Fluoxetine differentially alters alcohol intake and other consummatory behaviors in problem drinkers

Abstract

The effects of fluoxetine, a relatively long-acting serotonin uptake inhibitor, on the consumption of alcoholic and nonalcoholic drinks, cigarette smoking, and body weight were assessed in 29 men who were early stage problem drinkers. After a 2-week baseline, subjects were randomly assigned to receive 40 mg/day fluoxetine (n = 8), 60 mg/day fluoxetine (n = 11), or placebo (n = 10) for 4 weeks. Fluoxetine 60 mg/day decreased mean daily alcoholic drinks from (.hivin.X .+-. SEM) 8.3 .+-. 0.7 during baseline to 6.9 .+-. 0.7 and decreased total drinks per 14 days drom 115.8 .+-. 9.3 to 96.5 .+-. 9.5 (p < 0.01; 17.3% decrease from baseline), with no significant increase in days of abstinence. Neither 40 mg/day fluoxetine nor placebo had effects on intake of alcohol. Fluoxetine 60 mg/kg decreased total and mean daily alcoholic drinks compared with 40 mg/day fluoxetine (ANCOVA, both p < 0.02), but neither dose of fluoxetine was different from placebo. Compared with placebo, both 40 mg/day fluoxetine and 60 mg/day fluoxetine decreased the variability of the baseline to the treatment changes in alcoholic drinks (both p < 0.05). Although no differences were detected between treatment groups, 60 mg/day fluoxetine increased mean daily nonalcoholic beverages from baseline (5.0 .+-. 0.4 to 5.6 .+-. 0.3, p < 0.01) and increased daily cigarettes smoked (from 25.1 .+-. 4.6 to 26.9 .+-. 4.5, p < 0.05), whereas no significant changes from baseline were observed with 40 mg/day fluoxetine or placebo. Body weight decreased with both 40 mg/day fluoxetine (from 75.7 .+-. 4.7 kg to 73.8 .+-. 4.6 kg, p < 0.01) and 60 mg/day fluoxetine (from 81.4 .+-. 2.6 to 79.2 .+-. 2.5 kg, p < 0.05) but not with placebo. Patterns of response varied, but decreases in alcohol consumption were not related to side effects, an alcohol-sensitizing reaction, or changes in depression or anxiety. Our findings with men who are problem drinkers indicate that fluoxetine differentially alters consummatory behaviors. The reductions in alcohol intake and body weight are of clinical importance.