The current state of niacin research in alcoholics was reviewed. A five-year field trial with nicotinic acid strongly suggested great potential for benefit in alcoholics. The next logical step was a confirmatory blind crossover study. Such a study was considered even more important because it represented the kind of evidence acceptable to the scientific community, the author writes.
Three obstacles still stood in the way of such a study. The current literature and observations in previous studies allowed the development of a theoretical approach to the effect of nicotinic acid at the point of 5- OH-tryptamine metabolism. A set of clinical criteria was developed that had already been tested in a previous study based on the tryptamine metabolic cycle.
A satisfactory test form of nicotinic acid was found in the form of a timed release that eliminated the telltale histamine start symptoms, allowing identical placebo development. Once these significant barriers were removed, a blind crossover study was conducted in a study population selected to demonstrate maximum effect.