Wiesbeck G A, Weijers H-G, Wodarz N, Lesch O M, Glaser T, Boening J
Department of Psychiatry, University of Wüerzburg, Wüerzburg, Füechsleinstr, 15, D-97080, Wüerzburg, Germany.
Arch Womens Ment Health. 2003 Nov;6(4):259-62. doi: 10.1007/s00737-003-0010-z.
A study recently finished by our research group elucidated the effectiveness of flupenthixol decanoate (FLX) in maintaining abstinence in detoxified alcoholics. Flupenthixol decanoate is an established antipsychotic drug, which is well known for its mild antidepressant and anxiolytic activity as well as for its minimal sedation at low doses. It blocks dopamine binding at a number of receptor subtypes, primarily at D-1, D-2, D-3 and with less affinity at D4-receptors. It also affects serotonin binding at 5-HT2A and 5-HT2C receptors. In a double-blind placebo-controlled multicenter trial, 77 women and 204 men suffering from moderate or severe DSM-II-R alcohol dependence were randomly assigned to either 10 mg FLX or placebo both injected every second week over a period of 24 weeks (treatment phase) succeeded by a medication-free 24-weeks follow-up period. In the overall analysis the number of patients relapsed after 24 weeks of treatment (=main criterion of efficacy) was significantly higher in the FLX treated group (85.2%) than under placebo (65.5%). However, when differentiating this result according to sex the analysis revealed a gender-related discrepancy: while male patients had an almost 4-fold higher risk to relapse under FLX than under placebo (OR=3.95) this risk was barely elevated for female patients (OR=1.51). A significantly negative outcome due to FLX treatment was restricted to male alcoholics solely. In conclusion, gender-related differences to pharmacological relapse prevention with FLX have probably contributed to a better treatment outcome in women than in men.
我们研究小组最近完成的一项研究阐明了癸酸氟哌噻吨（FLX）在维持戒酒的酒精成瘾者戒断状态方面的有效性。癸酸氟哌噻吨是一种公认的抗精神病药物，以其轻度抗抑郁和抗焦虑活性以及低剂量时最小的镇静作用而闻名。它在多种受体亚型上阻断多巴胺结合，主要是在D-1、D-2、D-3受体，对D4受体的亲和力较低。它还影响5-HT2A和5-HT2C受体上的5-羟色胺结合。在一项双盲安慰剂对照多中心试验中，77名女性和204名患有中度或重度DSM-II-R酒精依赖的男性被随机分配接受10mg FLX或安慰剂治疗，均每两周注射一次，为期24周（治疗阶段），随后是24周的无药物随访期。在总体分析中，治疗24周后复发的患者数量（=疗效的主要标准）在接受FLX治疗的组中（85.2%）显著高于安慰剂组（65.5%）。然而，根据性别对该结果进行区分时，分析显示存在性别差异：男性患者在接受FLX治疗时复发的风险几乎是接受安慰剂治疗时的4倍（OR=3.95），而女性患者的这种风险仅略有升高（OR=1.51）。FLX治疗导致的显著负面结果仅局限于男性酗酒者。总之，FLX在预防药理学复发方面的性别差异可能导致女性的治疗效果优于男性。
