Johnson Bankole A
Department of Psychiatry, Division of Alcohol and Drug Addiction, The University of Texas Health Science Center at San Antonio, 3939 Medical Drive, Suite 100, San Antonio, TX 78229-3900, USA.
Expert Opin Pharmacother. 2004 Sep;5(9):1943-55. doi: 10.1517/14656566.5.9.1943.
The development of treatments for alcohol dependence has been significantly complicated by the multiple actions of ethanol at the neurotransmitter level, heterogeneity among patients with alcohol dependence, the complexity of defining and measuring the phenomenon of craving, and the challenge of quantifying alcohol intake in patients. Increasingly, anticonvulsant medications are showing promise for the safe and effective amelioration of alcohol withdrawal symptoms. Furthermore, there is evidence that anticonvulsant medications are promising treatments for reducing drinking and preventing relapse among alcohol-dependent individuals. In recent years, many medications have been evaluated for the treatment of alcohol dependence, including those that interact with dopaminergic, serotonergic, opioid or glutamate and/or GABA systems. So far, naltrexone, acamprosate and, more recently, the anticonvulsant, topiramate, have shown some efficacy for the treatment of heterogeneous populations of individuals with alcohol dependence. Both ondansetron and sertraline appear to have some efficacy in treating different subgroups of alcoholic.
乙醇在神经递质水平的多种作用、酒精依赖患者之间的异质性、定义和测量渴望现象的复杂性以及量化患者酒精摄入量的挑战，使得酒精依赖治疗方法的开发变得极为复杂。越来越多的抗惊厥药物显示出有望安全有效地改善酒精戒断症状。此外，有证据表明抗惊厥药物是减少酒精依赖个体饮酒量和预防复发的有前景的治疗方法。近年来，许多药物已被评估用于治疗酒精依赖，包括那些与多巴胺能、5-羟色胺能、阿片类或谷氨酸和/或γ-氨基丁酸系统相互作用的药物。到目前为止，纳曲酮、阿坎酸以及最近的抗惊厥药物托吡酯已显示出对不同酒精依赖个体群体的治疗有一定疗效。昂丹司琼和舍曲林似乎在治疗不同亚组的酗酒者方面都有一定疗效。
