Pharmacological interventions for alcohol use disorder: novel insights from recent clinical trials.

A review of current and emerging treatments for alcohol use disorder (AUD), which affects 27.1 million U.S. adults, argues that existing medications have mixed efficacy and that a shift toward precision medicine—identifying subgroups most responsive to existing or combination pharmacotherapies—is needed. The review also synthesizes novel agents on the treatment horizon, including glucagon-like peptide 1 receptor agonists, classic psychedelics, ketamine, immune modulators, and cannabinoids. Adopting precision medicine and these new compounds requires changes in healthcare systems, moving away from a one-size-fits-all model to improve cost-effectiveness and patient outcomes, though distribution challenges remain.

Study at a glance

Abstract

27.1 million adults in the United States have alcohol use disorder (AUD). However, current medications for AUD have mixed efficacy. As such, a shift in treatment approach and the development of novel pharmacotherapies for AUD is imperative. This review addresses novel insights on treating AUD through precision medicine that identifies subgroups of individuals most responsive to existing single or combination pharmacotherapies for AUD. In parallel, this review synthesizes the emergence of pharmacological agents for AUD that are on the treatment horizon. These include glucagon-like peptide 1 receptor agonists, classic psychedelics, ketamine, immune modulators, and cannabinoids. Data reviewed were culled from searches of the PubMed database and clinicaltrials.gov registry. Adopting a precision medicine approach and investigating novel compounds for AUD treatment requires a shift in systems of care. Precision medicine navigates away from the traditional 'one size fits all' health care model to emphasize the individual, leading to long-term cost-effectiveness and improved patient outcomes. Moreover, novel pharmacotherapies face challenges in the scale of their distribution throughout healthcare settings. The developments reviewed in this paper elucidate a paradigm shift necessary to facilitate the integration of precision medicine and the adoption of novel pharmacotherapies within the AUD field.