Mason Barbara J
Department of Neuropharmacology, The Scripps Research Institute, La Jolla, CA, USA.
Eur Neuropsychopharmacol. 2003 Dec;13(6):469-75. doi: 10.1016/j.euroneuro.2003.08.009.
This paper provides an evidence-based risk-benefit assessment of acamprosate and naltrexone in the treatment of alcohol dependence. A risk-benefit assessment is based on the premise that the choice of treatment depends on a number of factors, notably the adverse event profile and efficacy. An evidence-based approach attempts to operationalize how such risk-benefit assessments are made to inform physician choices. This approach involves a systematic assessment of all published double-blind, placebo-controlled trials. Based on this review, we conclude acamprosate and naltrexone are both useful in the treatment of alcohol dependence. However, the two drugs act in different ways in the brain, and their clinical profiles are different. Treatment effects seem to be more reliable for acamprosate, and this drug is better tolerated. The safety of the two drugs in combination has been supported by two independent double-blind studies, and combination treatment may offer an advantage for some patients.
本文提供了关于阿坎酸和纳曲酮治疗酒精依赖的循证风险效益评估。风险效益评估基于这样一个前提，即治疗方法的选择取决于多种因素，尤其是不良事件情况和疗效。循证方法试图将如何进行此类风险效益评估加以操作化，以便为医生的选择提供依据。这种方法包括对所有已发表的双盲、安慰剂对照试验进行系统评估。基于此项综述，我们得出结论：阿坎酸和纳曲酮在治疗酒精依赖方面均有用。然而，这两种药物在大脑中的作用方式不同，其临床特征也有所不同。阿坎酸的治疗效果似乎更可靠，且该药物耐受性更好。两项独立的双盲研究证实了这两种药物联合使用的安全性，联合治疗可能对某些患者具有优势。
