Summary And Treatment Implications

There is now growing evidence in humans that (1) glutamate receptors are an important target for ethanol in the brain, (2) ethanol actions at NMDA receptors contribute to its behavioral effects, (3) ethanol dependence may be associated with upregulation of NMDA receptors, (4) acute ethanol withdrawal may be associated with increased glutamate release and protracted withdrawal may be associated with reduced brain glutamate turnover, and (5) the familial risk for developing alcoholism may be associated with alterations in NMDA receptor function. Genetic variation that might link glutamatergic systems to the vulnerability to alcoholism and its treatment have yet to be explicated. Acamprosate is the first agent developed for the treatment of alcoholism with a mechanism of action that may be related to glutamate function. Future pharmacotherapy research glutamatergic pharmacotherapy research may explore medications designed to suppress withdrawal, reduce ethanol consumption, attenuate alcoholism-related cognitive deficits, protect neuronal viability, and reverse cerebral atrophy.

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