Serotonergic agents remain an important area of pharmacologic study as treatments for
alcoholism.
Selective serotonin reuptake inhibitors (
SSRIs) do not appear to be efficacious at treating a heterogeneous alcoholic group.
SSRIs may, however, possess utility in treating later-onset alcoholics and
alcoholism that is complicated by co-morbid major depression. The 5-HT(1A) partial agonist,
buspirone, does not appear to be an efficacious treatment for alcoholics without co-morbid disease.
Buspirone may, however, possess some utility in treating alcoholics with co-morbid
anxiety disorder.
Ritanserin, a 5-HT(2) antagonist, does not appear to be an efficacious treatment for
alcoholism at pharmacologically relevant clinical doses.
Ondansetron, a 5-HT(3) antagonist, is an efficacious and promising medication for the treatment of earlier-onset
alcoholism. The differential treatment effect of
SSRIs and
ondansetron among various subtypes of alcoholics is intriguing. Future research is needed to more clearly understand the biopsychosocial differences that typify a particular alcoholic subtype. This type of understanding could develop our ability to make reasonable predictions as to what alcoholic subtype would respond best to a particular serotonergic agent, which could then be provided.