Drugs for Relapse Prevention of Alcoholism (Milestones in Drug Therapy)

2017-07-07 02:10:07

Editors: Spanagel, Rainer; Mann, Karl F.

Title: Drugs for Relapse Prevention of Alcoholism, 1st Edition

> Front of Book > Preface

Preface

Alcoholism is a pathological behavioural syndrome, characterised by compulsive alcohol use, craving and relapses, even recurring after many years of abstinence. It is suggested that chronic alcohol abuse leads to persistent changes within several neurochemical pathways in the brain and furthermore that an imprinted drug and addiction memory may scarcely be extinguished. Hence, the question arises as to whether there ought to be a reasonable hope that pharmacological drugs will be developed that interfere with an addiction memory, and as a result, finally lead to a cure?

In this book, leading preclinical and clinical experts in the field of alcohol relapse prevention strive to furnish an answer to this question. None of the researchers or clinicians believes in a magic bullet that will be of help to all alcoholic patients in overcoming this disease. However, there is now convincing evidence demonstrating that specific subpopulations of alcoholic patients experience satisfactory benefit from currently available treatments. Today we have two medications for relapse prevention on the market - acamprosate and naltrexone. Although, currently, only a minority of alcoholic patients benefit from these medications, the approval of these compounds may be considered a hallmark in the field of psychopharmacology, even comparable to the era when the first antidepressant compounds were introduced.

In recent years we have been witnessing an enormous growth in the science and knowledge regarding the field of relapse prevention. The combination of elaborated animal models, molecular and genetic approaches along with clinical studies, have revealed novel drug targets as well as more effective pharmacological treatments. In contrast to developments in other areas of psychiatric diseases, convincing neurobiological concepts have evolved and there is a better understanding of how alcohol affects our brain. A driving sociological force behind these rapid developments has been a very serious need in our society, demanding better treatments for alcoholic patients. With the advent of alcoholism having publicly become accepted as a disease of the brain, many stigmas associated with this behavioural syndrome were torn down. Thus, patients are now more willing to accept the notion and the act of taking medication, especially as there are already very promising pharmacotherapeutic drugs on the horizon. However, the pharmaceutical industry is still reluctant to conquer this enormous market, simply because their market analysis is performed based on a profitable short-term run, thus misjudging the situation.

We hope that this work will help in speeding up the integration of anti-relapse treatment therapies into our health-care systems. The book is divided up into blocks of preclinical and clinical research, based on specific compound

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classes. In addition to the first generation of anti-relapse compounds such as disulfiram, acamprosate and naltrexone, a new generation of anti-relapse compounds is reviewed. In particular, compounds interacting with the serotonin, dopamine, glutamate, GABA, cannabinoid and neuropeptide Y system are illustrated. An excellent historical overview is provided, with methodological aspects of how to assess craving and relapse in animals and humans being described as well. Thus, the book ought to provide a basic knowledge for scientists and clinicians who are curious about novel therapeutic concepts of alcoholism and drug addiction in general.

We would like to thank all authors who contributed to this book. We thank Daniel Bachteler, who rearranged most of the figures and worked out the appendix on the chemical structures of the compounds cited in the book. However, we would like to especially thank Tarek Zghoul for language and content editing, in addition to formatting and streamlining the chapters. Finally, we hope that this book may be of interest to a wide spectrum of scientists, serving as a useful and interesting standard guide, for the present and many years to come.

Rainer Spanagel

Karl Mann

Mannheim, October 2004

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