Varenicline, an anti-smoking medication, may reduce craving for alcohol in people who drink heavily and for people with alcohol use disorder (AUD) who are also depressed, according to two recent studies. The research, funded by NIAAA and led by Sherry McKee, Ph.D., Professor of Psychiatry at Yale School of Medicine, provides more evidence that varenicline may be a potential treatment for AUD.
Previous research has shown that varenicline can reduce alcohol use among heavy drinkers; however, the mechanisms by which varenicline exerts its effects are not well-understood. To elucidate these mechanisms, researchers investigated the effects of varenicline on alcohol craving induced by cues associated with drinking (alcohol craving is a major cause of relapse in AUD). Volunteers who were smokers and drank heavily took varenicline or a placebo. After 10 days, they completed tests in a laboratory that assessed their cravings for alcohol in response to neutral cues and alcohol-related cues, such as smelling and handling a glass of alcohol.
Participants receiving varenicline reported less craving for alcohol when exposed to the alcohol-related cues compared to those who received the placebo. This finding suggests that reducing alcohol craving may be a mechanism through which varenicline exerts its effects on alcohol consumption.
In a separate study, Dr. McKee’s team reanalyzed data from a 2016 study of individuals with AUD to determine whether symptoms of depression, which frequently co-occurs with AUD, influenced the effectiveness of varenicline on reducing alcohol consumption. Participants who reported moderate to high levels of depression had less alcohol craving and drank less alcohol during laboratory tests after receiving varenicline. These findings show that depression may influence varenicline efficacy in individuals with AUD and suggest that varenicline may be helpful for reducing alcohol consumption in people who drink heavily and have heightened levels of depressive symptoms.
These studies shed light on a potential mechanism by which varenicline reduces drinking in individuals with AUD. Understanding the effects of varenicline on alcohol craving may prove useful in developing future AUD treatment strategies.
Roberts, W.; Harrison, E.L.R.; and McKee, S.A. Effects of varenicline on alcohol cue reactivity in heavy drinkers. Psychopharmacology 234(18):2737–2745, 2017. PMID: 28600734
Roberts, W.; Verplaetse, T.L.; Moore, K.; Oberleitner, L.; Picciotto, M.R.; and McKee, S.A. Effects of varenicline on alcohol self-administration and craving in drinkers with depressive symptoms. Journal of Psychopharmacology 31(7):906–914, 2017. PMID: 28351203