Monti P M, Rohsenow D J, Hutchison K E, Swift R M, Mueller T I, Colby S M, Brown R A, Gulliver S B, Gordon A, Abrams D B
Providence VA Medical Center, Brown University, Rhode Island 02912, USA.
Alcohol Clin Exp Res. 1999 Aug;23(8):1386-94.
Advancing knowledge of biobehavioral effects of interventions can result in improved treatments. Thus, a standardized laboratory cue reactivity assessment has been developed and validated to assess the cognitive and psychophysiological responses to a simulated high-risk situation: alcohol cues. The present study investigates the effects of a pharmacotherapy (naltrexone) on a laboratory-based, cue-elicited urge to drink among abstinent alcoholics in treatment.
Alcohol-dependent subjects were randomized to 12 weeks of naltrexone or placebo after completing a partial hospital program. After approximately 1 week on medication, all received cue reactivity assessment.
Significantly fewer patients taking naltrexone reported any urge to drink during alcohol exposure than did those on placebo. Those with any urges reported no decrement in level of the urges. Mean arterial pressure decreased significantly for those on placebo, but not for those on naltrexone, whereas cue-elicited decreases in heart rate were not affected by the medication.
The results have implications for models of relapse and naltrexone's effects. Cue reactivity methodology has utility for investigating hypothesized mediators of therapeutic effects of pharmacotherapies as well as behavioral treatments.
深入了解干预措施的生物行为效应有助于改进治疗方法。因此，已开发并验证了一种标准化的实验室线索反应性评估方法，用于评估对模拟高风险情境（酒精线索）的认知和心理生理反应。本研究调查了药物治疗（纳曲酮）对治疗中戒酒的酒精依赖者基于实验室线索引发的饮酒冲动的影响。
酒精依赖受试者在完成部分住院治疗项目后，被随机分配接受12周的纳曲酮或安慰剂治疗。在服药约1周后，所有受试者均接受线索反应性评估。
与服用安慰剂的患者相比，服用纳曲酮的患者在接触酒精期间报告有饮酒冲动的人数明显较少。有饮酒冲动的患者报告冲动程度没有降低。服用安慰剂的患者平均动脉压显著下降，而服用纳曲酮的患者则没有，线索引发的心率下降不受药物影响。
这些结果对复发模型和纳曲酮的作用具有启示意义。线索反应性方法可用于研究药物治疗以及行为治疗的假设治疗效果中介物。
