Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA.
CNS Neurol Disord Drug Targets. 2010 Mar;9(1):5-12. doi: 10.2174/187152710790966678.
Disulfiram treatment, despite its limitations, remains a viable option as a treatment for alcohol dependence and has shown recent promise in treating (1) those with co-morbid alcohol dependence and post-traumatic stress disorder, (2) those with co-morbid cocaine- and alcohol-dependence, and (3) those with cocaine-dependence alone. Although disulfiram's mechanism of action in alcohol dependence was long thought to be its effects as a psychological deterrent, more recent studies have uncovered potential anti-craving effects as well as direct effects of disulfiram on cocaine abuse, highlighting a few of the many potential and unique benefits disulfiram may have through its inhibition of dopamine beta-hydroxylase. This article will review the major clinical trials of disulfiram spanning nearly 60 years. We will discuss the pharmacodynamics and pharmacokinetics of disulfiram, indications and limitations of its use, suggestions for appropriate patient populations, and monitoring for compliance and adverse effects. We will also review recent literature on newer potential applications for disulfiram use via its unique action on dopamine beta-hydroxylase.
尽管双硫仑治疗存在局限性，但作为治疗酒精依赖的一种可行方法仍然存在，并且最近在治疗以下患者方面显示出了前景：（1）同时患有酒精依赖和创伤后应激障碍的患者；（2）同时患有可卡因和酒精依赖的患者；（3）仅患有可卡因依赖的患者。尽管双硫仑在酒精依赖中的作用机制长期以来被认为是其作为心理威慑的效果，但最近的研究揭示了其潜在的抗渴求作用以及双硫仑对可卡因滥用的直接作用，这突显了双硫仑通过抑制多巴胺β-羟化酶可能具有的许多潜在独特益处。本文将回顾近 60 年来双硫仑的主要临床试验。我们将讨论双硫仑的药效学和药代动力学、其使用的适应证和局限性、对合适患者人群的建议、以及对依从性和不良反应的监测。我们还将回顾最近关于双硫仑通过其对多巴胺β-羟化酶的独特作用在新的潜在应用方面的文献。
