Bailly D, Servant D, Blandin N, Beuscart R, Parquet P J
Psychopathology and Alcohology Unit, Hôpital de la Charité, Lille, France.
Biomed Pharmacother. 1992;46(9):419-24. doi: 10.1016/0753-3322(92)90047-b.
Alcohol withdrawal is associated with a decrease in gamma-aminobutyric acid neurotransmission. This explains the efficacy of benzodiazepines. However, an increase in adrenergic activity may also play a part in alcohol withdrawal symptoms, suggesting a potential efficacy of beta-blocking drugs. A double-blind comparative study of propranolol and diazepam was carried out in 28 patients suffering from moderate uncomplicated alcohol withdrawal. Patients were treated for 15 days with either 75 mg of propranolol or 30 mg of diazepam. The results show that both drugs at the dosages used are equipotent in reducing physical withdrawal symptoms and anxiety symptoms. This suggests that most likely the central as well as the peripheral effects determine the clinical usefulness of propranolol in the management of alcohol withdrawal. However, propranolol is ineffective in preventing major motor seizures, suggesting that different neurobiological mechanisms underlie the alcohol withdrawal symptoms.
酒精戒断与γ-氨基丁酸神经传递的减少有关。这解释了苯二氮䓬类药物的疗效。然而，肾上腺素能活性的增加也可能在酒精戒断症状中起作用，这表明β受体阻滞剂可能有效。对28例中度单纯酒精戒断患者进行了普萘洛尔和地西泮的双盲对照研究。患者分别接受75毫克普萘洛尔或30毫克地西泮治疗15天。结果表明，所使用剂量的两种药物在减轻身体戒断症状和焦虑症状方面具有同等效力。这表明，很可能是中枢和外周效应决定了普萘洛尔在酒精戒断管理中的临床效用。然而，普萘洛尔在预防严重运动性癫痫发作方面无效，这表明酒精戒断症状背后存在不同的神经生物学机制。
