Myrick Hugh, Anton Raymond, Voronin Konstantin, Wang Wei, Henderson Scott
Ralph H. Johnson Department of Veterans Affairs Medical Center, Research and Development Service, Charleston, South Carolina, USA.
Alcohol Clin Exp Res. 2007 Feb;31(2):221-7. doi: 10.1111/j.1530-0277.2006.00299.x.
There has been increasing interest in the use of anticonvulsant agents in the treatment of alcoholism. Anticonvulsant agents have mostly been evaluated as an alternative to benzodiazepines in the treatment of alcohol withdrawal. Among the advantages of using anticonvulsant agents in this capacity is their purported lack of interaction with alcohol (i.e., interactions that could increase psychomotor deficits, cognitive impairment, and increase intoxication). This is particularly important in the treatment of alcohol withdrawal and relapse prevention in outpatients. Unfortunately, these untoward clinical interactions between anticonvulsants and alcohol in alcoholic patients have not been thoroughly assessed. The current clinical laboratory study was conducted to evaluate the safety and tolerability of the anticonvulsant gabapentin in alcoholic subjects. In addition, the ability of gabapentin to reduce alcohol craving and consumption was evaluated.
Thirty-five non-treatment-seeking alcoholic subjects were enrolled in a subacute human laboratory study and received double-blind treatment with up to 1,200 mg of gabapentin (n=18) or placebo (n=17) for 8 days. The safety and tolerability of gabapentin were monitored in the natural environment during the first 5 days of medication treatment and during a free-choice limited access consumption paradigm following an initial drink of alcohol in a bar-lab setting on Day 7.
There was no overall effect of gabapentin on drinking or craving; however, it was tolerated (e.g., mood and sedation) as well as placebo over 5 days of natural drinking. During the bar-lab drinking session, there were no differences in subjective high or intoxication between subjects treated with gabapentin or placebo.
This study provides initial evidence that the anticonvulsant gabapentin is safe if used in conjunction with alcohol consumption in alcoholic individuals. Further study is needed with this and other lab models to determine the utility and safety of gabapentin in the treatment of alcoholism.
人们越来越关注使用抗惊厥药物治疗酒精中毒。抗惊厥药物大多被评估为在治疗酒精戒断时替代苯二氮䓬类药物的选择。以这种方式使用抗惊厥药物的优点之一是据称它们与酒精没有相互作用（即不会增加精神运动功能缺陷、认知障碍和中毒的相互作用）。这在门诊患者的酒精戒断治疗和预防复发中尤为重要。不幸的是，酒精中毒患者中抗惊厥药物与酒精之间的这些不良临床相互作用尚未得到充分评估。目前进行的这项临床实验室研究旨在评估抗惊厥药物加巴喷丁在酒精中毒受试者中的安全性和耐受性。此外，还评估了加巴喷丁减少酒精渴望和饮酒量的能力。
35名未寻求治疗的酒精中毒受试者参加了一项亚急性人体实验室研究，接受了为期8天的双盲治疗，其中18名受试者服用高达1200毫克的加巴喷丁，17名受试者服用安慰剂。在药物治疗的前5天以及第7天在酒吧实验室环境中首次饮酒后进行的自由选择限量饮酒模式期间，在自然环境中监测加巴喷丁的安全性和耐受性。
加巴喷丁对饮酒或渴望没有总体影响；然而，在5天的自然饮酒期间，它与安慰剂一样耐受（如情绪和镇静方面）。在酒吧实验室饮酒期间，服用加巴喷丁或安慰剂的受试者在主观兴奋或中毒方面没有差异。
这项研究提供了初步证据，表明抗惊厥药物加巴喷丁与酒精中毒个体饮酒同时使用时是安全的。需要使用此模型和其他实验室模型进行进一步研究，以确定加巴喷丁在治疗酒精中毒中的效用和安全性。
