美金刚对酒精依赖康复患者线索诱导的酒精渴望的影响。
Effect of memantine on cue-induced alcohol craving in recovering alcohol-dependent patients.
作者信息
Krupitsky Evgeny M, Neznanova Olga, Masalov Dimitry, Burakov Andrey M, Didenko Tatyana, Romanova Tatyana, Tsoy Marina, Bespalov Anton, Slavina Tatyana Y, Grinenko Alexander A, Petrakis Ismene L, Pittman Brian, Gueorguieva Ralitza, Zvartau Edwin E, Krystal John H
机构信息
Pavlov State Medical University, St. Petersburg, Russia.
出版信息
Am J Psychiatry. 2007 Mar;164(3):519-23. doi: 10.1176/ajp.2007.164.3.519.
OBJECTIVE
Ethanol blocks N-methyl-d-aspartic acid (NMDA) glutamate receptors. Increased NMDA receptor function may contribute to motivational disturbances that contribute to alcoholism. The authors assessed whether the NMDA receptor antagonist memantine reduces cue-induced alcohol craving and produces ethanol-like subjective effects.
METHOD
Thirty-eight alcohol-dependent inpatients participated in three daylong testing sessions in a randomized order under double-blind conditions. On each test day, subjects received 20 mg of memantine, 40 mg of memantine, or placebo, and subjective responses to treatment were assessed. The level of alcohol craving was assessed before and after exposure to an alcohol cue.
RESULTS
Memantine did not stimulate alcohol craving before exposure to an alcohol cue, and it attenuated alcohol cue-induced craving in a dose-related fashion. It produced dose-related ethanol-like effects without adverse cognitive or behavioral effects.
CONCLUSIONS
These data support further exploration of whether well-tolerated NMDA receptor antagonists might have a role in the treatment of alcoholism.
目的
乙醇可阻断N-甲基-D-天冬氨酸（NMDA）谷氨酸受体。NMDA受体功能增强可能导致引发酒精中毒的动机障碍。作者评估了NMDA受体拮抗剂美金刚是否能减少线索诱导的酒精渴望并产生类似乙醇的主观效应。
方法
38名酒精依赖住院患者在双盲条件下按随机顺序参加了为期三天的测试。在每个测试日，受试者分别接受20毫克美金刚、40毫克美金刚或安慰剂，并评估对治疗的主观反应。在暴露于酒精线索前后评估酒精渴望程度。
结果
美金刚在暴露于酒精线索前不会刺激酒精渴望，并且以剂量相关的方式减弱了酒精线索诱导的渴望。它产生了剂量相关的类似乙醇的效应，且无不良认知或行为影响。
结论
这些数据支持进一步探索耐受性良好的NMDA受体拮抗剂是否可能在酒精中毒治疗中发挥作用。
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