Petrakis Ismene L, Limoncelli Diana, Gueorguieva Ralitza, Jatlow Peter, Boutros Nashaat N, Trevisan Louis, Gelernter Joel, Krystal John H
West Haven VA Medical Center (116-A), 950 Campbell Ave., West Haven, CT 06516, USA.
Am J Psychiatry. 2004 Oct;161(10):1776-82. doi: 10.1176/ajp.161.10.1776.
A family history of alcoholism is a risk factor for the development of ethanol dependence. Ethanol is an antagonist of the N-methyl-d-aspartate (NMDA) glutamate receptor, and alterations in NMDA receptor function are thought to be involved in ethanol abuse and dependence. The purpose of this study was to determine in healthy individuals with no ethanol dependence whether response to the NMDA receptor antagonist ketamine would differentiate those with a family history of ethanol dependence from those without such a family history.
Healthy subjects between the ages of 21 and 30 received 40-minute intravenous infusions of saline, low-dose ketamine (0.1 mg/kg), and high-dose ketamine (0.5 mg/kg) on three separate test days in a randomized order under double-blind conditions. The healthy individuals with at least one first-degree relative and another first- or second-degree relative with ethanol dependence (N=16) were compared with those who had no family history of ethanol dependence in any first- or second-degree relative (N=29). Outcome measures included the Brief Psychiatric Rating Scale, Clinician-Administered Dissociative States Scale, verbal fluency, Hopkins Verbal Learning Test, a biphasic alcohol effects scale, visual analog scales of mood states, and ketamine levels.
During ketamine infusion, individuals with a family history of ethanol dependence showed an attenuated response in terms of perceptual alterations and dysphoric mood relative to those without such a family history.
These data suggest that alterations in NMDA receptor function may contribute to subjective response to ethanol and therefore also to the risk of developing alcoholism.
酗酒家族史是乙醇依赖发展的一个风险因素。乙醇是N-甲基-D-天冬氨酸(NMDA)谷氨酸受体的拮抗剂,NMDA受体功能的改变被认为与乙醇滥用和依赖有关。本研究的目的是确定在无乙醇依赖的健康个体中,对NMDA受体拮抗剂氯胺酮的反应是否能区分有乙醇依赖家族史的个体和无此类家族史的个体。
21至30岁的健康受试者在双盲条件下,于三个不同的测试日以随机顺序接受40分钟的静脉输注生理盐水、低剂量氯胺酮(0.1mg/kg)和高剂量氯胺酮(0.5mg/kg)。将至少有一个一级亲属以及另一个一级或二级亲属有乙醇依赖的健康个体(N = 16)与在任何一级或二级亲属中均无乙醇依赖家族史的个体(N = 29)进行比较。结果测量包括简明精神病评定量表、临床医生实施的分离状态量表、语言流畅性、霍普金斯语言学习测试、双相酒精效应量表、情绪状态视觉模拟量表和氯胺酮水平。
在氯胺酮输注期间,有乙醇依赖家族史的个体相对于无此类家族史的个体,在知觉改变和烦躁情绪方面表现出减弱的反应。
这些数据表明,NMDA受体功能的改变可能导致对乙醇的主观反应,因此也可能导致酗酒风险。