Effect of Varenicline Combined with High-Dose Alcohol on Craving, Subjective Intoxication, Perceptual Motor Response, and Executive Cognitive Function in Adults with Alcohol Use Disorders: Preliminary Findings

Alcohol Clin Exp Res. 2016 Jul;40(7):1567-76. doi: 10.1111/acer.13110. Epub 2016 Jun 1.

Abstract

Background: Varenicline has been found to decrease alcohol-motivated behaviors. Recent warnings regarding aversive events associated with varenicline used in conjunction with alcohol warrant further investigation into the safety of the drug when combined with alcohol. The purpose of this preliminary investigation was to examine the effect of combining varenicline with a high, fixed dose of alcohol on subjective reactivity and cognitive function in adults with alcohol use disorders (AUDs).

Methods: This double-blind, placebo-controlled preliminary investigation examined the effects of varenicline (0, 1, 2 mg/d) on subjective reactivity, cognition, perceptual motor function, and physiologic reactivity to a fixed dose of alcohol (vs. nonalcohol control beverage) using an established laboratory paradigm in smokers and nonsmokers meeting criteria for AUDs (n = 44). All participants had completed a parent varenicline study evaluating alcohol self-administration. Each subject completed 2 fixed-dose laboratory sessions assessing reactivity to a high-dose alcohol (0.08 g/dl) or a nonalcoholic control beverage, order counterbalanced.

Results: Varenicline attenuated alcohol-related increases in subjective intoxication and alcohol-related decreases in executive cognitive function. At baseline, varenicline reduced alcohol craving and diastolic blood pressure, and increased associative learning, working memory, and perceptual motor function. Varenicline produced nonspecific effects on diastolic blood pressure and heart rate. Overall, there were few differences in effects between 1 and 2 mg/d varenicline versus placebo.

Conclusions: These preliminary results continue to support the safety and use of varenicline in combination with alcohol in individuals meeting criteria for AUDs.

Keywords: Alcohol; Cognition; Fixed Dose; Laboratory; Nicotinic Acetylcholine Receptor; Perceptual Motor; Varenicline.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Alcohol-Related Disorders / drug therapy
  • Alcoholic Intoxication / drug therapy*
  • Alcoholic Intoxication / psychology
  • Association Learning / drug effects
  • Blood Pressure / drug effects
  • Craving / drug effects*
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Ethanol / adverse effects
  • Ethanol / antagonists & inhibitors*
  • Executive Function / drug effects*
  • Female
  • Heart Rate / drug effects
  • Humans
  • Male
  • Memory, Short-Term / drug effects
  • Nicotinic Agonists / therapeutic use
  • Psychological Tests
  • Psychomotor Performance / drug effects*
  • Varenicline / therapeutic use*
  • Young Adult

Substances

  • Nicotinic Agonists
  • Ethanol
  • Varenicline