Tyacke Robin J, Lingford-Hughes Anne, Reed Laurence J, Nutt David J
Neuropsychopharmacology Unit, Division of Experimental Medicine and Therapeutics, Imperial College London, London, UK.
Adv Pharmacol. 2010;58:373-96. doi: 10.1016/S1054-3589(10)58014-1.
The GABA(B) receptor plays an important role in the control of neurotransmitter release, and experiments using preclinical models have shown that modulation of this receptor can have profound effects on the reward process. This ability to affect the reward process has led to clinical investigations into the possibility that this could be a viable target in the treatment of addiction. Presented here is an overview of a number of studies testing this hypothesis in different drug dependencies. The studies reviewed have used the GABA(B) receptor agonist baclofen, which is currently the only GABA(B) agonist for use in humans. In addition, studies using the non-specific GABA(B) receptor agonists vigabatrin and tiagabine have been included. In some of the studies these were found to have efficacy in the initiation and maintenance of abstinence, as an anti-craving treatment and alleviation of withdrawal syndromes, while in other studies showing limited effects. However, there is enough evidence to suggest that modulators of the GABA(B) receptor have potential as adjunct treatments to aid in the initiation of abstinence, maintenance of abstinence, and prevention of cue-related relapse in some addictions. This potential is at present poorly understood or studied and warrants further investigation.
γ-氨基丁酸B（GABA(B)）受体在神经递质释放的调控中发挥着重要作用，临床前模型实验表明，对该受体的调节可对奖赏过程产生深远影响。这种影响奖赏过程的能力促使了临床研究，探讨其是否可能成为成瘾治疗的一个可行靶点。本文概述了一些针对不同药物依赖情况对这一假说进行测试的研究。所综述的研究使用了GABA(B)受体激动剂巴氯芬，它是目前唯一用于人类的GABA(B)激动剂。此外，还纳入了使用非特异性GABA(B)受体激动剂氨己烯酸和噻加宾的研究。在一些研究中，发现这些药物在戒断的启动和维持、作为抗渴望治疗以及缓解戒断综合征方面具有疗效，而在其他研究中则显示效果有限。然而，有足够的证据表明，GABA(B)受体调节剂有潜力作为辅助治疗手段，帮助在某些成瘾情况中启动戒断、维持戒断以及预防与线索相关的复发。目前，这种潜力尚未得到充分理解或研究，值得进一步探究。
