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Psychopharmacology (Berl). 2014 Oct;231(19):3843-53. doi: 10.1007/s00213-014-3519-0. Epub 2014 Apr 15.

Varenicline, low dose naltrexone, and their combination for heavy-drinking smokers: human laboratory findings.

Author information

1
Department of Psychology, University of California, 1285 Franz Hall, Box 951563, Los Angeles, CA, 90095-1563, USA, lararay@psych.ucla.edu.

Abstract

RATIONALE:

Heavy-drinking smokers constitute a sizeable and hard-to-treat subgroup of smokers, for whom tailored smoking cessation therapies are not yet available.

OBJECTIVES:

The present study used a double-blind, randomized, 2 × 2 medication design, testing varenicline alone (VAR; 1 mg twice daily), low dose naltrexone alone (L-NTX; 25 mg once daily), varenicline plus naltrexone, and placebo for effects on cigarette craving and subjective response to alcohol and cigarettes in a sample (n = 130) of heavy-drinking daily smokers (≥10 cigarettes/day).

METHODS:

All participants were tested after a 9-day titration period designed to reach a steady state on the target medication. Testing was completed at 12 h of nicotine abstinence, after consuming a standard dose of alcohol (target breath alcohol concentration = 0.06 g/dl) and after smoking the first cigarette of the day.

RESULTS:

The combination of VAR + L-NTX was superior to placebo, and at times superior to monotherapy, in attenuating cigarette craving, cigarette and alcohol "high," and in reducing ad-lib consumption of both cigarettes and alcohol during the 9-day medication titration period.

CONCLUSIONS:

These preliminary findings indicate that clinical studies of the combination of VAR + L-NTX for heavy drinkers trying to quit smoking are warranted and may ultimately improve clinical care for this sizeable and treatment-resistant subgroup of smokers.

PMID:
24733235
PMCID:
PMC4161630
DOI:
10.1007/s00213-014-3519-0
[Indexed for MEDLINE]
Free PMC Article

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