Zimelidine may Reduce Alcohol Consumption Slightly At present, drug treatment for alcoholics tends to be restricted to alcohol-sensitising drugs which produce

an aversive reaction to alcohol intake. In alcoholics, brain serotonin [5-hydroxytryptamine] levels are low, and zimelidine, a specific serotonin reuptake inhibitor, has been shown to reduce alcohol consumption in animals.

16 male, non-depressed, heavy drinkers were given 200 mgjday zimelidine or placebo (containing 20mg riboflavin marker) for 2 weeks, after a 2-week, baseline period, in a double-blind, crossover study lasting up to 10 weeks. Three subjects developed drug-induced hepatitis, and an additional 3 subjects later withdrew from the study. Compliance was confirmed by serum and urine analysis.

Serotonin reuptake was reduced by 53.8% during zimelidine treatment compared with baseline values. The mean percentage days of abstinence increased from 10-12% (baseline or placebo) to 27% during zimelidine treatment, and the number of daily drinks decreased slightly from 6.0-6.5 (baseline or placebo) to 5.5-5.6. There were significant variations between subjects in their response to zimelidine, but there was no significant change in depression or anxiety score during treatment, and there was no evidence of aversive effect.

These results suggest that ' ... zimelidine modifies alcohol intake by a different mechanism than previously tested drugs, possibly by modulating the central neural mechanism that controls drinking of alcohol.' Naranjo. CA et al.: Clinical Pharmacology and Therapeutics 35: 374 (Mar 1984)

0156-2703/84/0512-0015/0$01.00/0 © ADIS Press INPHARMA···· 12 May 1984 15