PHARMACOLOGIC REDUCTION OF ALCOHOL CONSUMPTION IN ALCOHOLIC PATIENTS

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Recent studies indicate that alcohol consumption is regulated by several interacting neurotransmitters, including the dopamine and serotonin systems. In a randomized double-blind design, chronic alcoholic outpatients will receive L-DOPA or L-5-hydroxytryptophan, both with the peripheral decaboxylase inhibitor carbidopa or placebo for a l-year period. During this year, alcohol consump- tion, liver function, craving for alcohol, mental status, psychosocial functioning, and compliance with medication will be assessed at regular intervals. Prior to entry into the study, after 3 months, and at 1 year, the following procedures will be conducted to measure drug effects: (1) behavioral evaluation; (2) determination of concentrations of drugs, monoamines, hormones, and peptides in blood and cerebrospinal fluid; (3) orthostatic changes in heart rate, blood pressure, and plasma norepinephrine concentrations; and (4) assessment of plasma vasopressin response to saline infusion. Changes in alcohol consumption will be related to biochemical and behavioral parameters.