Is Naltrexone More Effective in Alcohol-Dependent Patients with a Sweet Tooth?
Naltrexone has modest efficacy for alcohol dependence. Sweet preference may reflect endogenous opioid activity and predict the efficacy of naltrexone. A 32-week double-blind placebo-controlled trial examined the relationship between sweet preference and naltrexone efficacy among 78 alcohol-dependent subjects (45 were assigned to the naltrexone group). Subjects ranked 6 concentrations of sucrose solution, results of which were used to generate a “sweet score” based on the correlation between preference and sweetness (sucrose concentration).
- The effect of naltrexone on the number of relapses to heavy drinking* was significantly different for those with higher versus lower sweet scores. Higher sweet scores were associated with fewer relapses to heavy drinking in the naltrexone group but not in the placebo group: For every 1-unit increase in sweet score in the naltrexone group, there were 1.2 fewer relapses reported during the study period.
- The effect of naltrexone on weekly alcohol consumption and craving was not significantly affected by sweet preference.