Numerous genetic markers for alcoholism have been discovered, but not everyone who has the genetic marker develops the disease. Environmental factors also play a role in the development of the alcoholism. Epigenetic factors are things that modify genes, like switches that can turn them on or off.
Many of the genes associated with the development of alcoholism encode components of neurotransmitters, particularly serotonin. Serotonin is an important neurotransmitter that regulates mood and low levels are thought to cause depression.
A recent review examined the SLC6A4 gene, which encodes a serotonin transporter protein. The researchers looked at the genetic and pharmacogenetic data in context with patients’ clinical histories. Patients were classified as Type I or Type II alcoholics, according to Cloninger’s typology.
Types of alcoholics
Robert Cloninger, M.D., explored the genetic and environmental factors that led to the development of alcoholism in a Swedish population. In the course of his research, he noted two distinct categories of alcoholics. Cloninger’s typology of alcoholism is briefly summarized as follows:
Type I: Drinks to relieve anxiety; onset after age 25; affects men and women; genetic and environmental etiology; progressive
Type II: Drinks to induce euphoria; onset before age 25; affects mainly men; genetic etiology; not progressive but associated with fighting and arrests
Type I alcoholics were found to carry the short allele variation for their serotonin transporter gene. This finding was consistent with previous work that demonstrated that the short variation was associated with chronic anxiety and depression as well as alcoholism. Perhaps this type of alcoholism does develop from “self-medicating” depression and anxiety symptoms over many years.
Type II alcoholics most often carried the long allele variation, which has been associated with psychopathy in other studies. Like Type II alcoholism, psychopathy also is more common in males, is associated with aggression and antisocial behavior, and has a typical onset in adolescence or young adulthood.
The primary purpose of the study was to determine whether genetic markers could be used to predict response to psychotropic medications. Regarding medication response, those with the long allele were more likely to respond to selective serotonin reuptake inhibitors (SSRIs) than those with the short version. Those with the long version also responded to placebos.
People with certain SLC6A4 gene variations, particularly the short allele variation, may be at risk for depression, anxiety and Type I alcoholism throughout their lives. Early identification might help prevent the development of alcoholism. However, antidepressant medication would not be appropriate until symptoms develop, if they develop at all.
Nonpharmacological means for increasing serotonin levels have been described. There are four primary methods:
If you or someone you love has tried to stop drinking or taking drugs without success, detoxification and treatment can help. New medications and therapies can make the process safe and comfortable. Breaking free from addiction is the first step toward living a healthy and purposeful life.
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About the author
Dana Connolly, Ph.D., is a senior staff writer for Sovereign Health, where she translates current research into practical information. She earned her Ph.D. in research and theory development from New York University and has decades of experience in clinical care, medical research and health education. Sovereign Health is a health information resource, and Dr. Connolly helps to ensure excellence in our model. For more information and other inquiries about this article, contact the author at firstname.lastname@example.org.