Abstract Background Response to naltrexone varies among individuals with alcohol use disorder (AUD). Studies in Western populations have linked the sweet-liking (SL) phenotype, reflecting an individual's hedonic response to sweet taste, to improved outcomes with naltrexone. However, cultural and ethnic variations in SL raise questions about the generalizability of this association. This exploratory investigation examined the relationship between SL phenotype and naltrexone treatment outcomes in Taiwanese patients with AUD. Methods Patients with DSM-5-defined severe AUD who had completed alcohol withdrawal were enrolled in an 8-week open-label naltrexone trial. Participants completed a sweet taste test and were categorized into SL or sweet-disliking (SDL) groups. Outcomes included alcohol consumption (drinking days per week, heavy drinking days per week, drinks per drinking day, abstinent days), alcohol craving, and depression and anxiety severity. Generalized estimating equations were used to assess the effects of time, group, and their interaction. Results Ninety-one patients were enrolled (SL: n = 44; SDL: n = 47). Baseline characteristics were comparable between groups, except for smoking-related variables. After adjusting for smoking, both groups showed improvements in alcohol use and psychological measures over time. A significant group-by-time interaction was found for drinks per drinking day, with the SL group showing more favorable outcomes than the SDL group (P = 0.03). Conclusions This is the first exploratory investigation in Asians to assess SL phenotype in relation to naltrexone response in AUD patients. The SL phenotype was associated with reduced alcohol consumption over 8 weeks of naltrexone treatment, supporting SL phenotype as a potential biomarker for personalized AUD treatment.
Chang et al. (Wed,) studied this question.