Naranjo C A, Kadlec K E
Clinical Pharmacology Program, Addiction Research Foundation, Toronto, Ontario, Canada.
Alcohol Alcohol Suppl. 1991;1:523-6.
Relapse is a frequent problem for recovered alcoholics since up to 80% do so within 6 months of completing treatment. Although the mechanisms underlying relapse are unknown, several internal and external cues have been associated with it. Desire (or craving) for alcohol is an internal cue which may precipitate relapse and is amenable to physiological and pharmacological studies. Recent studies have indicated that pharmacological manipulations of the serotonergic system can produce variations in craving for alcohol. For example, when challenged with the putative serotonin1 (5-HT1) agonist, m-chlorophenylpiperazine (m-CPP), alcoholics report increases in craving and desire for alcohol (George et al, 1990). In our studies with moderately dependent alcoholics, 5-HT uptake inhibitors (e.g., citalopram) reduced both the craving for and the consumption of alcohol. Studies are underway to identify the mechanism underlying these findings. Other systems may also regulate alcohol craving. However, some agents which allegedly decreased alcohol intake in animals, such as enalapril, an angiotensin converting enzyme inhibitor, showed no effect on desire for or intake of alcohol in humans. A better understanding of the neural and systemic mechanisms underlying alcohol craving may help us in the prediction and/or prevention of relapse in treated alcoholics.
复发是戒酒者康复后常见的问题，因为高达80%的人在完成治疗后的6个月内会复发。虽然复发背后的机制尚不清楚，但一些内部和外部线索与之相关。对酒精的渴望是一种内部线索，可能会引发复发，并且适合进行生理学和药理学研究。最近的研究表明，对血清素能系统的药物操作会导致对酒精渴望的变化。例如，当用假定的血清素1（5-HT1）激动剂间氯苯哌嗪（m-CPP）进行刺激时，酗酒者报告对酒精的渴望和欲望增加（乔治等人，1990年）。在我们对中度依赖酗酒者的研究中，5-羟色胺摄取抑制剂（如西酞普兰）减少了对酒精的渴望和饮酒量。目前正在进行研究以确定这些发现背后的机制。其他系统也可能调节对酒精的渴望。然而，一些据称能减少动物酒精摄入量的药物，如血管紧张素转换酶抑制剂依那普利，对人类对酒精的欲望或摄入量没有影响。更好地理解对酒精渴望背后的神经和全身机制可能有助于我们预测和/或预防接受治疗的酗酒者复发。
