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Attenuation of insula response to alcohol cues by varenicline in heavy drinkers: association with alcohol self-administration

Monday, September 22, 2014 — Poster Session I

12:00 p.m. – 2:00 p.m.

FAES Academic Center



* FARE Award Winner


  • JL Gowin
  • V Vatsalya
  • ML Schwandt
  • R Momenan
  • ME Coe
  • ML Cooke
  • S Bartlett
  • M Heilig
  • VA Ramchandani


Alcohol dependence has been associated with enhanced sensitivity to alcohol cues in neural reward circuitry, including the striatum and insula. Varenicline, a nicotinic acetylcholine receptor (nAChR) partial agonist, is an FDA-approved smoking cessation medication, and recent evidence suggests it may also reduce heavy drinking among alcoholics. This study tested the hypothesis that varenicline reduces drinking by attenuating the reward circuitry’s response to alcohol cues. 29 adult heavy drinkers were randomized to receive varenicline (2 mg/day) or placebo for 3 weeks. Following 2 weeks of treatment, participants underwent a functional magnetic resonance imaging scan while performing the Alcohol-Food Incentive Delay task, where they saw cues signaling the chance to win alcohol, food or no rewards. Participants completed a laboratory intravenous alcohol self-administration at baseline and one week after the fMRI scan to assess alcohol intake. The varenicline group (N=17) relative to the placebo group (N=12) showed significantly reduced activity in left ventral striatum, right amygdala and right insula following an alcohol cue. Higher activation in the right insula following the alcohol cue was associated with greater alcohol self-administration in the second session. These results suggest that varenicline may reduce alcohol consumption through reduced activity of brain regions associated with alcohol salience.

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