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5‐ HTTLPR Moderates Naltrexone and Psychosocial Treatment Responses in Heavy Drinking Men Who Have Sex with Men
Author(s) -
Chen Andrew C. H.,
Davis Christine M.,
Kahler Christopher W.,
Kuerbis Alexis N.,
Covault Jonathan,
Kranzler Henry R.,
Morgenstern Jon
Publication year - 2014
Publication title -
alcoholism: clinical and experimental research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.267
H-Index - 153
eISSN - 1530-0277
pISSN - 0145-6008
DOI - 10.1111/acer.12492
Subject(s) - 5 httlpr , psychosocial , randomized controlled trial , naltrexone , placebo , serotonin transporter , genotype , psychology , medicine , motivational interviewing , clinical psychology , psychiatry , serotonin , antagonist , genetics , receptor , alternative medicine , pathology , biology , gene
Background A functional polymorphism (5‐ HTTLPR ) in the promoter region of the serotonin transporter gene has been widely studied as a risk factor and moderator of treatment for a variety of psychopathologic conditions. To evaluate whether 5‐ HTTLPR moderates the effects of treatment to reduce heavy drinking, we studied 112 high‐functioning E uropean‐ A merican men who have sex with men ( MSM ). Subjects participated in a randomized clinical trial of naltrexone ( NTX ) and cognitive behavioral therapy ( CBT ) for problem drinking. Methods Subjects were treated for 12 weeks with 100 mg/d of oral NTX or placebo ( PBO ). All participants received medical management with adjusted brief behavioral compliance enhancement treatment ( BBCET ) alone or in combination with modified behavioral self‐control therapy ( MBSCT ; an amalgam of motivational interviewing and CBT ). Participants were genotyped for the tri‐allelic 5‐ HTTLPR polymorphism (i.e., low‐activity S′ or high‐activity L′ alleles). Results During treatment, the number of weekly heavy drinking days ( HDD ; defined as 5 or more standard drinks per day) was significantly lower in subjects with the L′L′ ( N = 26, p = 0.015) or L′S′ ( N = 52, p = 0.016) genotype than those with the S′S′ ( N = 34) genotype regardless of treatment type. There was a significant interaction of genotype with treatment: For subjects with the S′S′ genotype, the effects of MBSCT or NTX on HDD were significantly greater than the minimal intervention (i.e., BBCET or PBO , p = 0.007 and p = 0.049, respectively). In contrast, for subjects with 1 or 2 L ′ alleles, the effects of the more intensive psychosocial treatment ( MBSCT ) or NTX did not significantly differ from BBCET or PBO . Conclusions These preliminary findings support the utility of the 5‐ HTTLPR polymorphism for personalizing treatment selection in problem drinkers.