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一项关于奥氮平治疗酒精依赖障碍的双盲、安慰剂对照研究。

A double-blind, placebo-controlled study of olanzapine in the treatment of alcohol-dependence disorder.

作者信息

Guardia José, Segura Lidia, Gonzalvo Begoña, Iglesias Lisbeth, Roncero Carlos, Cardús María, Casas Miguel

机构信息

Addictive Behavior Unit, Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.

出版信息

Alcohol Clin Exp Res. 2004 May;28(5):736-45. doi: 10.1097/01.alc.0000125352.06688.f7.

Abstract

BACKGROUND

A 12-week, double-blind, randomized, parallel-group clinical trial, comparing olanzapine and placebo treatment together with cognitive-behavioral psychotherapy, was carried out to determine the efficacy, safety, and tolerability of olanzapine in the treatment of alcoholism.

METHODS

A total of 60 alcohol-dependent patients were assigned to 12 weeks' treatment with either olanzapine or placebo. The primary variable relapse to heavy drinking rate was evaluated by means of intention-to-treat analyses. Alcohol consumption, craving, adverse events, and changes in the biochemical markers of heavy drinking and possible toxicity were also evaluated.

RESULTS

We did not find significant differences in the survival analysis between placebo and olanzapine-treated patients (Kaplan-Meier log rank = 0.46, df = 1, p = 0.50). Eleven (37.9%) patients treated with olanzapine relapsed compared with 9 (29%) of those receiving placebo (chi = 0.53, df = 1, p = 0.5). Although some adverse events (weight gain, increased appetite, drowsiness, constipation, and dry mouth) were found more frequently in the olanzapine group, differences did not reach statistical significance in comparison with the placebo group.

CONCLUSIONS

Olanzapine was well tolerated, as the rate of adverse events was low, and it was safe, because it did not interfere with the normalization of biochemical markers of heavy drinking or alter liver function markers. Alcohol-dependent patients showed good adherence and compliance with the treatment protocol, but we found no differences in relapse rate or other drinking variables when comparing olanzapine with placebo-treated patients.

摘要

背景

开展了一项为期12周的双盲、随机、平行组临床试验,比较奥氮平与安慰剂联合认知行为心理治疗,以确定奥氮平治疗酒精中毒的疗效、安全性和耐受性。

方法

总共60名酒精依赖患者被分配接受为期12周的奥氮平或安慰剂治疗。通过意向性分析评估主要变量重度饮酒复发率。还评估了酒精摄入量、渴望程度、不良事件以及重度饮酒生化标志物的变化和可能的毒性。

结果

在生存分析中,我们未发现安慰剂组和奥氮平治疗组患者之间存在显著差异(Kaplan-Meier对数秩检验=0.46,自由度=1,p=0.50)。接受奥氮平治疗的患者中有11名(37.9%)复发,而接受安慰剂治疗的患者中有9名(29%)复发(卡方检验=0.53,自由度=1,p=0.5)。虽然奥氮平组更频繁地出现一些不良事件(体重增加、食欲增加、嗜睡、便秘和口干),但与安慰剂组相比,差异未达到统计学显著性。

结论

奥氮平耐受性良好,因为不良事件发生率较低,且它是安全的,因为它不干扰重度饮酒生化标志物的正常化或改变肝功能标志物。酒精依赖患者对治疗方案表现出良好的依从性,但在比较奥氮平与安慰剂治疗的患者时,我们未发现复发率或其他饮酒变量存在差异。

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