Department of Psychiatry, Taipei City Hospital and Psychiatric Center, Taipei, Taiwan; Department of Psychiatry, School of Medicine, Taipei Medical University, Taipei, Taiwan.
Br J Clin Pharmacol. 2014 Feb;77(2):242-52. doi: 10.1111/bcp.12163.
Substance abuse or addictive disorder is a global problem. A greater understanding of the associated changes in brain pathophysiology supports the notion that pharmacological treatments are part of the necessary treatment options. Craving is a core symptom of addictive disorder. It refers to a strong desire to use drugs again either to re-experience positive effects or to diminish negative experiences. Currently there are a number of medicines that are effective in the treatment of addictive disorders. These medications can either be for substitution (same pharmacological effect as the abused substance) or anticraving (decrease the craving of the abused substance). In this MEDLNE based review, specific compounds (naltrexone, acamprosate, topiramate, disulfiram, baclofen, N-acetylcysteine and bupropion) were selected that are known to diminish desire to use (anticraving effect) and that have been trialled for a number of different substance addictive disorders. Their therapeutic potential in clinical practice is discussed in light of their efficacy.
物质滥用或成瘾障碍是一个全球性问题。对相关脑病理生理学变化的更深入了解支持了这样一种观点，即药理学治疗是必要治疗选择的一部分。渴望是成瘾障碍的核心症状。它是指强烈希望再次使用药物，要么重新体验积极的效果，要么减轻负面的体验。目前有许多药物对治疗成瘾障碍有效。这些药物可以是替代物（与滥用物质具有相同的药理作用）或抗渴求物（减少对滥用物质的渴望）。在本次基于 MEDLNE 的综述中，选择了一些已知能够减少使用欲望（抗渴求作用）的特定化合物（纳曲酮、阿坎酸、托吡酯、双硫仑、巴氯芬、N-乙酰半胱氨酸和安非他酮），这些化合物已在多种不同的物质成瘾障碍中进行了试验。根据其疗效，讨论了它们在临床实践中的治疗潜力。
