This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. During the past decade, the pharmacotherapy of alcoholism has received increasing attention both from NIAAA and the pharmaceutical industry. However, despite the FDA approval of naltrexone for relapse prevention, medications are still not widely used to treat the disorder. This contrasts sharply with the treatment of nicotine dependence, for example, as well as other psychiatric disorders. In an effort to broaden the options for pharmacotherapy of alcoholism, this proposal will examine the effects of sertraline, a selective serotonin reuptake inhibitor (SSRI), for the treatment of alcohol dependence. The study is based on evidence that, although SSRI therapy is not appropriate for all alcoholics (Kranzler et al. 1996a, Pettinati et al. 2000), there exists a substantial subgroup with the disorder (i.e., Type A or later-onset alcoholics) for whom SSRI's appear to exert a clinically important effect. Since sertraline is well tolerated and among the most widely prescribed psychotropic medications in the world, a prospective demonstration of its efficacy could have a broad influence on the treatment of alcohol dependence. Consequently, this study will examine the safety and efficacy of sertraline, the mechanism and duration of those effects and the best method for subtyping alcoholics to identify individuals for whom the medication is most likely to produce a clinically important reduction in drinking behavior.
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