Effect of naltrexone and ondansetron on alcohol cue-induced activation of the ventral striatum in alcohol-dependent people

Context—Medication treatment of alcoholism is presently not particularly robust. Neuroimaging techniques might predict which medications could be useful in the treatment of alcohol dependence. Objective—To explore the effect of naltrexone, ondansetron, or the combination of these medications on cue-induced craving and ventral striatum activation. Design, Setting, Participants—Functional brain imaging (Phillips 1.5T scanner) was conducted during alcohol cue presentation in 90 non-treatment seeking alcohol-dependent (by DSM-IV criteria) and 17 social drinking (less than 14 drinks per week) paid volunteers recruited through advertisements at an academic center. Interventions—A taste of alcohol and a series of alcohol related pictures, neutral beverage pictures and visual control images were provided to volunteers after seven days of double blind randomly assigned daily dosing with 50mg naltrexone (n=23), 0.50mg ondansetron (n=23), the combination of the two medications (n=20), or matching placebos (n=24). Main Outcome Measures—Difference in brain blood oxygen level-dependent (BOLD) magnetic resonance when viewing alcohol pictures versus neutral beverage pictures with a particular focus o