For the more than 2 million Amercians seeking treatment for alcohol dependence, news of a new drug is welcomed. An old treatment for alcoholism has been made new by changing the drug, naltrexone, (which was originally administered orally to), to an injectible form. The once monthly form of naltrexone, made by Alkermes Inc, will be called Vivitrol. In early April of 2006, the Food and Drug Administration approved Vivitrol for use in alcoholics to be administered at physician's offices only.
The once daily pill form of naltrexone resulted in poor compliance and clinician's hope the new treatment approach will result in better success rates for alcoholics when combined with counseling. The treatment is only recommended in patients who are abstaining from alcohol and helps address cravings so that alcoholics may be successful in their efforts. Unfortunately, there are risks of severe liver damage. The drugmaker states that vivitrol is "contraindicated in acute hepatitis or liver failure, and its use in patients with active liver disease must be carefully considered in light of its hepatotoxic effects. The margin of separation between the apparently safe dose of naltrexone and the dose causing hepatic injury appears to be only five-fold or less."
It appears that naltrexone influences opioid receptors in the brain. The company cites, "Although the mechanism responsible for the reduction in alcohol consumption observed with VIVITROL treatment is not entirely understood, preclinical data suggests that occupation of the opioid receptors results in the blockade of the neurotransmitters in the brain that are believed to be involved with alcohol dependence. This blockade may result in the reduction in alcohol consumption observed in patients treated with VIVITROL."
Posted by Dr. Jennifer Stagg on August 12, 2006 01:58 PM
