Effects of Citalopram on Cue-Induced Alcohol Craving and Thalamic D2/3 Dopamine Receptor Availability

Int J Neuropsychopharmacol. 2019 Apr 1;22(4):286-291. doi: 10.1093/ijnp/pyz010.

Abstract

Background: Selective serotonin reuptake inhibitors are often used in alcohol use disorders. Clinical trials with selective serotonin reuptake inhibitors for alcohol use disorders, however, have yielded mixed results. The goal of this project was to assess whether a single i.v. dose of a selective serotonin reuptake inhibitor reduces craving for alcohol and/or simultaneously increases striatal dopamine concentration in individuals with alcohol dependence.

Methods: Alcohol-dependent (DSM-IV-TR criteria) volunteers and matched controls (n = 10/group) underwent a double-blind, placebo-controlled, within-subjects study. Participants received i.v. citalopram (40 mg) or saline (counter-balanced) followed by a cue-induced craving assessment and [18F]-fallypride positron emission tomography scanning.

Results: In the alcohol-dependent individuals, the citalopram (compared with saline) resulted in decreased cue-induced craving for alcohol. For the whole study group, cue-induced alcohol craving was inversely correlated with thalamic (but not striatal) dopamine D2/3 receptor availability.

Conclusions: Acute serotonin reuptake inhibition reduces cue-induced alcohol craving. Furthermore, thalamic dopamine abnormalities and the striatal hyperdopaminergic hypothesis of alcohol use disorder are supported.

Keywords: PET; alcohol; antidepressant; citalopram; craving.

Publication types

  • Controlled Clinical Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Administration, Intravenous
  • Adult
  • Alcoholism / drug therapy*
  • Benzamides
  • Citalopram / administration & dosage
  • Citalopram / pharmacokinetics*
  • Corpus Striatum / drug effects*
  • Craving / drug effects*
  • Cues
  • Double-Blind Method
  • Female
  • Humans
  • Male
  • Middle Aged
  • Positron-Emission Tomography
  • Pyrrolidines
  • Receptors, Dopamine D2 / drug effects*
  • Receptors, Dopamine D3 / drug effects*
  • Selective Serotonin Reuptake Inhibitors / administration & dosage
  • Selective Serotonin Reuptake Inhibitors / pharmacokinetics*
  • Thalamus / drug effects*

Substances

  • Benzamides
  • DRD2 protein, human
  • DRD3 protein, human
  • N-((1-allyl-2-pyrrolidinyl)methyl)-5-(3-fluoropropyl)-2,3-dimethoxybenzamide
  • Pyrrolidines
  • Receptors, Dopamine D2
  • Receptors, Dopamine D3
  • Serotonin Uptake Inhibitors
  • Citalopram