Pharmacogenetics of alcohol use disorder treatments: an update
Emily E. Hartwell & Henry R. Kranzler
Received 11 Dec 2018, Accepted 03 Jun 2019, Accepted author version posted online: 04 Jun 2019, Published online: 11 Jun 2019
Download citation  https://doi.org/10.1080/17425255.2019.1628218 

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ABSTRACT
Introduction: Alcohol use disorder (AUD) is highly prevalent; costly economically, socially, and interpersonally; and grossly undertreated. The low rate of utilization of medications with demonstrated (albeit modest) efficacy is particularly noteworthy. One approach to increasing the utility and safety of available medications is to use a precision medicine approach, which seeks to identify patients for whom specific medications are likely to be most efficacious and have the fewest adverse effects.

Areas Covered: We review the literature on the pharmacogenetics of AUD treatment using both approved and off-label medications. We cover both laboratory studies and clinical trials, highlighting valuable mechanistic insights and underscoring the potential value of precision-based care for AUD.

Expert Opinion: Pharmacotherapy can be a useful component of AUD treatment. Currently, the evidence regarding genetic predictors of medication efficacy is very limited. Thus, a precision medicine approach is not yet ready for widespread clinical implementation. Further research is needed to identify candidate genetic variants that moderate the response to both established and novel medications. The growing availability of large-scale, longitudinal datasets that enable the synthesis of genetic and electronic health record data provides important opportunities to develop this area of research.

KEYWORDS: Alcohol use disorder, pharmacogenetics, precision medicine, pharmacotherapy, genetic moderators