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Effect of Prazosin and Naltrexone on Alcohol Craving and Alcohol Consumption in Veterans and Service Members with and without PTSD

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Technical Report,04 Dec 2018,03 Dec 2019

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Seattle Institute for Biomedical and Clinical Research Seattle United States

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Military personnel are at risk for developing hazardous drinking patterns post-deployment that can negatively impact their health and psychiatric stability. This phenomenon is compounded by the fact that despite recent gains in establishing effective pharmacological and behavioral treatments for alcohol use disorders AUD, nonremittance and relapse remain major problems for those with AUDs. One individual factor that is strongly associated with continued problematic use and relapse is craving. Three different types of craving have been hypothesized, reward, relief, and obsessive, and each is postulated to be mediated by different neurological substrates. The neural networks postulated to subserve reward and relief craving receive afferents from and project to noradrenergic neurons in non-human primates and humans express alpha1 adrenergic receptors. Given the interplay of the noradrenergic system with craving-related brain systems, blocking alphas1 receptors with the noradrenergic antagonist, prazosin, theoretically has the potential to modulate reward and relief craving. This study is to evaluate whether prazosin alone andor in conjunction with naltrexone is effective at reducing reward and relief craving for alcohol. The proposed study also seeks to evaluate whether specific individual characteristics, including PTSD status, moderate medication response. In 2019, we completed data entry, data quality assurance, and preliminary analyses. Dr. Murray Raskind presented the promising results of these analyses at the September CDMRP meeting. We were interested in expanding our study to active servicemembers in the Madigan Army Medical Center and submitted our application however, we learned later on that the DoD was reluctant to support this work, thus we are focusing our efforts on writing and submitting a manuscript and will submit a follow-up grant next year.

Subject Categories:

  • Psychology
  • Military Forces and Organizations
  • Psychology
  • Military Forces and Organizations

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