addictive behaviors, and GLP-1 analogues may be used for treatment alcohol use disorder (AUD). Here, we examined effects semaglutide, a long-acting analogue, on biobehavioral correlates rodents. A drinking-in-the-dark procedure was to test semaglutide binge-like drinking male female mice. We also tested dependence-induced rats, as well acute spontaneous inhibitory postsynaptic currents (sIPSCs) from central amygdala (CeA) infralimbic cortex (ILC) neurons. Semaglutide dose-dependently reduced mice; similar effect observed intake other caloric/noncaloric solutions. rats. increased sIPSC frequency CeA ILC neurons alcohol-naive suggesting enhanced GABA release, but had no overall transmission alcohol-dependent In conclusion, analogue decreased across different models species modulated neurotransmission, providing support clinical testing potentially novel pharmacotherapy AUD.

Язык: Английский

---

Mechanisms of Behavior Change in Substance Use Disorder With and Without Formal Treatment

Annual Review of Clinical Psychology, Год журнала: 2022, Номер 18(1), С. 497 - 525

Опубликована: Фев. 9, 2022

This article provides a narrative review of studies that examined mechanisms behavior change in substance use disorder. Several have some support, including self-efficacy, craving, protective behavioral strategies, and increasing substance-free rewards, whereas others minimal support (e.g., motivation, identity). The recommendations for expanding the research agenda studying change, designs to manipulate putative mechanisms, measurement approaches expand temporal units analysis during efforts, more outside treatment, analytic move beyond mediation tests. dominant causal inference approach focuses on treatment individuals as agents could be expanded include molar patterns temporally extended environmental contexts. Molar may advance understanding how recovery from disorder is influenced by broader contextual features, community-level variables, social determinants health.

Язык: Английский

---

A contextualized reinforcer pathology approach to addiction

Nature Reviews Psychology, Год журнала: 2023, Номер 2(5), С. 309 - 323

Опубликована: Март 21, 2023

Язык: Английский

---

Alcohol Use Disorder Treatment: Problems and Solutions

The Annual Review of Pharmacology and Toxicology, Год журнала: 2024, Номер 64(1), С. 255 - 275

Опубликована: Янв. 23, 2024

Alcohol use disorder (AUD) afflicts over 29 million individuals and causes more than 140,000 deaths annually in the United States. A heuristic framework for AUD includes a three-stage cycle—binge/intoxication, withdrawal/negative affect, preoccupation/anticipation—that provides starting point exploring heterogeneity of with regard to treatment. Effective behavioral health treatments US Food Drug Administration–approved medications are available but greatly underutilized, creating major treatment gap. This review outlines challenges that face alcohol field closing this gap offers solutions, including broadening end points approval AUD; increasing uptake screening, brief intervention, referral treatment; addressing stigma; implementing definition recovery; engaging early educating health-care professionals public about associated misuse. Additionally, focuses on potential targets development by utilizing model addiction domains dysfunction mediating neurobiology AUD.

Язык: Английский

---

Designing clinical trials to address alcohol use and alcohol-associated liver disease: an expert panel Consensus Statement

Nature Reviews Gastroenterology & Hepatology, Год журнала: 2024, Номер 21(9), С. 626 - 645

Опубликована: Июнь 7, 2024

Most patients with alcohol-associated liver disease (ALD) engage in heavy drinking defined as 4 or more drinks per day (56 g) 8 (112 week for women and 5 (70 15 (210 men. Although abstinence from alcohol after diagnosis of ALD improves life expectancy reduces the risk decompensation disease, few studies have evaluated whether treatment use disorders will reduce progression improve liver-related outcomes. In November 2021, National Institute Alcohol Abuse Alcoholism commissioned a task force that included hepatologists, addiction medicine specialists, statisticians, clinical trialists members regulatory agencies to develop recommendations design conduct trials evaluate effect use, particularly eliminate ALD. The conducted extensive reviews relevant literature on Findings were presented at one in-person meeting discussed over next 16 months final recommendations. As directly address this topic, 28 approved by all represent consensus expert opinions. Alcohol-associated is main cause morbidity mortality globally. This Consensus Statement makes design, best practice effects disorder.

Язык: Английский

---

Once-Weekly Semaglutide in Adults With Alcohol Use Disorder

JAMA Psychiatry, Год журнала: 2025, Номер unknown

Опубликована: Фев. 12, 2025

Importance Preclinical, observational, and pharmacoepidemiology evidence indicates that glucagon-like peptide 1 receptor agonists (GLP-1RAs) may reduce alcohol intake. Randomized trials are needed to determine the clinical significance of these findings. Objective To evaluate effects once-weekly subcutaneous semaglutide on consumption craving in adults with use disorder (AUD). Design, Setting, Participants This was a phase 2, double-blind, randomized, parallel-arm trial involving 9 weeks outpatient treatment. Enrollment occurred at an academic medical center US from September 2022 February 2024. Of 504 potential participants assessed, 48 non–treatment-seeking AUD were randomized. Intervention received (0.25 mg/week for 4 weeks, 0.5 1.0 mg week) or placebo weekly clinic visits. Main Outcomes Measures The primary outcome laboratory self-administration, measured pretreatment posttreatment (0.5 mg/week). Secondary exploratory outcomes, including prospective changes craving, assessed Results Forty-eight (34 [71%] female; mean [SD] age, 39.9 [10.6] years) Low-dose reduced amount consumed during self-administration task, medium large effect sizes grams (β, −0.48; 95% CI, −0.85 −0.11; P = .01) peak breath concentration −0.46; −0.87 −0.06; .03). Semaglutide treatment did not affect average drinks per calendar day number drinking days, but significantly −0.41; −0.73 −0.09; .04) −0.39; .01), also predicting greater reductions heavy over time relative 0.84; 0.71 0.99; .04). A significant treatment-by-time interaction indicated predicted cigarettes subsample individuals current cigarette −0.10; −0.16 −0.03; .005). Conclusions Relevance These findings provide initial low-dose can some justifying larger GLP-1RAs disorder. Trial Registration ClinicalTrials.gov Identifier: NCT05520775

Язык: Английский

---

Management of alcohol use disorder: a gastroenterology and hepatology-focused perspective

˜The œLancet. Gastroenterology & hepatology, Год журнала: 2025, Номер unknown

Опубликована: Фев. 1, 2025

Язык: Английский

---

Does semaglutide reduce alcohol intake in Danish patients with alcohol use disorder and comorbid obesity? Trial protocol of a randomised, double-blinded, placebo-controlled clinical trial (the SEMALCO trial)

BMJ Open, Год журнала: 2025, Номер 15(1), С. e086454 - e086454

Опубликована: Янв. 1, 2025

Introduction Alcohol use disorder (AUD) is a massive burden for the individual, relatives and society. Despite this, treatment gap wide compared with other mental health disorders. Treatment options are sparse, only three Food Drug Administration (FDA)-approved pharmacotherapies. Glucagon-like peptide-1 (GLP-1) receptor agonists have shown promising effects in reducing alcohol consumption preclinical experiments, clinical trials high demand to investigate these potentially beneficial patients diagnosed AUD. Methods analysis The of once-weekly GLP-1 agonist semaglutide will be investigated 26-week, randomised, placebo-controlled, double-blinded trial. 108 AUD comorbid obesity (body mass index (BMI)≥30 kg/m 2 )) randomised either or placebo combination cognitive behavioural therapy. A subgroup structural, functional neurochemical brain imaging performed at baseline after 26 weeks treatment. primary endpoint reduction heavy drinking days, defined as days excess 48/60 g per day (women men, respectively). Secondary endpoints include changes from week consumption, smoking status, quality life, fibrosis-4 score, plasma concentration phosphatidylethanol, gamma-aminobutyric acid (GABA) levels, cue reactivity, connectivity white matter tract integrity. Status Recruitment started June 2023. Ethics dissemination study approved by Committee Capital Region Denmark, Danish Board Health Data Protection Agency. All sign written consent form before being included Results disseminated through peer-reviewed publications conference presentations. After results published, all de-identified data available Mendeley database. Trial registration number NCT05895643 .

Язык: Английский

---

Management of alcohol use disorder in patients with cirrhosis in the setting of liver transplantation

Nature Reviews Gastroenterology & Hepatology, Год журнала: 2021, Номер 19(1), С. 45 - 59

Опубликована: Ноя. 1, 2021

Язык: Английский

---