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[酒精依赖的复发预防:阿坎酸与纳曲酮联合用药的药理学策略]

[Relapse prevention in alcohol dependence: acamprosate and naltrexone as a combined pharmacological strategy].

作者信息

Gahr M, Kölle M A, Schönfeldt-Lecuona C

机构信息

Abteilung für Psychiatrie und Psychotherapie III, Universitätsklinikum Ulm, Leimgrubenweg 12-14, Ulm, Germany.

出版信息

Nervenarzt. 2013 May;84(5):584-9. doi: 10.1007/s00115-012-3633-3.

Abstract

Acamprosate and naltrexone are established strategies for pharmacologic relapse prevention in patients with alcohol dependence. Regarding pharmacodynamic and pharmacokinetic considerations the combination of both agents for this indication is a reasonable treatment option that has been described to be safe and effective in clinical studies. However, this combination is uncommon in clinical practice. We report the case of a patient with severe alcohol and benzodiazepine dependence who achieved the longest interval of abstinence under combined treatment with acamprosate and naltrexone since the development of addiction. In addition, the currently available evidence regarding efficacy, safety and tolerability of both agents is discussed. In summary the combined treatment with both agents should be considered in patients who did not achieve abstinence under monotherapy unless contraindications are present.

摘要

阿坎酸和纳曲酮是用于预防酒精依赖患者药物复吸的既定策略。从药效学和药代动力学角度考虑,两种药物联合用于该适应症是一种合理的治疗选择,临床研究表明其安全有效。然而,这种联合用药在临床实践中并不常见。我们报告了一例严重酒精和苯二氮䓬依赖患者的病例,该患者自成瘾以来,在阿坎酸和纳曲酮联合治疗下实现了最长的戒酒间隔。此外,还讨论了目前关于这两种药物的疗效、安全性和耐受性的现有证据。总之,对于单药治疗未实现戒酒的患者,除非存在禁忌症,否则应考虑两种药物联合治疗。

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