LONG-ACTING INJECTABLE BROMOCRIPTINE DOES NOT REDUCE RELAPSE IN ALCOHOLICS

Dopamine is one of several neurotransmitters that may mediate alcohol intake and dependence. A randomized, double-blind, placebo-controlled international, multicentre study was conducted to assess the effects o f a long-acting injectable preparation of bromocriptine, a dopamine ag onist, (Parlodel-LAR((R))) in reducing relapse in 366 moderately/sever ely dependent alcoholics (DSM-III-R), drinking approximately 200g alco hol (14.5 standard drinks) per day. After detoxification they were ran domized to receive six monthly injections of bromocriptine 25 mg (n = 120), bromocriptine 50 mg (n = 124), or placebo (n = 122). Brief psych osocial treatment was allowed. At 6 months there were no significant d ifferences between treatment groups in rates of relapse to any drinkin g or to drinking greater than or equal to 5 days per month and greater than or equal to 3 drinks per day. Pre-treatment alcohol intake did n ot determine response. Efficacy ratings by subjects and investigators and adverse events, reported by 51 % of subjects, did not differ betwe en treatments. The results of this large study, in which compliance wa s enhanced by Parlodel-LAR((R)), do not indicate that bromocriptine is efficacious in the maintenance of abstinence or reduced drinking. Pos sible reasons for the discrepancy between these conclusions and those of some previous clinical trials, in which bromocriptine was reported to reduce symptoms of alcohol withdrawal and dependence, are discussed .