Ondansetron, an anti-nausea drug best known for its use in cancer chemotherapy, has been reported to be effective in reducing drinking, especially in patients with early-onset alcoholism (before age 25) . In their discussion, the authors speculate that ondansetron changes the balance of activity among the neurotransmitters dopamine and serotonin. In particular, it reduces the activity at one of the serotonin receptors, 5-HT3; in previous animal studies, blocking this receptor had been found to reduce the consumption of alcohol. It is hypothesized that early-onset alcoholics may carry a genetic variant of the receptor that makes them more vulnerable to the addictive effects of alcohol. Interestingly, the blood test used to measure alcohol use in this study is a new one: it measures carbohydrate-deficient transferrin (CDT), which accumulates in the blood with sustained heavy drinking, as haemoglobin Aic does in diabetes, and persists at elevated levels for weeks after drinking stops. The test was recently approved by the US Food and Drug Administration for use in alcohol treatment centres and may soon become widespread.
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