Alcohol & Alcoholism Vol. 39, No. 4, pp. 271-275, 2004
Alcohol & Alcoholism Vol. 39, No. 4 © Medical Council on Alcohol 2004; all rights reserved
COMMENTARY
CHALLENGES TO MEDICATIONS DEVELOPMENT IN TREATING ALCOHOL DEPENDENCE: AN INTERNATIONAL PERSPECTIVE
SUMMARY OF A SYMPOSIUM HELD AT THE ESBRA CONGRESS, PRAGUE, 13 SEPTEMBER 2003
1 Department of Psychiatry, Royal Brisbane Hospital, Brisbane, Queensland, Australia, 2 Laboratoire de Psychobiologie, Biologie du Comportement, Université de Louvain, Louvain-la-Neuve and 3 Department of Statistics, Faculty of Economics, University of Mons, Mons, Belgium, 4 Department of Psychopharmacology, Central Institute of Mental Health, University of Heidelberg, Mannheim and 5 Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany, 6 Department of Neuroscience, University of Cagliari, Monserrato, Italy, 7 Department of Clinical Alcohol Research, Lund University, Malmö University Hospital, Malmö, Sweden, 8 Department of Molecular and Biomedical Pharmacology, University of Kentucky, Lexington, Kentucky, 9 Treatment Research Branch, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland, 10 Department of Psychiatry, University of Connecticut Health Center, Farmington, Connecticut, 11 Department of Psychiatry, Medical University of South Carolina, Charleston, South Carolina, 12 Departments of Psychiatry and Pharmacology, The University of Texas Health Science Center at San Antonio, San Antonio, Texas and 13 Waggoner Center for Alcohol and Addiction Research, Section on Neurobiology, University of Texas, Austin, Texas, USA
* Author to whom correspondence should be addressed at: Department of Molecular and Biomedical Pharmacology, University of Kentucky, Cooper and University Drives, Lexington, Kentucky 40546-0236, USA. Tel.: +606 257 1085; Fax: +606 323 1077; E-mail: jlittlet{at}uky.edu
(Received 27 February 2004; first review notified 3 March 2004; in revised form 23 March 2004; accepted 28 March 2004)
Few medications for treating alcohol dependence exist. Greater partnership is needed between academia and the pharmaceutical industry to develop, licence and market efficacious medications for treating alcohol dependence. Methodologies that span the divide between preclinical and large-scale clinical studies need to be developed in order to provide sufficient information on safety, toleration, drug-interaction profile and efficacy, with which to guide development decisions. Due to the heterogeneous nature of alcohol dependence, the effort of developing an efficacious medication is likely to be enhanced by clearer choices about the characteristics of the population. Careful consideration of potential mechanism of action of the putative therapeutic medication should enable the appropriate choice of drinking endpoint. The pharmaceutical industry in collaboration with academia might need to develop new approaches to determining appropriate treatment endpoints with regulatory bodies. The investment risk to industry should be appraised not only in terms of the rather poor results of previous marketing efforts but with a view to the opportunity to penetrate a potentially enormous and largely untapped market.