Litten Raye Z, Fertig Joanne, Mattson Margaret, Egli Mark
Division of Treatment and Recovery Research, National Institute on Alcohol Abuse and Alcoholism, 5635 Fishers Lane, Room 2041, Bethesda, MD 20852-1705, USA.
Expert Opin Emerg Drugs. 2005 May;10(2):323-43. doi: 10.1517/14728214.10.2.323.
During the past decade, efforts to develop medications for alcoholism have burgeoned. Three agents, disulfiram, naltrexone and acamprosate, are now approved in a large number of countries. Although many patients have benefited from existing medications, their effects are moderate, and some alcoholics fail to respond to them. A host of new agents are currently under active investigation. Critical barriers must be overcome to ensure that future efforts in the development of medications for alcohol use disorders reach full fruition. These challenges include: establishing key targets for drug discovery; validating animal and human screening models; and developing biomarkers to help predict treatment success. In addition, it is important to formulate methodological and statistical strategies to efficiently conduct alcohol pharmacotherapy trials; to specify genetic and phenotypic patient characteristics associated with efficacy and safety for lead compounds; to forge productive alliances among governmental agencies, the pharmaceutical industry and academic researchers to further drug development; and, ultimately and perhaps most difficult, to engage the practitioner community to incorporate medications into the alcohol treatment process.
在过去十年中，开发治疗酒精成瘾药物的努力蓬勃发展。目前，双硫仑、纳曲酮和阿坎酸这三种药物已在许多国家获得批准。尽管许多患者已从现有药物中受益，但其效果一般，一些酗酒者对这些药物没有反应。目前许多新型药物正在积极研究中。必须克服一些关键障碍，以确保未来开发治疗酒精使用障碍药物的努力取得圆满成功。这些挑战包括：确定药物研发的关键靶点；验证动物和人体筛选模型；开发有助于预测治疗成功的生物标志物。此外，制定有效开展酒精药物治疗试验的方法和统计策略也很重要；明确与先导化合物的疗效和安全性相关的遗传和表型患者特征；在政府机构、制药行业和学术研究人员之间建立富有成效的联盟以推动药物开发；最终，也许也是最困难的，是促使从业者群体将药物纳入酒精治疗过程。
