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Marin MCD, Pedro MOP, Perrotte G, Martins-da-Silva AS, Lassi DLS, Blaas IK, Castaldelli FI, Brisola dos Santos MB, Kortas GT, Campos MW, Torales J, Ventriglio A, Périco CDAM, Negrão AB, Leopoldo K, de Andrade AG, Malbergier A, Castaldelli-Maia JM. Pharmacological Treatment of Alcohol Cravings. Brain Sci 2023; 13:1206. [PMID: 37626562 PMCID: PMC10452441 DOI: 10.3390/brainsci13081206] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 08/03/2023] [Accepted: 08/04/2023] [Indexed: 08/27/2023] Open
Abstract
(1) Background: The treatment of substance addiction is challenging and has persisted for decades, with only a few therapeutic options. Although there are some recommendations for specific treatments for Alcohol Use Disorder (AUD), there is no specific medication used to treat alcohol cravings, which could benefit millions of patients that are suffering from alcoholism. Cravings, or the urge to use drugs, refer to the desire to experience the effects of a previously experienced psychoactive substance. (2) Methods: We included original studies of alcohol abuse or dependence extracted from a controlled, blind, pharmacological treatment study which presented measures and outcomes related to alcohol cravings. (3) Results: Specific drugs used for the treatment of alcoholism, such as Naltrexone and Acamprosate, have had the best results in relieving craving symptoms, as well as promoting abstinence. Baclofen and anticonvulsants such as Gabapentin and Topiramate have shown good results in promoting abstinence and the cessation of cravings. (4) Conclusions: Specific drugs used for the treatment of alcoholism to obtain the best results can be considered the gold standard for promoting abstinence and relieving cravings. Anticonvulsants and Baclofen also had good results, with these medications being considered as second-line ones. Varenicline is an option for alcohol dependents who also concomitantly ingest tobacco.
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Affiliation(s)
- Matheus Cheibub David Marin
- Perdizes Institute (IPer), Clinics Hospital of the Medical School (HCFMUSP), University of São Paulo, São Paulo 05021-001, Brazil; (M.C.D.M.); (D.L.S.L.); (I.K.B.); (G.T.K.); (A.B.N.); (A.G.d.A.); (A.M.)
- Hospital Sírio-Libanês, São Paulo 01308-050, Brazil; (M.O.P.P.); (M.B.B.d.S.)
| | - Maria Olívia Pozzolo Pedro
- Hospital Sírio-Libanês, São Paulo 01308-050, Brazil; (M.O.P.P.); (M.B.B.d.S.)
- Department of Psychiatry, Medical School, University of São Paulo, São Paulo 05403-903, Brazil; (A.S.M.-d.-S.); (K.L.)
| | - Giuliana Perrotte
- Department of Neuroscience, Medical School, FMABC University Center, Santo André 09060-870, Brazil; (G.P.); (C.d.A.-M.P.)
| | - Anderson S. Martins-da-Silva
- Department of Psychiatry, Medical School, University of São Paulo, São Paulo 05403-903, Brazil; (A.S.M.-d.-S.); (K.L.)
| | - Dangela L. S. Lassi
- Perdizes Institute (IPer), Clinics Hospital of the Medical School (HCFMUSP), University of São Paulo, São Paulo 05021-001, Brazil; (M.C.D.M.); (D.L.S.L.); (I.K.B.); (G.T.K.); (A.B.N.); (A.G.d.A.); (A.M.)
| | - Israel Kanaan Blaas
- Perdizes Institute (IPer), Clinics Hospital of the Medical School (HCFMUSP), University of São Paulo, São Paulo 05021-001, Brazil; (M.C.D.M.); (D.L.S.L.); (I.K.B.); (G.T.K.); (A.B.N.); (A.G.d.A.); (A.M.)
- Department of Neuroscience, Medical School, FMABC University Center, Santo André 09060-870, Brazil; (G.P.); (C.d.A.-M.P.)
| | | | | | - Guilherme Trevizan Kortas
- Perdizes Institute (IPer), Clinics Hospital of the Medical School (HCFMUSP), University of São Paulo, São Paulo 05021-001, Brazil; (M.C.D.M.); (D.L.S.L.); (I.K.B.); (G.T.K.); (A.B.N.); (A.G.d.A.); (A.M.)
- Hospital Sírio-Libanês, São Paulo 01308-050, Brazil; (M.O.P.P.); (M.B.B.d.S.)
- Department of Psychiatry, Medical School, University of São Paulo, São Paulo 05403-903, Brazil; (A.S.M.-d.-S.); (K.L.)
| | - Marcela Waisman Campos
- Department of Cognitive Neurology, Neuropsychiatry, and Neuropsychology, Fleni, Buenos Aires C1428AQK, Argentina;
| | - Julio Torales
- Department of Medical Psychology, School of Medical Sciences, Universidad Nacional de Asunción, San Lorenzo 111454, Paraguay;
- Regional Institute of Health Research, Universidad Nacional de Caaguazú, Coronel Oviedo 050106, Paraguay
- School of Health Sciences, Universidad Sudamericana, Pedro Juan Caballero 130112, Paraguay
| | - Antonio Ventriglio
- Department of Experimental Medicine, Medical School, University of Foggia, 71100 Foggia, Italy;
| | | | - André B. Negrão
- Perdizes Institute (IPer), Clinics Hospital of the Medical School (HCFMUSP), University of São Paulo, São Paulo 05021-001, Brazil; (M.C.D.M.); (D.L.S.L.); (I.K.B.); (G.T.K.); (A.B.N.); (A.G.d.A.); (A.M.)
| | - Kae Leopoldo
- Department of Psychiatry, Medical School, University of São Paulo, São Paulo 05403-903, Brazil; (A.S.M.-d.-S.); (K.L.)
| | - Arthur Guerra de Andrade
- Perdizes Institute (IPer), Clinics Hospital of the Medical School (HCFMUSP), University of São Paulo, São Paulo 05021-001, Brazil; (M.C.D.M.); (D.L.S.L.); (I.K.B.); (G.T.K.); (A.B.N.); (A.G.d.A.); (A.M.)
- Hospital Sírio-Libanês, São Paulo 01308-050, Brazil; (M.O.P.P.); (M.B.B.d.S.)
- Department of Psychiatry, Medical School, University of São Paulo, São Paulo 05403-903, Brazil; (A.S.M.-d.-S.); (K.L.)
- Department of Neuroscience, Medical School, FMABC University Center, Santo André 09060-870, Brazil; (G.P.); (C.d.A.-M.P.)
| | - André Malbergier
- Perdizes Institute (IPer), Clinics Hospital of the Medical School (HCFMUSP), University of São Paulo, São Paulo 05021-001, Brazil; (M.C.D.M.); (D.L.S.L.); (I.K.B.); (G.T.K.); (A.B.N.); (A.G.d.A.); (A.M.)
- Department of Psychiatry, Medical School, University of São Paulo, São Paulo 05403-903, Brazil; (A.S.M.-d.-S.); (K.L.)
| | - João Maurício Castaldelli-Maia
- Hospital Sírio-Libanês, São Paulo 01308-050, Brazil; (M.O.P.P.); (M.B.B.d.S.)
- Department of Psychiatry, Medical School, University of São Paulo, São Paulo 05403-903, Brazil; (A.S.M.-d.-S.); (K.L.)
- Department of Neuroscience, Medical School, FMABC University Center, Santo André 09060-870, Brazil; (G.P.); (C.d.A.-M.P.)
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OUP accepted manuscript. J AOAC Int 2022; 105:1162-1174. [DOI: 10.1093/jaoacint/qsac023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 01/10/2022] [Accepted: 02/07/2022] [Indexed: 11/14/2022]
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Singh L, Joshi T, Tewari D, Echeverría J, Mocan A, Sah AN, Parvanov E, Tzvetkov NT, Ma ZF, Lee YY, Poznański P, Huminiecki L, Sacharczuk M, Jóźwik A, Horbańczuk JO, Feder-Kubis J, Atanasov AG. Ethnopharmacological Applications Targeting Alcohol Abuse: Overview and Outlook. Front Pharmacol 2020; 10:1593. [PMID: 32116660 PMCID: PMC7034411 DOI: 10.3389/fphar.2019.01593] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 12/09/2019] [Indexed: 12/12/2022] Open
Abstract
Excessive alcohol consumption is the cause of several diseases and thus is of a major concern for society. Worldwide alcohol consumption has increased by many folds over the past decades. This urgently calls for intervention and relapse counteract measures. Modern pharmacological solutions induce complete alcohol self-restraint and prevent relapse, but they have many side effects. Natural products are most promising as they cause fewer adverse effects. Here we discuss in detail the medicinal plants used in various traditional/folklore medicine systems for targeting alcohol abuse. We also comprehensively describe preclinical and clinical studies done on some of these plants along with the possible mechanisms of action.
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Affiliation(s)
- Laxman Singh
- Centre for Biodiversity Conservation & Management, G.B. Pant National Institute of Himalayan Environment & Sustainable Development, Almora, India
| | - Tanuj Joshi
- Department of Pharmaceutical Sciences, Faculty of Technology, Kumaun University Bhimtal Campus, Nainital, India
| | - Devesh Tewari
- Department of Pharmacognosy, School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, India
- Institute of Genetics and Animal Breeding of the Polish Academy of Sciences, Jastrzebiec, Poland
| | - Javier Echeverría
- Department of Environmental Sciences, Faculty of Chemistry and Biology, Universidad de Santiago de Chile, Santiago, Chile
| | - Andrei Mocan
- Department of Pharmaceutical Botany, “Iuliu Hațieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Archana N. Sah
- Department of Pharmaceutical Sciences, Faculty of Technology, Kumaun University Bhimtal Campus, Nainital, India
| | - Emil Parvanov
- Institute of Molecular Genetics, Academy of Sciences of the Czech Republic, Division BIOCEV, Prague, Czechia
| | - Nikolay T. Tzvetkov
- Institute of Molecular Biology “Roumen Tsanev”, Department of Biochemical Pharmacology and Drug Design, Bulgarian Academy of Sciences, Sofia, Bulgaria
- Department Global R&D, NTZ Lab Ltd., Sofia, Bulgaria
| | - Zheng Feei Ma
- Department of Public Health, Xi’an Jiaotong-Liverpool University, Suzhou, China
- School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Yeong Yeh Lee
- School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Piotr Poznański
- Institute of Genetics and Animal Breeding of the Polish Academy of Sciences, Jastrzebiec, Poland
| | - Lukasz Huminiecki
- Institute of Genetics and Animal Breeding of the Polish Academy of Sciences, Jastrzebiec, Poland
| | - Mariusz Sacharczuk
- Institute of Genetics and Animal Breeding of the Polish Academy of Sciences, Jastrzebiec, Poland
| | - Artur Jóźwik
- Institute of Genetics and Animal Breeding of the Polish Academy of Sciences, Jastrzebiec, Poland
| | - Jarosław O. Horbańczuk
- Institute of Genetics and Animal Breeding of the Polish Academy of Sciences, Jastrzebiec, Poland
| | - Joanna Feder-Kubis
- Faculty of Chemistry, Wrocław University of Science and Technology, Wybrzeże Wyspiańskiego, Wrocław, Poland
| | - Atanas G. Atanasov
- Institute of Genetics and Animal Breeding of the Polish Academy of Sciences, Jastrzebiec, Poland
- Department of Pharmacognosy, University of Vienna, Vienna, Austria
- Institute of Neurobiology, Bulgarian Academy of Sciences, Sofia, Bulgaria
- Ludwig Boltzmann Institute for Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria
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Liu J, Shi YC, Lee DYW. Applications of Pueraria lobata in treating diabetics and reducing alcohol drinking. CHINESE HERBAL MEDICINES 2019; 11:141-149. [PMID: 32831815 PMCID: PMC7434045 DOI: 10.1016/j.chmed.2019.04.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Pueraria lobata is one of the most important medicinal herbs used traditionally in China. According to Shanghan Lun (Treatise on Exogenous Febrile Disease), it has been used traditionally to relieve body heat, eye soring, dry mouth, headache associated with high blood pressure, and stiff neck problems. Modern studies in the 1970s revealed that isoflavonoids extracted from P. lobata were the bioactive components of an herbal remedy namely Yufeng Ningxin Tablets for the treatment of patients after stroke. This article reviews recent application of P. lobota in the treatment of diabetics and in reducing alcohol drinking. In view of its low toxicity profile, P. lobota stands an excellent chance to be developed as a phytomedicine for treating human diseases.
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Affiliation(s)
- Jing Liu
- Bio-Organic and Natural Products Research Laboratory, Mailman Research Center, McLean Hospital/Harvard Medical School, Belmont, MA 02478, USA
| | | | - David Yue-Wei Lee
- Bio-Organic and Natural Products Research Laboratory, Mailman Research Center, McLean Hospital/Harvard Medical School, Belmont, MA 02478, USA
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Feinberg T, Wieland LS, Miller LE, Munir K, Pollin TI, Shuldiner AR, Amoils S, Gallagher L, Bahr-Robertson M, D'Adamo CR. Polyherbal dietary supplementation for prediabetic adults: study protocol for a randomized controlled trial. Trials 2019; 20:24. [PMID: 30616613 PMCID: PMC6323847 DOI: 10.1186/s13063-018-3032-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Accepted: 11/01/2018] [Indexed: 12/15/2022] Open
Abstract
Background Prediabetes describes a state of hyperglycemia outside of normal limits that does not meet the criteria for diabetes diagnosis, is generally symptomless, and affects an estimated 38% of adults in the United States. Prediabetes typically precedes the diagnosis of type 2 diabetes, which accounts for increased morbidity and mortality. Although the use of dietary and herbal supplements is popular worldwide, and a variety of single herbal medicines have been examined for glycemic management, the potential of increasingly common polyherbal formulations to return glycemic parameters to normal ranges among adults with prediabetes remains largely unexplored. The purpose of this study is to evaluate the efficacy of a commercially available, polyherbal dietary supplement on glycemic and lipid parameters in prediabetic individuals. Methods In this multi-site, double-blinded, randomized controlled clinical trial, 40 participants with prediabetes will be randomized to either a daily oral polyherbal dietary supplement (GlucoSupreme™ Herbal; Designs for Health®, Suffield, CT, USA; containing cinnamon bark (Cinnamomum cassia), banaba leaf (Lagerstroemia speciosa standardized to 1% corosolic acid), kudzu root (Pueraria lobata standardized to 40% isoflavones), fenugreek seed (Trigonella foenum-graceum standardized to 60% saponins), gymnema leaf (Gymnema sylvestre standardized to 25% gymnemic acid), American ginseng root (Panax quinquefolius standardized to 5% ginsenosides), and berberine HCl derived from bark (Berberis aristata)) or placebo for 12 weeks. Short-, medium-, and comparatively long-term markers of glycemic control (blood glucose and fasting insulin, fructosamine, and glycated hemoglobin/A1c, respectively), and other glycemic parameters (GlycoMark, β-cell function, and insulin sensitivity/resistance) will be obtained. Lipid profile (total cholesterol, LDL, HDL, and triglycerides), inflammation (hs-CRP), progression to type 2 diabetes mellitus, as well as safety indices (ALT, AST) will be obtained. An intention-to-treat analysis will be used to assess changes in study outcomes. Discussion Treatment options for adults with prediabetes are currently limited. This study aims to evaluate the safety and efficacy of a commercially available dietary supplement in the popular, but as yet insufficiently studied, category of polyherbal formulas for the management of glycemic parameters and other biomarkers associated with prediabetes. Trial registration ClinicalTrials.gov, ID: NCT03388762. Retrospectively registered on 4 January 2018. Electronic supplementary material The online version of this article (10.1186/s13063-018-3032-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Termeh Feinberg
- University of Maryland School of Medicine Center for Integrative Medicine, Baltimore, MD, USA. .,Yale University School of Medicine Center for Medical Informatics, New Haven, CT, USA.
| | - L Susan Wieland
- University of Maryland School of Medicine Center for Integrative Medicine, Baltimore, MD, USA
| | | | - Kashif Munir
- University of Maryland School of Medicine Center for Diabetes and Endocrinology, Baltimore, MD, USA
| | - Toni I Pollin
- University of Maryland School of Medicine Department of Medicine, Baltimore, MD, USA
| | - Alan R Shuldiner
- University of Maryland School of Medicine Department of Medicine, Baltimore, MD, USA
| | - Steve Amoils
- Alliance Integrative Medicine, Cincinatti, OH, USA
| | | | - Mary Bahr-Robertson
- University of Maryland School of Medicine Center for Integrative Medicine, Baltimore, MD, USA
| | - Christopher R D'Adamo
- University of Maryland School of Medicine Center for Integrative Medicine, Baltimore, MD, USA
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Barajaz AM, Kliethermes CL. An assessment of the utilization of the preclinical rodent model literature in clinical trials of putative therapeutics for the treatment of alcohol use disorders. Drug Alcohol Depend 2017; 181:77-84. [PMID: 29035708 DOI: 10.1016/j.drugalcdep.2017.09.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 09/11/2017] [Accepted: 09/12/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Rodent models of Alcohol Use Disorders (AUD) are used extensively by preclinical researchers to develop new therapeutics for the treatment of AUD. Although these models play an important role in the development of novel, targeted therapeutics, their role in bringing therapeutics to clinical trials is unclear, as off-label use of existing medications not approved for the treatment of AUD is commonly seen in the clinic and clinical trials. METHOD In the current study, we used the Clinicaltrials.gov database to obtain a list of drugs that have been tested for efficacy in a clinical trial between 1997 and 2017. We then conducted a set of literature searches to determine which of the 98 unique drugs we identified had shown efficacy in a rodent model of an AUD prior to being tested in a clinical trial. RESULTS We found that slightly less than half of the drugs tested in clinical trials (48%) had shown prior efficacy in any rodent model of an AUD, while the remaining 52% of drugs were used off-label, or in some cases, following non-published studies. CONCLUSION This study raises the question of how clinical researchers incorporate results from preclinical studies in the decision to bring a drug to a clinical trial. Our results underscore the need for ongoing communication among preclinical and clinical researchers.
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Affiliation(s)
- Ashley M Barajaz
- Drake University, Department of Psychology and Neuroscience, 1344 27th Street, Des Moines, IA 50311, United States
| | - Christopher L Kliethermes
- Drake University, Department of Psychology and Neuroscience, 1344 27th Street, Des Moines, IA 50311, United States.
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Mangot AG, Murthy VS, Jamale S. Pattern of prescription, dispensation and administration of disulfiram among patients with alcohol use disorder attending a general hospital psychiatry unit in rural India. Asian J Psychiatr 2017; 28:170-174. [PMID: 28784380 DOI: 10.1016/j.ajp.2017.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 05/03/2017] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Disulfiram was the first medication approved to treat alcohol dependence and has been found to be safe and efficacious. This cross sectional, observational, qualitative study was conducted with the aim to assess the pattern of dispensation of disulfiram among patients with alcohol use disorder (AUD). MATERIAL AND METHODS Data was collected using a customized questionnaire consisting of 32 questions regarding socio-demographic characteristics, psychiatric history, pattern of dispensation of disulfiram/disulfiram-like product (DLP) and related knowledge. Descriptive statistics and frequency distribution tables were used for analysing the data using Microsoft Excel 2013. RESULTS Thirty seven percent (n=100) of the total patients with ADS (n=268) screened had a history of administration of disulfiram/DLP. Tablets were the commonest (60%) formulation of disulfiram/DLP advised by the dispenser, only 4% of whom were psychiatrists. Surreptitious administration was preferred by family members (76%). Majority of the patients (44%) received the medication only once or twice. LIMITATIONS The actual product - disulfiram and/or DLP - could not be chemically tested to confirm the identity. Considering the socio-economic and cultural background where the study was conducted, it would be difficult to generalize the findings. DISCUSSION Disulfiram/DLP was prescribed by physicians and faith healers alike. They seem to promote surreptitious administration of disulfiram with full agreement of relatives, thereby potentially exposing the patient to life threatening complications. Hence it is recommended that disulfiram prescription should involve stricter guidelines and DLP like kudzu in traditional/herbal products should also be brought under the same purview as disulfiram.
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Affiliation(s)
- Ajish G Mangot
- Department of Psychiatry, Krishna Institute of Medical Sciences Deemed University, Karad, District Satara, Maharashtra, 415110, India.
| | - Vasantmeghna S Murthy
- Department of Psychiatry, Krishna Institute of Medical Sciences Deemed University, Karad, District Satara, Maharashtra, 415110, India
| | - Shubhangi Jamale
- Department of Psychiatry, Krishna Institute of Medical Sciences Deemed University, Karad, District Satara, Maharashtra, 415110, India
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Liang J, Olsen RW. Alcohol use disorders and current pharmacological therapies: the role of GABA(A) receptors. Acta Pharmacol Sin 2014; 35:981-93. [PMID: 25066321 PMCID: PMC4125717 DOI: 10.1038/aps.2014.50] [Citation(s) in RCA: 86] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Accepted: 05/16/2014] [Indexed: 12/18/2022] Open
Abstract
Alcohol use disorders (AUD) are defined as alcohol abuse and alcohol dependence, which create large problems both for society and for the drinkers themselves. To date, no therapeutic can effectively solve these problems. Understanding the underlying mechanisms leading to AUD is critically important for developing effective and safe pharmacological therapies. Benzodiazepines (BZs) are used to reduce the symptoms of alcohol withdrawal syndrome. However, frequent use of BZs causes cross-tolerance, dependence, and cross-addiction to alcohol. The FDA-approved naltrexone and acamprosate have shown mixed results in clinical trials. Naltrexone is effective to treat alcohol dependence (decreased length and frequency of drinking bouts), but its severe side effects, including withdrawal symptoms, are difficult to overcome. Acamprosate showed efficacy for treating alcohol dependence in European trials, but two large US trials have failed to confirm the efficacy. Another FDA-approved medication, disulfiram, does not diminish craving, and it causes a peripheral neuropathy. Kudzu is the only natural medication mentioned by the National Institute on Alcohol Abuse and Alcoholism, but its mechanisms of action are not yet established. It has been recently shown that dihydromyricetin, a flavonoid purified from Hovenia, has unique effects on GABAA receptors and blocks ethanol intoxication and withdrawal in alcoholic animal models. In this article, we review the role of GABAA receptors in the treatment of AUD and currently available and potentially novel pharmacological agents.
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Affiliation(s)
- Jing Liang
- Department of Molecular & Medical Pharmacology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Richard W Olsen
- Department of Molecular & Medical Pharmacology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
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Ulbricht C, Costa D, Dam C, D'Auria D, Giese N, Isaac R, LeBlanc Y, Rusie E, Weissner W, Windsor RC. An evidence-based systematic review of kudzu (Pueraria lobata) by the Natural Standard Research Collaboration. J Diet Suppl 2014; 12:36-104. [PMID: 24848872 DOI: 10.3109/19390211.2014.904123] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
An evidence-based systematic review of kudzu (Pueraria lobata) by the Natural Standard Research Collaboration consolidates the safety and efficacy data available in the scientific literature using a validated, reproducible grading rationale. This article includes written and statistical analysis of clinical trials, plus a compilation of expert opinion, folkloric precedent, history, pharmacology, kinetics/dynamics, interactions, adverse effects, toxicology, and dosing.
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Singh AK, Jiang Y, Gupta S, Younus M, Ramzan M. Anti-Inflammatory Potency of Nano-Formulated Puerarin and Curcumin in Rats Subjected to the Lipopolysaccharide-Induced Inflammation. J Med Food 2013; 16:899-911. [DOI: 10.1089/jmf.2012.0049] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Affiliation(s)
- Ashok K. Singh
- Department of Veterinary Population Medicine, College of Veterinary Medicine, University of Minnesota, St. Paul, Minnesota
| | - Yin Jiang
- Department of Veterinary Population Medicine, College of Veterinary Medicine, University of Minnesota, St. Paul, Minnesota
| | - Shveta Gupta
- Department of Veterinary Population Medicine, College of Veterinary Medicine, University of Minnesota, St. Paul, Minnesota
| | - Mohamod Younus
- Department of Veterinary Population Medicine, College of Veterinary Medicine, University of Minnesota, St. Paul, Minnesota
| | - Mohamod Ramzan
- Department of Veterinary Population Medicine, College of Veterinary Medicine, University of Minnesota, St. Paul, Minnesota
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Lukas SE, Penetar D, Su Z, Geaghan T, Maywalt M, Tracy M, Rodolico J, Palmer C, Ma Z, Lee DYW. A standardized kudzu extract (NPI-031) reduces alcohol consumption in nontreatment-seeking male heavy drinkers. Psychopharmacology (Berl) 2013; 226:65-73. [PMID: 23070022 PMCID: PMC3562758 DOI: 10.1007/s00213-012-2884-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2012] [Accepted: 09/15/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVE We previously demonstrated that short-term treatment with a standardized kudzu extract (NPI-031) reduced alcohol drinking by men and women in a natural setting. The present study was conducted in nontreatment-seeking heavy drinkers to assess the safety and efficacy of 4 weeks of kudzu extract in an outpatient setting. METHOD This randomized between-subject, double-blind, placebo-controlled study involved 2 weeks of baseline, 4 weeks of treatment, and 2 weeks of follow-up. Seventeen men (21-33 years) who reported drinking 27.6 ± 6.5 drinks/week with a diagnosis of alcohol abuse/dependence took either kudzu extract (250 mg isoflavones, t.i.d.) or matched placebo on a daily basis. They reported alcohol consumption and desire to use alcohol using a wrist actigraphy device; twice weekly laboratory visits were scheduled to monitor medication adherence and adverse events. RESULTS Medication adherence was excellent and there were no adverse events and changes in vital signs, blood chemistry, and renal or liver function. There was no effect on alcohol craving, but kudzu extract significantly reduced the number of drinks consumed each week by 34-57 %, reduced the number of heavy drinking days, and significantly increased the percent of days abstinent and the number of consecutive days of abstinence. CONCLUSIONS A standardized formulation of kudzu extract produced minimal side effects, was well-tolerated, and resulted in a modest reduction in alcohol consumption in young nontreatment-seeking heavy drinkers. Additional studies using treatment-seeking alcohol-dependent persons will be necessary to determine the usefulness of this herbal preparation in reducing alcohol use in other populations.
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Affiliation(s)
- Scott E Lukas
- Behavioral Psychopharmacology Research Laboratory/MIC, Mail Stop 319 McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA.
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Kushner S, Han D, Oscar-Berman M, William Downs B, Madigan MA, Giordano J, Beley T, Jones S, Barh D, Simpatico T, Dushaj K, Lohmann R, Braverman ER, Schoenthaler S, Ellison D, Blum K. Declinol, a Complex Containing Kudzu, Bitter Herbs (Gentian, Tangerine Peel) and Bupleurum, Significantly Reduced Alcohol Use Disorders Identification Test (AUDIT) Scores in Moderate to Heavy Drinkers: A Pilot Study. ACTA ACUST UNITED AC 2013; 4. [PMID: 24273684 DOI: 10.4172/2155-6105.1000153] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
It is well established that inherited human aldehyde dehydrogenase 2 (ALDH-2) deficiency reduces the risk for alcoholism. Kudzu plants and extracts have been used for 1,000 years in traditional Chinese medicine to treat alcoholism. Kudzu contains daidzin, which inhibits ALDH-2 and suppresses heavy drinking in rodents. Decreased drinking due to ALDH-2 inhibition is attributed to aversive properties of acetaldehyde accumulated during alcohol consumption. However not all of the anti-alcohol properties of diadzin are due to inhibition of ALDH-2. This is in agreement with our earlier work showing significant interaction effects of both pyrozole (ALDH-2 inhibitor) and methyl-pyrozole (non-inhibitor) and ethanol's depressant effects. Moreover, it has been suggested that selective ALDH 2 inhibitors reduce craving for alcohol by increasing dopamine in the nucleus accumbens (NAc). In addition there is significant evidence related to the role of the genetics of bitter receptors (TAS2R) and its stimulation as an aversive mechanism against alcohol intake. The inclusion of bitters such as Gentian & Tangerine Peel in Declinol provides stimulation of gut TAS2R receptors which is potentially synergistic with the effects of Kudzu. Finally the addition of Radix Bupleuri in the Declinol formula may have some protective benefits not only in terms of ethanol induced liver toxicity but neurochemical actions involving endorphins, dopamine and epinephrine. With this information as a rationale, we report herein that this combination significantly reduced Alcohol Use Disorders Identification Test (AUDIT) scores administered to ten heavy drinkers (M=8, F=2; 43.2 ± 14.6 years) attending a recovery program. Specifically, from the pre-post comparison of the AUD scores, it was found that the score of every participant decreased after the intervention which ranged from 1 to 31. The decrease in the scores was found to be statistically significant with the p-value of 0.00298 (two-sided paired test; p-value = 0.00149 for one-sided test). Albeit this being a small pilot, we are encouraged about these significant results, and caution any interpretation until larger controlled studies are executed.
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Affiliation(s)
- Steven Kushner
- Department of Nutritional Science, ALM Research & Development, Inc., Tampa, FL, USA
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Penetar DM, Toto LH, Farmer SL, Lee DYW, Ma Z, Liu Y, Lukas SE. The isoflavone puerarin reduces alcohol intake in heavy drinkers: a pilot study. Drug Alcohol Depend 2012; 126:251-6. [PMID: 22578529 PMCID: PMC3430804 DOI: 10.1016/j.drugalcdep.2012.04.012] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2012] [Revised: 04/12/2012] [Accepted: 04/13/2012] [Indexed: 11/30/2022]
Abstract
BACKGROUND Isoflavone compounds naturally occurring in the root of the kudzu plant have been used historically to treat alcohol-related problems. A pilot study was conducted to assess the effects of one primary isoflavone--puerarin--for its ability to modify alcohol intake in humans. METHODS Ten (10) healthy adult volunteers were administered puerarin (1200 mg daily) in a double-blind, placebo-controlled, crossover design experiment for one week prior to an afternoon drinking session lasting 1.5h. Participants had access to up to six bottles of their preferred brand of beer in addition to juice and water. A time course of drinking, sip volumes, and total amount consumed were recorded. RESULTS Participants consumed on average 3.5 (±0.55) beers when treated with placebo and 2.4 (±0.41) beers when treated with puerarin. In contrast to drinking following placebo treatment when 3 participants drank 5 beers and 1 participant drank all 6 beers, none drank 5 or 6 beers when treated with puerarin. Drinking topography also changed. When treated with puerarin, participants decreased sip size, took more sips to finish a beer, and took longer to consume each beer. Additionally, after finishing a beer, latency to opening the next beer was increased. CONCLUSIONS This study is the first demonstration that a single isoflavone found in the kudzu root can alter alcohol drinking in humans. These results suggest that alcohol consumption patterns are influenced by puerarin administration and this botanical medication may be a useful adjunct in the treatment of excessive alcohol intake.
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Affiliation(s)
- David M. Penetar
- Behavioral Psychopharmacology Research Laboratory, McLean Hospital, Belmont, MA 02478,Department of Psychiatry, Harvard Medical School, Boston, MA 02115,Corresponding Author: David M. Penetar BPRL, mail stop 319 McLean Hospital 115 Mill Street Belmont, MA 02478 Phone: 617-855-2913 FAX: 617-855-3774
| | - Lindsay H. Toto
- Behavioral Psychopharmacology Research Laboratory, McLean Hospital, Belmont, MA 02478
| | - Stacey L. Farmer
- Behavioral Psychopharmacology Research Laboratory, McLean Hospital, Belmont, MA 02478
| | - David Y.-W. Lee
- Department of Bio-Organic and Natural Products Laboratory, McLean Hospital, Belmont, MA 02478,Natural Pharmacia International, Inc, Burlington, MA 01803
| | - Zhongze Ma
- Department of Bio-Organic and Natural Products Laboratory, McLean Hospital, Belmont, MA 02478
| | - Yanze Liu
- Natural Pharmacia International, Inc, Burlington, MA 01803
| | - Scott E. Lukas
- Behavioral Psychopharmacology Research Laboratory, McLean Hospital, Belmont, MA 02478,Department of Psychiatry, Harvard Medical School, Boston, MA 02115
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Tang YL, Hao W, Leggio L. Treatments for alcohol-related disorders in China: a developing story. Alcohol Alcohol 2012; 47:563-70. [PMID: 22683652 DOI: 10.1093/alcalc/ags066] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
AIMS Alcohol-related disorders (ARDs) have become an increasing mental health and social challenge in China. Research from China may provide important clinical information for researchers and clinicians around the world. However, most of the Chinese research on ARDs has only been published in Chinese language journals. This article summarizes publications related to treatments for ARDs found in the Chinese literature. METHODS A descriptive study based on literature identified from searches of the China National Knowledge Infrastructure (1979-2012), Pubmed databases and hand-picked references with emphasis on traditional Chinese medicine (TCM). RESULTS More than 1500 Chinese language papers on treatment for ARDs were found and ~110 were selected. Many medications used in the Western countries (e.g. disulfiram and acamprosate) are not available in China, and no drugs have been officially approved for alcohol dependence. TCM approaches (including acupuncture, electroacupunture and herbals) have played a role in treatment for ARDs with some positive results. These unique methods are reviewed and the need for additional controlled studies is noted. CONCLUSION Currently, very limited facilities, medications or programs are available for patients with ARDs in China, thus much improvement is needed in the field, including setting up intervention/treatment programs.
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Affiliation(s)
- Yi-Lang Tang
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 2004 Ridgewood Drive, Suite 218, Atlanta, GA 30322, USA.
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16
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Alcoholism and Substance Abuse. Integr Med (Encinitas) 2012. [DOI: 10.1016/b978-1-4377-1793-8.00065-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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17
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Abenavoli L, Capasso F, Addolorato G. Phytotherapeutic approach to alcohol dependence: new old way? PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2009; 16:638-644. [PMID: 19216063 DOI: 10.1016/j.phymed.2008.12.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2008] [Revised: 10/13/2008] [Accepted: 12/12/2008] [Indexed: 05/27/2023]
Abstract
Alcohol abuse and dependence represent a worldwide problem from both medical and social points of view. In Italy it is estimated that there are about one million alcohol-dependent subjects. The pharmacological treatment of patients with alcohol dependence plays a key role in order to achieve alcohol abstinence and prevent relapse. At present, the possible utility of the complementary medicines in the treatment of alcohol dependence is controversial. In the last years, pre-clinical and clinical data from traditional medicines suggest that novel pharmacological approaches for treatment of alcoholism and alcohol abuse may stem from natural substances. The present review summarizes the findings of the effects of phytotherapy in alcohol addiction.
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Affiliation(s)
- Ludovico Abenavoli
- Department of Experimental and Clinical Medicine, University Magna Graecia, Catanzaro, Italy.
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18
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Lu L, Liu Y, Zhu W, Shi J, Liu Y, Ling W, Kosten TR. Traditional medicine in the treatment of drug addiction. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2009; 35:1-11. [PMID: 19152199 DOI: 10.1080/00952990802455469] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
AIMS To evaluate clinical trials and neurochemical mechanisms of the action of traditional herbal remedies and acupuncture for treating drug addiction. METHODS We used computerized literature searches in English and Chinese and examined texts written before these computerized databases existed. We used search terms of treatment and neurobiology of herbal medicines, and acupuncture for drug abuse and dependence. RESULTS Acupuncture showed evidence for clinical efficacy and relevant neurobiological mechanisms in opiate withdrawal, but it showed poor efficacy for alcohol and nicotine withdrawal or relapse prevention, and no large studies supported its efficacy for cocaine in well-designed clinical trials. Clinical trials were rare for herbal remedies. Radix Puerariae showed the most promising efficacy for alcoholism by acting through daidzin, which inhibits mitocochondrial aldehyde dehydrogenase 2 and leads to disulfiram-like alcohol reactions. Peyote also has some evidence for alcoholism treatment among Native Americans. Ginseng and Kava lack efficacy data in addictions, and Kava can be hepatotoxic. Thunbergia laurifolia can protect against alcoholic liver toxicity. Withania somnifera and Salvia miltiorrhiza have no efficacy data, but can reduce morphine tolerance and alcohol intake, respectively, in animal models. CONCLUSIONS Traditional herbal treatments can compliment pharmacotherapies for drug withdrawal and possibly relapse prevention with less expense and perhaps fewer side effects with notable exceptions. Both acupuncture and herbal treatments need testing as adjuncts to reduce doses and durations of standard pharmacotherapies.
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Affiliation(s)
- Lin Lu
- National Institute on Drug Dependence, Peking University, Beijing, China.
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BEHERE RISHIKESHV, MURALIDHARAN KESAVAN, BENEGAL VIVEK. Complementary and alternative medicine in the treatment of substance use disorders-a review of the evidence. Drug Alcohol Rev 2009; 28:292-300. [DOI: 10.1111/j.1465-3362.2009.00028.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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20
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Complementary therapies for treating alcoholism. Fitoterapia 2008; 79:142-7. [DOI: 10.1016/j.fitote.2007.11.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2007] [Accepted: 11/13/2007] [Indexed: 11/18/2022]
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Affiliation(s)
| | - Eric Yarnell
- Botanical Medicine Academy, Vashon, Washington and Bastyr University, Kenmore, Washington
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Overstreet DH, Rezvani AH, Cowen M, Chen F, Lawrence AJ. Modulation of high alcohol drinking in the inbred Fawn-Hooded (FH/Wjd) rat strain: implications for treatment. Addict Biol 2006; 11:356-73. [PMID: 16961764 DOI: 10.1111/j.1369-1600.2006.00033.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The Fawn-Hooded rat (FH/Wjd) is an inbred alcohol-preferring rat strain, unlike most of the other strains that were selectively bred for high alcohol intake and preference. It was chosen for study some 16 years ago because of a reported mutation that disrupted platelet serotonin function. Although the FH/Wjd rat has high alcohol intake (>5 g/kg/day) and preference (>65%), interbreeding with an alcohol-non-preferring inbred strain suggested that these measures are unrelated to the serotonin abnormality. Similarly, the exaggerated immobility of the FH/Wjd rats in the forced swim test did not correlate with the high alcohol intake. Many compounds have been tested in the FH/Wjd rats after both acute and chronic treatment and a substantial number of them have proved effective. However, as the case with opiate antagonists, tolerance to the effects of the drug can develop. An up-regulation of opioid receptors accompanied the chronic treatment and this mechanism may account for the development of tolerance. Tolerance to opiate antagonists has also been demonstrated in two of the selectively bred alcohol-preferring rat lines, but it is unknown whether this process may contribute to the relapses seen in individuals being treated with naltrexone. Other drugs that reliably decrease alcohol intake in the FH/Wjd rats include the 5-hydroxytryptamine-2A receptor antagonist, amperozide, the mGlu5 receptor antagonist 3-[(2-methyl-1,3-thiazol-4-yl)ethynyl]pyridine (MTEP) and herbal derivatives such as ibogaine, St. John's wort and kudzu extract. Thus, studies in the FH/Wjd rat have led to the discovery of a wide variety of targets for the development of novel agents to treat alcoholism. The fact that several of these drugs were shown to reduce alcohol intake in some of the selectively bred alcohol-preferring rat lines and/or alcohol-preferring vervet monkeys increases our confidence that they are good candidates for further development.
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Affiliation(s)
- David H Overstreet
- Bowles Center for Alcohol Studies & Department of Psychiatry, University of North Carolina at Chapel Hill, USA.
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Abstract
Alcoholism is a serious problem throughout the world. The development of alcoholism remedies have medical, social and economical significance. In view of the pitfalls of psychological dependence and adverse behavioural effects of synthetic drugs, the development of low toxicity and high efficiency medicines derived from natural products exhibits expansive market prospects. Based on these considerations, we summarize briefly folk application of traditional hangover remedies and clinical application of herbal complex and patent medicines for alcoholism treatment. We have reviewed the effects of natural medicines on intake, absorption and metabolism of alcohol, as well as the protective effects on alcohol-induced acute and chronic tissue injury.
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Affiliation(s)
- B J Xu
- Department of Food Science and Technology, College of Agriculture and Biotechnology, Chungnam National University, Daejon, South Korea
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Abstract
BACKGROUND The use of complementary medicines in those with mental health problems is well documented. However, their effectiveness is often not established and they may be less harmless than commonly assumed. AIMS To review the complementary medicines routinely encountered in psychiatric practice, their effectiveness, potential adverse effects and interactions. METHOD Electronic and manual literature search on the effectiveness and safety of psychotropic complementary medicines. RESULTS Potentially useful substances include ginkgo and hydergine as cognitive enhancers, passion flower and valerian as sedatives, St John's wort and s-adenosylmethionine as antidepressants, and selenium and folate to complement antidepressants. The evidence is less conclusive for the use of omega-3 fatty acids as augmentation treatment in schizophrenia, melatonin for tardive dyskinesia and 18-methoxycoronaridine, an ibogaine derivative, for the treatment of cocaine and heroin addiction. CONCLUSIONS Systematic clinical trials are needed to test promising substances. Meanwhile, those wishing to take psychotropic complementary medicines require appropriate advice.
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Affiliation(s)
- Ursula Werneke
- Division of Psychiatry, Homerton University Hospital, East Wing, Homerton Row, London E9 6SR, UK.
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Lukas SE, Penetar D, Berko J, Vicens L, Palmer C, Mallya G, Macklin EA, Lee DYW. An extract of the Chinese herbal root kudzu reduces alcohol drinking by heavy drinkers in a naturalistic setting. Alcohol Clin Exp Res 2005; 29:756-62. [PMID: 15897719 DOI: 10.1097/01.alc.0000163499.64347.92] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Of the available medications for treating alcohol-related problems, none are universally effective, and all have side effects that may limit their use. Extracts of kudzu containing a variety of isoflavones have been shown to reduce alcohol drinking in rats and hamsters. METHODS The present study was designed to test the efficacy of a kudzu extract in a clinical population. Male and female "heavy" alcohol drinkers were treated with either placebo or a kudzu extract for 7 days and then given an opportunity to drink their preferred brand of beer while in a naturalistic laboratory setting. Participants served as their own controls, and order of treatment exposure was counterbalanced. Drinking behavior was monitored by a digital scale that was located in the top of an end table. RESULTS Kudzu treatment resulted in significant reduction in the number of beers consumed that was paralleled by an increase in the number of sips and the time to consume each beer and a decrease in the volume of each sip. These changes occurred in the absence of a significant effect on the urge to drink alcohol. There were no reported side effects of kudzu treatment. CONCLUSION These data suggest that an extract of this leguminous plant may be a useful adjunct in reducing alcohol intake in a naturalistic setting.
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Affiliation(s)
- Scott E Lukas
- Behavioral Psychopharmacology Research Laboratory, McLean Hospital, Belmont, Massachusetts 02478, USA.
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Abstract
PURPOSE OF REVIEW To review recent studies that have examined the efficacy of natural and complementary therapies as treatments for substance use disorders and their complications. RECENT FINDINGS Despite increasing interest in natural and complementary therapies for substance use disorders, rigorous clinical studies in this area are few in number. Recent clinical studies, although preliminary, have reported potential therapeutic effects for hypericum in the treatment of smoking cessation, for prickly pear extract in the prevention of alcohol hangover and magnesium supplementation as an adjunct to methadone treatment. Other clinical studies have reported negative findings for ginkgo as an adjunctive treatment for cocaine dependence, for artichoke in prevention of alcohol hangover, and acupuncture for alcohol withdrawal. Relevant findings from animal studies are also discussed. Neither vitamin E nor Liv 52 had a useful effect in alcohol-related liver disease. A study of silymarin in baboons, which was undertaken in an attempt to untangle the conflicting findings of human studies, reported a potential for this compound to prevent liver injury. There is increasing awareness of safety issues associated with complementary therapies. Safety issues pertinent to substance use treatment are discussed in this review. SUMMARY Several pharmacological and psychosocial treatments for substance use disorders are solidly evidence-based and improve both individual and public health outcomes. At this stage, there remains insufficient evidence to support the use of natural and complementary therapies as a primary intervention for substance use disorders. Further clinical trials are required to clarify the potential role of particular agents.
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Affiliation(s)
- Angela J Dean
- Kids in Mind Research, Mater Child and Youth Mental Health Service and Mater Pharmacy Services, Mater Hospital, South Brisbane, Queensland, Australia.
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Benlhabib E, Baker JI, Keyler DE, Singh AK. Effects of Purified Puerarin on Voluntary Alcohol Intake and Alcohol Withdrawal Symptoms in P Rats Receiving Free Access to Water and Alcohol. J Med Food 2004; 7:180-6. [PMID: 15298765 DOI: 10.1089/1096620041224102] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Alcohol preferring (P) rats, given "free choice" of water, exhibited daily intake of 60-75 g of water/kg of body weight. When given "free choice" of water and 15% ethanol, P rats consumed 7-13 g of alcohol/kg. Their water intake decreased proportionally to the alcohol intake, but total fluid intake did not differ significantly. Alcohol withdrawal after 50 days of alcohol drinking caused withdrawal symptoms such as hypersensitivity, poor coordination, and tremors. A daily 50 mg/kg dose of puerarin (PU) caused approximately 50% suppression in alcohol intake, but did not affect body weight and food and total fluid intake in P rats receiving "free choice" of water and 15% ethanol. Alcohol ingestion gradually returned to the control level despite consistent PU intake. However, alcohol intake following alcohol withdrawal was suppressed in PU-fed P rats. PU suppressed the severity of alcohol withdrawal symptoms. Thus, withdrawal symptoms do not occur in PU-fed rats even though their alcohol ingestion is comparable to that in control P rats. Brain, plasma, and liver samples were analyzed for the presence of kudzu root isoflavones, which are mostly PU (>90% of total isoflavones) and a trace amount of daidzin. Liver samples obtained from PU-fed P rats contained 20-30 microg/g of PU. An important observation was that plasma or brain samples obtained from PU-fed or alcohol + PU-fed rats did not contain PU. This study indicated that PU feeding transiently suppressed alcohol intake and abolished withdrawal symptoms at a time when alcohol intake had returned to the control level. The absence of PU in plasma and brain indicates the possibility that some nonspecific mechanism may be involved in the anti-alcoholism effects of PU in P rats.
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Affiliation(s)
- Elhabib Benlhabib
- Department of Veterinary Diagnostic Medicine, College of Veterinary Medicine, University of Minnesota, 1333 Gortner Avenue, St. Paul, MN 55108, USA
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Abstract
The present review summarizes the findings of the effects of extracts of purified compounds from several plants on alcohol intake in alcohol-preferring rats. These include St. John's wort (Hypericum perforatum, HPE), kudzu (Pueraria lobata) and ibogaine (Tabernanthe iboga). Alcohol-preferring (P), Marchigian Sardinian (msP), high-alcohol-drinking (HAD), Fawn-Hooded (FH) rats were allowed to drink alcohol or water voluntarily to establish baseline levels. Pure compounds (puerarin, daidzin, daidzein or analogs) isolated from kudzu, extracts from HPE or ibogaine and its analog were given by either intraperitoneal or oral administration. After acute administration, all agents dose-dependently reduced alcohol intake with minimal effects on food intake. Puerarin and HPE were also effective following chronic treatment. Overall, it is clear that pure compounds (daidzin, puerarin), extracts from St. John's wort, ibogaine and an ibogaine analog suppress alcohol intake in animal models of excessive drinking with minimal effects on other appetitive behaviors. Although the true mechanisms of action of these compounds on alcohol intake are not fully understood, with the current information, it appears that these compounds exert their effects by modulating several neuronal systems implicated in drinking behavior. However, their role in the future of pharmacotherapy for alcoholism will depend upon the outcome of carefully conducted clinical trials.
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Affiliation(s)
- Amir H Rezvani
- Department of Psychiatry, Duke University Medical Center, Box 3412, Durham, NC 27710, USA.
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Overstreet DH, Keung WM, Rezvani AH, Massi M, Lee DYW. Herbal remedies for alcoholism: promises and possible pitfalls. Alcohol Clin Exp Res 2003; 27:177-85. [PMID: 12605067 DOI: 10.1097/01.alc.0000051022.26489.cf] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
This review summarizes the findings of the effects on alcohol intake in alcohol-preferring rats of extracts or purified compounds from two of the most promising herbs: kudzu (Pueraria lobata) and St. John's Wort (Hypericum perforatum). It is a summary of a symposium presented at the 2002 RSA meeting in San Francisco. The meeting organizers/co-chairs were David Overstreet and Wing-Ming Keung. The presentations were (1) Introduction to the symposium, by David Y. W. Lee and David H. Overstreet; (2) Effects of daidzin on alcohol intake-search for mechanisms of action, by Wing-Ming Keung; (3) Long-term suppressive effects of puerarin on alcohol drinking in rats, by David Overstreet and David Y. W. Lee; (4) St. John's Wort extract reduces alcohol intake in FH and P rats, by Amir Rezvani and David Overstreet; and (5) extracts reduce alcohol intake in Marchigian Sardinian alcohol-preferring rats, by Maurizio Massi.
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Affiliation(s)
- David H Overstreet
- Bowles Center for Alchohol Studies (DHO), University of North Carolina, Chapel Hill, North Carolina 27599-7178, USA.
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Keyler DE, Baker JI, Lee DYW, Overstreet DH, Boucher TA, Lenz SK. Toxicity study of an antidipsotropic Chinese herbal mixture in rats: NPI-028. J Altern Complement Med 2002; 8:175-83. [PMID: 12006125 DOI: 10.1089/107555302317371460] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To determine the potential toxicity and safety of the Chinese herbal medicine NPI-028 in rats following subchronic (3-month) exposure via daily oral consumption. DESIGN Subchronic toxicity was evaluated in four groups of rats (n = 10 per group) receiving NPI-028 orally at a dose of either 0.0 (normal diet control), 0.5, 1.0, or 2.0 g/kg, ingested as part of their daily diet for 3 months. NPI-028 was incorporated into powdered rat chow diet as a specific percent of the total diet provided each day. The primary active isoflavone content of NPI-028 (puerarin) used in the rat diet was also determined. OUTCOME MEASURES Subchronic toxicity was assessed over a 3-month period by biweekly measurement of water and food intake, weight gain, and visual inspection for maintenance of grooming and normal behavior. At the end of the study period rats were euthanized and blood was obtained for hematologic and chemical analysis. Organs were removed for histopathologic examination. RESULTS Rats in all three NPI-028 dose groups were similar to the control group in weight gain, food intake, and water intake over the study period. Hematology, blood chemistries, and organ histology in rats at all three NPI-028 doses did not significantly differ from control rats. Minor exceptions were elevated urea nitrogen values at all NPI-028 doses, and increased triglyceride and thyroid-stimulating hormone values in the lowest NPI-028 dose-treated group. Puerarin (used as a dietary isoflavone marker) content of NPI-028 was 26 mg/g dry weight. CONCLUSIONS NPI-028 ingested orally at doses up to 2.0 g/kg per day in the rat diet for up to 3 months resulted in normal growth with no changes in hematologic or hepatic parameters, and only minor alterations in renal and blood chemistry parameters. There was no evidence of abnormal histology. These data suggest the long-term daily oral consumption of NPI-028 as a part of the daily diet for 3 months, at the doses studied, is safe in rats. Thus, NPI-028 may potentially be safe for clinical use as an antidipsotropic agent.
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Affiliation(s)
- Daniel E Keyler
- Center for Addiction and Alternative Medicine Research, Natural Products and Toxicology Laboratories, Minneapolis Medical Research Foundation, MN 55404, USA.
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