Niederhofer Helmut, Staffen Wolfgang, Mair Alois
Christian Doppler-Klinik, A-5020 Salzburg, Austria.
Alcohol Alcohol. 2003 Jan-Feb;38(1):50-3. doi: 10.1093/alcalc/agg011.
About 50% of alcoholic patients relapse within 3 months of treatment. Previous studies have suggested that cyanamide may help to prevent such relapse. The aim of our study was to assess the efficacy and safety of long-term cyanamide treatment in alcohol dependence of adolescents.
In this, double-blind, placebo-controlled study, we recruited 26 patients, aged 16-19 years, with chronic (frequent and regular) or episodic (frequent, but irregular) alcohol dependence. Patients were randomly allocated treatment with cyanamide (200 mg daily) or a placebo for 90 days. Patients were assessed on the day the treatment was started, and on days 30 and 90, by interview, self-report, questionnaire and laboratory screening. Patients were classified as abstinent, relapsing or non-attending. Time to first treatment failure (relapse or non-attendance) was the primary outcome measure.
The cyanamide (n = 13) and placebo (n = 13) groups were well matched in terms of baseline demographic and alcohol-related variables. Mean cumulative abstinence duration was significantly greater in the cyanamide group than in the placebo group. Apart from occasional diarrhoea, there was no difference in side effects between groups.
Cyanamide seems to be an effective and well tolerated pharmacological adjunct to psychosocial and behavioural treatment programmes for the treatment of some adolescent alcohol-dependent patients. Because of reported hepatotoxic, haematological and dermatological side effects, patients should be observed continuously by experienced clinicians. Further studies are necessary to prove the efficacy of cyanamide in adolescents.
约50%的酒精依赖患者在治疗后3个月内复发。既往研究表明，氨基氰可能有助于预防此类复发。我们研究的目的是评估长期使用氨基氰治疗青少年酒精依赖的疗效和安全性。
在这项双盲、安慰剂对照研究中，我们招募了26名年龄在16至19岁之间、患有慢性（频繁且规律）或发作性（频繁但不规律）酒精依赖的患者。患者被随机分配接受氨基氰（每日200毫克）或安慰剂治疗90天。在治疗开始当天、第30天和第90天，通过访谈、自我报告、问卷调查和实验室筛查对患者进行评估。患者被分类为戒酒、复发或未就诊。首次治疗失败（复发或未就诊）的时间是主要结局指标。
氨基氰组（n = 13）和安慰剂组（n = 13）在基线人口统计学和酒精相关变量方面匹配良好。氨基氰组的平均累积戒酒持续时间显著长于安慰剂组。除偶尔腹泻外，两组间副作用无差异。
对于一些青少年酒精依赖患者，氨基氰似乎是心理社会和行为治疗方案中一种有效且耐受性良好的药物辅助治疗方法。鉴于有报道称存在肝毒性、血液学和皮肤病学方面的副作用，应由经验丰富的临床医生持续观察患者。有必要进行进一步研究以证实氨基氰在青少年中的疗效。
