Nava Felice, Manzato Ezio, Leonardi Claudio, Lucchini Alfio
Italian Society of Addiction Medicine (FeDerSerD), Department of Addiction Medicine, Milan, Italy.
Prog Neuropsychopharmacol Biol Psychiatry. 2008 Dec 12;32(8):1867-72. doi: 10.1016/j.pnpbp.2008.08.019. Epub 2008 Sep 4.
An open randomized study lasting 12 months was performed to evaluate the efficacy of methadone or buprenorphine to suppress alcohol use in two hundred and eighteen heroin addicts with alcohol dependence. Daily maintenance doses of methadone were 80, 120, 160, and 200 mg/day, while doses of buprenorphine were 8, 16, 24, and 32 mg/day. As expected, both treatments were able to reduce both heroin use and addiction severity (measured with ASI interview). However, although both medications were able to suppress alcohol use, the highest dose of buprenorphine was better than the highest dose of methadone, in reducing alcohol craving, ethanol intake (measured as daily number of drinks), and the ASI subscale of alcohol use. The mechanism underlying the effects of the opioid maintenance therapy on the reduction of alcohol intake is still unclear. The results of the present study may represent the first clinical evidence of the potential effective use of the highest doses of buprenorphine for the suppression of ethanol intake in heroin addicts with alcohol dependence.
一项为期12个月的开放性随机研究开展，以评估美沙酮或丁丙诺啡对218名有酒精依赖的海洛因成瘾者抑制饮酒的疗效。美沙酮的每日维持剂量为80、120、160和200毫克/天，而丁丙诺啡的剂量为8、16、24和32毫克/天。正如预期的那样，两种治疗方法都能够减少海洛因使用和成瘾严重程度（通过成瘾严重程度指数访谈测量）。然而，尽管两种药物都能够抑制饮酒，但在减少酒精渴望、乙醇摄入量（以每日饮酒次数衡量）和酒精使用的成瘾严重程度指数子量表方面，丁丙诺啡的最高剂量优于美沙酮的最高剂量。阿片类维持治疗对减少酒精摄入量的作用机制仍不清楚。本研究结果可能代表了高剂量丁丙诺啡在抑制有酒精依赖的海洛因成瘾者乙醇摄入方面潜在有效使用的首个临床证据。
