Wednesday, March 21, 2018

More Evidence Chantix May Reduce Heavy Drinking(*)

A newly published study suggests varenicline (Chantix) may have role in the treatment of co-occurring alcohol use disorder and smoking.  Results from the Phase 2, randomized placebo-controlled trial, published in last month's JAMA Psychiatry, showed a reduction in the percentage of heavy drinking days among some of its participants.  These results, however, came with a big asterisk: the improvements were only seen among the men enrolled in the study, while the women in the placebo group showed more improvement than those in the medication group.

Chantix has been FDA-approved for smoking cessation since 2006.  As a partial nicotinic acetylcholine receptor agonist, it has been called the "Suboxone of nicotine addiction."  As researchers gained insights into the converging role this receptor system plays in both smoking and alcohol reward, the idea that it could have value in alcohol use disorder (AUD) treatment gained momentum.  Preclinical studies in 2007, 2009, and 2011 showed some promising results, indicating rodents taking the medicine drank less alcohol than those who weren't.  This led to several small human trials of Chantix for heavy drinking, though with mixed results.  The February study was the first to show such divergent results between the two genders, and it is unclear why men fared so much better than the women enrolled in the study.

Nevertheless, these results contribute a little more data to the search for new addiction medications and suggest prescribers may want to consider Chantix for their male patients who both smoke and drink heavily.  Here at Alltyr Clinic, we have seen some of our AUD patients respond quite well to Chantix.  Since our clinicians routinely screen our patients who smoke for their desire to quit, it has been a logical option to consider as a firstline treatment. Despite the less-than-blockbuster results of this study, we are glad to hear about any new research on potential medication options.

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