Heberlein A, Bleich S, Kornhuber J, Hillemacher T
Psychiatrische und Psychotherapeutische Klinik, Universitätsklinikum Erlangen, Schwabachanlage 6, Erlangen.
Fortschr Neurol Psychiatr. 2008 Jul;76(7):421-8. doi: 10.1055/s-2008-1038220.
Many studies address the neurobiological mechanisms of alcohol craving. The study results obtained so far show that there may be at least three subtypes of craving, which may be linked to changes in different neurotransmitter systems. Actually in Germany acamprosate and disulfiram are approved for clinical use for the prevention of alcohol relapse. Also off-label therapy with naltrexone is possible. However studies show that these substances are not effective in all patients. In the light of hypothetical changes in different neurotransmitter systems, subtype specific therapy may be necessary for successful prevention of alcohol relapse. Therefore new therapy options are needed in order to treat alcohol dependent persons. Substances that seem to have efficacy in preclinical or preliminary clinical studies are baclofen, topiramate, odansetron, rimonabant and memantine.
许多研究探讨了酒精渴望的神经生物学机制。目前获得的研究结果表明,渴望可能至少有三种亚型,这可能与不同神经递质系统的变化有关。实际上在德国,阿坎酸和双硫仑已被批准用于临床预防酒精复发。纳曲酮也可进行非标签治疗。然而,研究表明这些物质并非对所有患者都有效。鉴于不同神经递质系统的假设性变化,可能需要针对亚型的特异性疗法才能成功预防酒精复发。因此,需要新的治疗方案来治疗酒精依赖者。在临床前或初步临床研究中似乎有效的物质有巴氯芬、托吡酯、奥氮平、利莫那班和美金刚。