Tambour Sophie, Quertemont Etienne
Unité de Recherche en Psychologie Expérimentale et Neurosciences Cognitives (URPENC), Université de Liège, Boulevard du Rectorat 5/B32, B-4000 Liège, Belgium.
Fundam Clin Pharmacol. 2007 Feb;21(1):9-28. doi: 10.1111/j.1472-8206.2006.00459.x.
In recent years, advances in neuroscience led to the development of new medications to treat alcohol dependence and especially to prevent alcohol relapse after detoxification. Whereas the earliest medications against alcohol dependence were fortuitously discovered, recently developed drugs are increasingly based on alcohol's neurobiological mechanisms of action. This review discusses the most recent developments in alcohol pharmacotherapy and emphasizes the neurobiological basis of anti-alcohol medications. There are currently three approved drugs for the treatment of alcohol dependence with quite different mechanisms of action. Disulfiram is an inhibitor of the enzyme aldehyde dehydrogenase and acts as an alcohol-deterrent drug. Naltrexone, an opiate antagonist, reduces alcohol craving and relapse in heavy drinking, probably via a modulation of the mesolimbic dopamine activity. Finally, acamprosate helps maintaining alcohol abstinence, probably through a normalization of the chronic alcohol-induced hyperglutamatergic state. In addition to these approved medications, many other drugs have been suggested for preventing alcohol consumption on the basis of preclinical studies. Some of these drugs remain promising, whereas others have produced disappointing results in preliminary clinical studies. These new drugs in the field of alcohol pharmacotherapy are also discussed, together with their mechanisms of action.
近年来，神经科学的进展促使了用于治疗酒精依赖，尤其是预防脱毒后酒精复发的新药物的研发。最早用于对抗酒精依赖的药物是偶然发现的，而最近研发的药物越来越多地基于酒精的神经生物学作用机制。本综述讨论了酒精药物治疗的最新进展，并强调了抗酒精药物的神经生物学基础。目前有三种获批用于治疗酒精依赖的药物，其作用机制差异很大。双硫仑是乙醛脱氢酶的抑制剂，用作戒酒药物。纳曲酮是一种阿片拮抗剂，可能通过调节中脑边缘多巴胺活性来减少重度饮酒者对酒精的渴望和复发。最后，阿坎酸可能通过使慢性酒精引起的高谷氨酸能状态正常化来帮助维持戒酒。除了这些获批的药物外，基于临床前研究，还有许多其他药物被建议用于预防饮酒。其中一些药物仍然很有前景，而另一些在初步临床研究中产生了令人失望的结果。本文还讨论了酒精药物治疗领域的这些新药及其作用机制。
