McGregor Iain S, Gallate Jason E
School of Psychology, University of Sydney, A19 Sydney, NSW 2006, Australia.
Addict Behav. 2004 Sep;29(7):1341-57. doi: 10.1016/j.addbeh.2004.06.011.
Current pharmacotherapies for alcohol dependence in humans (e.g., naltrexone, acamprosate) are meeting with only limited therapeutic success. The development of novel pharmacotherapies is urgently needed but is reliant upon the screening of large numbers of candidate "anticraving" drugs using appropriate animal models. The development of animal models is complex because (1) laboratory animals are often reluctant to consume large quantities of alcohol, (2) inducing a state of alcohol dependence, analogous to the human condition, may require many months of alcohol exposure, (3) concluding that a given drug selectively reduces alcohol craving requires very carefully controlled experiments, and (4) false positives and false negatives may result from the sometimes distinct physiology and psychology of the alcohol-addicted human and rat. To address some of these problems, our laboratory has recently developed the "beer model" of alcohol dependence and craving. Rats, like humans, have a prodigious appetite for beer and will drink much more beer than equivalent ethanol solutions in water. Beer consumption in rats leads to clear signs of intoxication, anxiety reduction, and signs of withdrawal when beer access is suddenly denied. We have found that beer craving in rats is selectively reduced by the cannabinoid receptor antagonist SR 141716 and the opioid receptor antagonist naltrexone. Combining these two drugs appears to have a synergistic anticraving effect. Other promising pharmacotherapies for the future are discussed.
目前用于治疗人类酒精依赖的药物疗法(如纳曲酮、阿坎酸)仅取得了有限的治疗成效。迫切需要开发新的药物疗法,但这依赖于使用合适的动物模型对大量候选“抗渴望”药物进行筛选。动物模型的开发很复杂,原因如下:(1)实验动物通常不愿大量摄入酒精;(2)诱导出类似于人类情况的酒精依赖状态可能需要数月的酒精暴露;(3)要得出某种特定药物能选择性降低酒精渴望的结论,需要非常严格控制的实验;(4)酒精成瘾的人类和大鼠有时在生理和心理上存在明显差异,这可能导致假阳性和假阴性结果。为了解决其中一些问题,我们实验室最近开发了酒精依赖和渴望的“啤酒模型”。大鼠和人类一样,对啤酒有极大的胃口,比起水中等量的乙醇溶液,它们会喝更多的啤酒。大鼠饮用啤酒会导致明显的醉酒迹象、焦虑减轻,以及突然停止供应啤酒时的戒断迹象。我们发现,大麻素受体拮抗剂SR 141716和阿片受体拮抗剂纳曲酮能选择性降低大鼠对啤酒的渴望。联合使用这两种药物似乎具有协同抗渴望作用。文中还讨论了未来其他有前景的药物疗法。