The Role of Selective Serotonin Reuptake Inhibitors in Reducing Alcohol Consumption.

Preclinical and clinical studies demonstrated an inverse relationship between serotonergic activityand alcohol consumption. The selective serotonin reuptake inhibitors (SSRIs) fluoxetine, citalopram,and fluvoxamine have subsequently been examined for their ability to reduce alcohol consumption inalcoholic subjects. Interindividual variability in response to SSRIs is large, with reductions in alcoholconsumption ranging from 10% to more than 70%. Several factors, including gender, alcoholic subtype,and extent of drinking, appear to affect the treatment efficacy of the SSRIs. A significant challengefor researchers is to identify the subject variables that predict treatment response, providing abasis for guiding alcohol-dependent individuals to the treatment that is most likely to be effective forthem. This article reviews the available clinical studies, discusses possible mechanisms of action forthe SSRIs, and describes a model for predicting treatment responses in alcoholic subjects.