Swift R M
Department of Psychiatry and Human Behavior, Brown University, Providence, Rhode Island, USA.
Alcohol Res Health. 1999;23(3):207-13.
The use of medications as an adjunct to alcoholism treatment is based on the premise that craving and other manifestations of alcoholism are mediated by neurobiological mechanisms. Three of the four medications approved in the United States or Europe for treating alcoholism are reported to reduce craving; these include naltrexone (ReVia), acamprosate, and tiapride. The remaining medication, disulfiram (Antabuse), may also possess some anticraving activity. Additional medications that have been investigated include ritanserin, which has not been shown to decrease craving or drinking levels in humans, and ondansetron, which shows promise for treating early onset alcoholics, who generally respond poorly to psychosocial treatment alone. Use of anticraving medications in combination (e.g., naltrexone plus acamprosate) may enhance their effectiveness. Future studies should address such issues as optimal dosing regimens and the development of strategies to enhance patient compliance.
药物作为酒精成瘾治疗的辅助手段，其使用基于这样一个前提，即酒精成瘾的渴望及其他表现是由神经生物学机制介导的。在美国或欧洲获批用于治疗酒精成瘾的四种药物中，有三种据报道可减少渴望；这些药物包括纳曲酮（ReVia）、阿坎酸和硫必利。剩下的药物双硫仑（Antabuse）可能也具有一定的抗渴望活性。其他已被研究的药物包括利坦色林，它在人类身上未显示出可降低渴望或饮酒量，还有昂丹司琼，它对治疗早期酒精成瘾者显示出前景，这类患者通常对单纯的心理社会治疗反应不佳。联合使用抗渴望药物（如纳曲酮加阿坎酸）可能会提高其疗效。未来的研究应解决诸如最佳给药方案以及提高患者依从性策略的制定等问题。
