The Impact of Hot Food Preferences on Naltrexone's Effects on Subjective Acute Responses to Alcohol in Social Drinkers / 신경정신의학

OBJECTIVES: Both capsaicin, a pungent substance of hot food, and alcohol, are known to affect central opioid activity. The purpose of this study was to investigate the difference in the subjective acute responses to alcohol and the effect of naltrexone on them among those who prefer hot food to varying degrees. METHODS: Twelve male medical students were divided into two groups using a cross-over design. One group was given naltrexone on only the first (25 mg) and the second day (50 mg), and the other group was given naltrexone on only the eighth (25 mg) and the ninth day (50 mg). On the second and the ninth day, the acute effect of alcohol was assessed in all subjects, using the Biphasic Alcohol Effects Scale (BAES) just before drinking and at 15 minutes, 30 minutes and 60 minutes after drinking (0.6 ml/kg). Alcohol craving was also measured, using Visual Analogue Scale for craving (VAS-C) and blood alcohol concentration (BAC), at the same interval. For statistical analysis, subjects of both group were re-divided into two group, those with a strong preference and those with a less preference (LP) for hot (spicy) food (SP), using the Food Preference Scale. RESULTS: 1) Repeated measures of ANOVA (2 preference groups x 4 time blocks) on the stimulative subscale of BAES yielded no significant group by block interaction of naltrexone administration. Repeated measures of ANOVA (2 drug groups x 4 time blocks) on the stimulative subscale of BAES revealed a significant group by block interaction in SP (p=0.028), but not in LP. The paired t-test revealed that significant suppression of the stimulative subscale of BAES was observed at 15 minutes and 30 minutes after drinking when naltrexone condition was compared with no-medication condition in SP (p=0.014; p=0.007). 2) For the sedative subscale of BAES, VAS-C and BAC, repeated measures of ANOVA yielded no significant group by block interaction by either hot food preference or naltrexone administration. CONCLUSION: For those who prefer hot food, the effect of stimulative acute alcohol was suppressed by naltrexone. This result strongly suggests that naltrexone could prevent relapse more effectively in those who prefer hot food.

Effect of Naltrexone on Acute Alcohol Response in Social Drinker / 신경정신의학

OBJECTIVES: We investigated the effects of naltrexone on acute alcohol response, stimulant and sedative, in healthy social drinkers using two doses of alcohol intake. METHODS : Twenty four healthy male medical students were voluntarily participated. The experimental method was crossover design. Subjects received 25 mg/day or 50 mg/day of naltrexone on the experimental days. Biphasic Alcohol Effects Scale (BAES), alcohol craving, and blood alcohol concentration (BAC) were measured before drinking and at 15, 30, 45, 60, 90, and 120 min after drinking. RESULTS : 1) Group of 0.6 mg/kg of alcohol intake. When the scores of stimulative subscale of BAES were compared between the naltrexone and control group, the scores were significantly lower in the naltrexone group at 15 and 90 min after drinking. Alcohol induced sedative effect was significantly higher in the naltrexone group at 90 min after drinking. The alcohol induced alcohol craving at 45 and 60 min after drinking was significantly lower in the naltrexone group as compared to the control. 2) Group of 0.3 mg/kg of alcohol intake. The alcohol induced stimulative effect evident in the control group seen in the time span of 15 to 45 min after drinking was not seen in the naltrexone group. The increase of alcohol induced alcohol craving noticed at 30 min after drinking in the control group was not seen in the naltrexone group. BAC at 15 min after drinking was lower in the naltrexone group compared to the control. CONCLUSION : Naltrexone is suggested to attenuate stimulative effect, to intensify sedative effect, and to block alcohol induced alcohol craving. These triple actions might be utilized for treatment and prevention of relapse of alcohol dependence.

Alcohol Urge and Plasma beta-endorphin Change after Alcohol Challenge in Naltrexone Pretreated Social Drinker / 신경정신의학

OBJECTIVES: The present study was performed to evaluate whether naltrexone treatment are effectively lowering the urge of alcohol drinking, and to investigate the its mechanism of action. METHODS: 15 healthy male social drinkers were voluntarily participated. The experimental method was double-blind placebo-controlled cross over design. Subjects ingested a naltrexone (50mg)/day or placebo for 1 week. Plasma beta-endorphin, plasma ACTH and serum cortisol levels were measured before, at 20 minutes and at 60 minutes after alcohol exposure. Subjects completed self-report questionnaires such as the visual analog scales of drink urge and the alcohol sensation scales at regular intervals. RESULTS: 1) During naltrexone pretreatment period, subjects reported more headache, dizziness, nervousness, fatigue, day somnolence, nausea, and decreased appetite than placebo pretreatment period. But serum GOT/GPT levels were not significantly different between two pretreatment periods. 2) In case of naltrexone pretreatment, subjects reported significantly less urge to alcohol drink on the self-reporting urge scales, especially at post-drinking 20 minutes and 60 minutes than placebo pretreatment. 3) After alcohol challenge, subjects reported significantly more dizziness on the alcohol sensation scales in case of naltrexone pretreatment, and reported less mood elevation trend though it was not statistically significant. Other scores were not significantly different between two pretreatments. 4) Plasma beta-endorphin levels were significantly different when treated with naltrexone. In case of naltrexone-pretreatment, the increasing degree of plasma beta-endorphin during 20 minutes after alcohol challenge was significantly higher than placebo pretreatment. 5) Basal plasma ACTH level and basal serum cortisol level were not significantly different between two pretreatments. After alcohol challenge, only the decreasing degree of plasma ACTH levels during 20 minutes was significantly lowered in the naltrexone pretreatment than placebo pretreatment. CONCLUSIONS: Naltrexone reduced urge to alcohol drinking in social drinker. The action mechanism of naltrexone may be partially blocking opioid positive reward system and partially alcohol mimicking its property.