Using genotyping to improve the effectiveness of Naltrexone

Researchers

  1. Professor Jason White, University of Adelaide
  2. Professor Andrew Somogyi, University of Adelaide
  3. Dr Carolyn Edmonds, University of Adelaide
  4. Mr Rinaldo Minniti, University of Adelaide

Summary

Naltrexone is considered one of the two most effective pharmacotherapies for treating alcohol problems. Its use is still limited in Australia and the effectiveness of alcohol interventions could be enhanced by increased Naltrexone prescription. One factor leading to this under-utilisation may be lack of confidence in the effectiveness of the drug. While research trials show an overall positive outcome, many patients do not benefit from Naltrexone treatment and would be better diverted to other types of alcohol interventions.

This project examines whether a simple genetic test can determine which people will best respond to Naltrexone, particularly in the treatment of alcohol dependence. This may also improve outcomes, encourage prescription of Naltrexone and reduce unnecessary Naltrexone treatment.

Outcomes

The results of this study indicate that Naltrexone is an effective treatment for alcohol dependence, with high levels of treatment retention, as well as significant decreases in self-reported and objective indicators of alcohol use. Unfortunately, genotype was not a predictor of success, but pre-treatment abstinence did show an association with positive outcomes. Better outcomes were observed in participants who commenced treatment after a period of detoxification at an inpatient clinic. Participants who specified a goal of abstinence were significantly more likely to achieve their goal than those referred from other sources, and a greater number of days abstinent prior to treatment was also associated with better outcomes.

The results of this study do not support the use of genotyping to identify patients who might respond best to Naltrexone. This avoids costly tests, but recognises other factors that may help identify those who are better suited to the treatment.

The correct citation for this report is: White, JM, Somogyi, AA, Edmonds C, Minniti, R 2007 Using genotyping to improve the effectiveness of Naltrexone. Unpublished: University of Adelaide.

FARE continues to fund and undertake research that contributes to the knowledge-base about alcohol harms and strategies to reduce them.

This research is used to inform our approach to evidence-based alcohol policy development, ensuring that the solutions we are advocating for are informed by research. FARE’s research is also often quoted by governments, other not-for-profit organisations and researchers in public discussions about alcohol, demonstrating that FARE is seen as a leading source of information.

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