Flórez Gerardo, García-Portilla Paz, Alvarez Sandra, Saiz Pilar A, Nogueiras Luis, Bobes Julio
Unidad Asistencial As Burgas, Ourense, Spain.
Alcohol Clin Exp Res. 2008 Jul;32(7):1251-9. doi: 10.1111/j.1530-0277.2008.00680.x.
To compare topiramate versus naltrexone in the treatment of alcohol dependence.
A 6-month naturalistic, randomized and open-label, trial of topiramate versus naltrexone, with assessments at enrollment and after 3 and 6 months of treatment. The setting was an outpatient alcohol clinic. One hundred and two alcohol-dependent patients who had been drinking heavily during the past month were included. Two randomized groups were created. In one, naltrexone was used as the therapeutic agent and, in the other, topiramate was chosen as the therapeutic agent. Both groups received psychological relapse prevention therapy. Outcome was measured using tools that assessed alcohol intake, cravings, disability, and quality of life; changes in biomarkers of alcohol intake were also used. With all the data, a secondary composite measure was created in order to assess each patient's global alcohol intake and its consequences.
Both groups showed substantial reduction in their drinking. Naltrexone patients had higher nicotine consumption throughout the study. Topiramate was better at reducing alcohol-related cravings throughout the study. Both treatments had a similar mean cost throughout the study.
Both topiramate and naltrexone were efficacious in the treatment of alcohol dependence, and the treatment costs were similar. There is a trend for topiramate to be superior to naltrexone on critical measures of drinking; however, the study did not have adequate statistical power to establish this fact.
比较托吡酯与纳曲酮治疗酒精依赖的效果。
一项为期6个月的自然主义、随机且开放标签的试验，比较托吡酯与纳曲酮，在入组时以及治疗3个月和6个月后进行评估。研究地点为门诊酒精诊所。纳入了102名在过去一个月内大量饮酒的酒精依赖患者。创建了两个随机分组。一组使用纳曲酮作为治疗药物，另一组选择托吡酯作为治疗药物。两组均接受心理预防复发治疗。使用评估酒精摄入量、渴望程度、残疾状况和生活质量的工具来衡量结果；还使用了酒精摄入量生物标志物的变化。利用所有数据创建了一个次要综合指标，以评估每位患者的总体酒精摄入量及其后果。
两组的饮酒量均大幅减少。在整个研究过程中，纳曲酮组患者的尼古丁消费量更高。在整个研究过程中，托吡酯在减少与酒精相关的渴望方面效果更好。在整个研究过程中，两种治疗的平均成本相似。
托吡酯和纳曲酮在治疗酒精依赖方面均有效，且治疗成本相似。在饮酒的关键指标上，托吡酯有优于纳曲酮的趋势；然而，该研究没有足够的统计效力来证实这一事实。
