Captopril and hydrochlorothiazide (Capozide) combine to enhance the reduction in voluntary alcohol intake in rats

Differences in Sociodemographic and Alcohol-Related Clinical Characteristics Between Treatment Seekers and Nontreatment Seekers and Their Role in Predicting Outcomes in the COMBINE Study for Alcohol Use Disorder

BACKGROUND

One of the challenges in early-stage clinical research aimed at developing novel treatments for alcohol use disorder (AUD) is that the enrolled participants are heavy drinkers, but do not seek treatment for AUD.

AIMS

To compare nontreatment seekers with alcohol dependence (AD) from 4 human laboratory studies conducted at Brown University (N = 240; 65.4% male) to treatment seekers with AD from the multisite COMBINE study (N = 1,383; 69.1% male) across sociodemographic and alcohol-related clinical variables and to evaluate whether the variables that significantly differentiate the 2 samples predict the 3 main COMBINE clinical outcomes: time to relapse, percent days abstinent (PDA), and good clinical outcome.

METHODS

Sample characteristics were assessed by parametric and nonparametric testing. Three regression models measured the association between the differing variables and the 3 main COMBINE clinical outcomes.

RESULTS

The nontreatment seekers, compared to the treatment seekers, were more ethnically diverse, less educated, single, and working part-time or unemployed (p's < 0.05); they met fewer DSM-IV AD criteria and had significantly lower scores on alcohol-related scales (p's < 0.05); they were less likely to have a father with alcohol problems (p < 0.0001) and had a significantly earlier age of onset and longer duration of AD (p's < 0.05); they also had significantly more total drinks, drinks per drinking day, heavy drinking days (HDD), and lower PDA in the 30 days prior to baseline (p's < 0.0001 to <0.05). Having more HDD in the 30 days prior to baseline predicted all of the 3 COMBINE clinical outcomes. All the other characteristics mentioned above that differed significantly between the 2 groups predicted at least 1 of the 3 COMBINE clinical outcomes, except for level of education, age of onset, and duration of AD.

CONCLUSIONS

The observed differences between groups should be considered in efforts across participant recruitment at different stages of the development of new treatments for AUD.

Angiotensin II stimulates intake of ethanol in C57BL/6J mice

The influence of intracerebroventricular (i.c.v.) infusion of angiotensin II on intake of water and ethanol solutions was determined in C57BL/6J mice. Compared to other mice, C57 mice do not show an aversion to ethanol solutions. With both water and ethanol solutions available, the C57 mice consumed 40-60% of their total daily fluid intake as ethanol solution when the concentration of ethanol solution offered was 4-14%. When given a choice between 0.3 M KCl and either 4 or 10% ethanol solution, the mice clearly preferred the ethanol solution. With water only available, i.c.v. infusion of angiotensin II increased intake from 3-5 mL/day (baseline) to 11-12 mL/ day (Day 4 of infusion). A similar increase in intake occurred in mice with access to a nonpreferred solution of 0.3 M KCl. In comparison, when only 4% ethanol solution was available, angiotensin II increased intake to 7-8 mL/day, and when only 10% ethanol solution was available, intake was transiently increased. The results demonstrated that thirst for water caused by i.c.v. infusion of angiotensin II in C57 mice is similar to that observed in BALB/C mice. Unlike BALB/C mice, however, i.c.v. infusion of angiotensin II stimulated intake of ethanol solution. The failure of angiotensin II to cause a large increase in 4% ethanol solution or a sustained increase in 10% ethanol solution intake does not seem to be caused by an aversion to the taste of ethanol solution, but most likely due to postingestional factors.

Pharmacotherapies for alcohol problems: a review of research with focus on developments since 1991

Research on medications to treat alcohol problems has flourished in the last 5 years. Whereas before this time most projects focused on withdrawal agents, at least equal interest has now extended to drugs that may directly reduce urge to drink. The most promising medications in this regard are the opiate antagonists and acamprosate. Considerable attention has also been devoted to serotonergic agents. As aids to detoxification, pharmacologic agents that affect the multiple neural systems disrupted by acute alcohol withdrawal remain under active investigation. Significant progress is also being made in identifying medications to assist alcoholics suffering collateral psychopathology, especially depression and anxiety based disorders. Unfortunately, fewer gains have been realized in the development of medications to assist patients simultaneously dependent on both alcohol and illicit drugs. Also, research to develop amethystic agents remains in its very early stages.

Increased alcohol consumption in weight-reduced rats is modulated by the renin-angiotensin system

Weight reduction and food restriction increase the self-administration of alcohol and other drugs of abuse, but the underlying physiological mechanisms have not been identified. Because weight reduction alters angiotensin (ANG) II activity, and ANG II is known to modulate alcohol intake, ANG II may play a role in the enhanced alcohol consumption of food-deprived weight-reduced rats and in the drop in alcohol intake when these rats are refed. Two groups of rats were reduced to and maintained at 80% of their free feeding weights and offered daily 40 min access to a 6% (w/v) alcohol solution and water. Water was available ad lib. After alcohol intake stabilized, one group was given daily injections of the angiotensin converting enzyme inhibitor captopril (5.0 mg/kg) for 6 days while the other group received the saline vehicle. Following this, each group continued to receive either captopril or vehicle injections but was returned to ad lib feeding. Captopril did not alter alcohol intake when the rats were food-deprived and weight-reduced, but did significantly attenuate the decline in alcohol consumption compared to the vehicle group when both groups were refed and regaining weight. These findings suggest that the increase in alcohol intake with food restriction and its decline following refeeding are, in part, related to changes in ANG II activity.