5‐HTTLPR Moderates Naltrexone and Psychosocial Treatment Responses in Heavy Drinking Men Who Have Sex with Men. (28th July 2014)

• Record Type: Journal Article
• Authors: Chen, Andrew C. H.; Davis, Christine M.; Kahler, Christopher W.; Kuerbis, Alexis N.; Covault, Jonathan; Kranzler, Henry R.; Morgenstern, Jon
• Is Part Of: Alcoholism. Volume 38:Number 9(2014:Sep.)
• Page Start: 2362
• Page End: 2368
• Publication Date: 2014-07-28
• Subjects: Alcoholism -- Periodicals; Alcoholism -- Periodicals; Alcoolisme; Electronic journals; Périodique électronique (Descripteur de forme); Ressource Internet (Descripteur de forme); 616.861005
• DOI: 10.1111/acer.12492
• Languages: English
• ISSNs: 0145-6008

Abstract

<abstract abstract-type="main" id="acer12492-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="acer12492-sec-0001" sec-type="section"> <title>Background</title> <p>A functional polymorphism (5‐HTTLPR) in the promoter region of the serotonin transporter gene has been widely studied as a risk factor and moderator of treatment for a variety of psychopathologic conditions. To evaluate whether 5‐HTTLPR moderates the effects of treatment to reduce heavy drinking, we studied 112 high‐functioning European‐American men who have sex with men (MSM). Subjects participated in a randomized clinical trial of naltrexone (NTX) and cognitive behavioral therapy (CBT) for problem drinking.</p> </sec> <sec id="acer12492-sec-0002" sec-type="section"> <title>Methods</title> <p>Subjects were treated for 12 weeks with 100 mg/d of oral NTX or placebo (PBO). All participants received medical management with adjusted brief behavioral compliance enhancement treatment (BBCET) alone or in combination with modified behavioral self‐control therapy (MBSCT; an amalgam of motivational interviewing and CBT). Participants were genotyped for the tri‐allelic 5‐HTTLPR polymorphism (i.e., low‐activity S′ or high‐activity L′ alleles).</p> </sec> <sec id="acer12492-sec-0003" sec-type="section"> <title>Results</title> <p>During treatment, the number of weekly heavy drinking days (HDD; defined as 5 or more standard drinks per day) was significantly lower in subjects with the L′L′ (<italic>N</italic> = 26, <italic>p</italic> = 0.015) or L′S′ (<italic>N</italic> = 52, <italic>p</italic> = 0.016) genotype than those with the S′S′ (<italic>N</italic> = 34) genotype regardless of treatment type. There was a significant interaction of genotype with treatment: For subjects with the S′S′ genotype, the effects of MBSCT or NTX on HDD were significantly greater than the minimal intervention (i.e., BBCET or PBO, <italic> p</italic> = 0.007 and <italic>p</italic> = 0.049, respectively). In contrast, for subjects with 1 or 2 L′ alleles, the effects of the more intensive psychosocial treatment (MBSCT) or NTX did not significantly differ from BBCET or PBO.</p> </sec> <sec id="acer12492-sec-0004" sec-type="section"> <title>Conclusions</title> <p>These preliminary findings support the utility of the 5‐HTTLPR polymorphism for personalizing treatment selection in problem drinkers.</p> </sec> </abstract>