Alcohol Dependence

Individualized treatment of alcohol dependence

Clearly there have been barriers to the adoption of the pharmacological treatment of alcohol dependence. Perhaps one of the most serious has been the limited effectiveness of currently available antidipsotropic medications.

Successful pharmacogenomic identification of patients who are highly likely to respond to pharmacological treatment could dramatically change the perception of clinicians in the field who are providing treatment. Similarly, young investigators would be attracted to a novel approach to the investigation of a chronic problem.

Ultimately, a better understanding of the biological basis of pharmacological treatment could lead to new strategies to initiate early intervention and eventually even prevention.

Overview

A primary goal of this program is to develop infrastructure for an expanding research team dedicated to the theme of designing and launching systematic pharmacogenomic probe studies of pharmacologic treatments for alcohol use disorders broadly and severe alcohol dependence more narrowly.

Mayo Clinic has been awarded a $2.5 million grant from the National Institute on Alcohol Abuse to establish a center for Individualized Treatment of Alcohol Dependence. The grant was awarded to David A. Mrazek, M.D., Chair of Psychiatry and Psychology, who serves as the future center's program director.

The grant is part of the American Recovery and Reinvestment Act (ARRA) and intended to develop and implement critical research, stimulate future growth and to advance public health and health care delivery.

This program utilizes the genomic and pharmacogenomic research infrastructure that is currently available at Mayo Clinic, coupled with the long-standing commitment to provide state of the art treatment for alcohol dependent patients. Given the scope of the public health implications of alcohol dependence, creating a program with the capacity to more effectively treat patients using innovative new strategies promises to have a major impact.

Multidisciplinary team

The grant funds the creation of an expanded multidisciplinary team of investigators who will work together to:

• Conduct pharmacogenomic studies to identify which alcohol dependent patients are most likely to respond to antidipsotropic treatment.
• Use the techniques of medicine, pharmacology, and genomics to determine which patients will are likely to benefit from medications designed to cause adverse results when alcohol is consumed.
• Design and conduct both preclinical and clinical studies that will provide new knowledge about the responses of individual patients to pharmacological treatments. This is achieved using currently available antidipsotropic medications, as well as antidipsotropic medications in development.

Program goals

To develop an integrated and expanded multidisciplinary team of both preclinical and clinical investigators who will work together at the Mayo Clinic to develop pharmacogenomics strategies for the identification of patients who are most likely to benefit from antidipsotropic medications as part of their comprehensive treatment for alcohol dependence.

To develop additional infrastructure at the Mayo Clinic to capitalize on currently available research resources with the goal of developing new pharmacogenomic studies designed to identify those patients who are most likely to respond to antidipsotropic medications. A key objective will be to link the research centers of excellence that are already established at the Mayo Clinic with our developing team of S. C. Johnson investigators to initiate new studies of the individualized treatment of alcohol dependence and build upon ongoing research.

To further develop training opportunities in research strategies that can define the pharmacogenomic variability associated with successful treatment of alcohol dependence. Both preclinical trainees and clinical trainees will be recruited to participate in pharmacogenomic studies of antidipsotropic medications and to enroll in the currently available research training programs at the Mayo Clinic. The creation of expanded training opportunities will be a key component of achieving this aim. This goal will synergistically support Aim 1 as research efforts of new trainees will be integrated into the ongoing and newly developed research initiatives of the investigators supported by the P20 exploratory/development alcohol research center.

To work collaboratively using the resources provided by P20 support over the course of four years to systematically develop a proposal that will result in the creation of a full P50 translational alcohol research center dedicated to studying individualized treatment for alcohol dependence.