Wackernah Robin C, Minnick Matthew J, Clapp Peter
Department of Pharmacy Practice, School of Pharmacy, Rueckert-Hartman College for Health Professions, Regis University, Denver, CO, USA.
Department of Pharmaceutical Sciences, School of Pharmacy, Rueckert-Hartman College for Health Professions, Regis University, Denver, CO, USA.
Subst Abuse Rehabil. 2014 Jan 23;5:1-12. doi: 10.2147/SAR.S37907. eCollection 2014.
Alcohol use disorders (AUD) continue to be a concerning health issue worldwide. Harmful alcohol use leads to 2.5 million deaths annually worldwide. Multiple options exist for the management of dependence on alcohol, not all of which are approved by drug-regulating agencies. Current practice in treating AUD does not reflect the diversity of pharmacologic options that have potential to provide benefit, and guidance for clinicians is limited. Few medications are approved for treatment of AUD, and these have exhibited small and/or inconsistent effects in broad patient populations with diverse drinking patterns. The need for continued research into the treatment of this disease is evident in order to provide patients with more specific and effective options. This review describes the neurobiological mechanisms of AUD that are amenable to treatment and drug therapies that target pathophysiological conditions of AUD to reduce drinking. In addition, current literature on pharmacologic (both approved and non-approved) treatment options for AUD offered in the United States and elsewhere are reviewed. The aim is to inform clinicians regarding the options for alcohol abuse treatment, keeping in mind that not all treatments are completely successful in reducing craving or heavy drinking or increasing abstinence.
酒精使用障碍（AUD）在全球范围内仍然是一个令人担忧的健康问题。有害饮酒每年在全球导致250万人死亡。对于酒精依赖的管理有多种选择，但并非所有这些选择都得到了药物监管机构的批准。目前治疗AUD的做法并未反映出具有潜在益处的药理学选择的多样性，并且针对临床医生的指导有限。很少有药物被批准用于治疗AUD，而且这些药物在具有不同饮酒模式的广泛患者群体中显示出微小和/或不一致的效果。为了给患者提供更具体、有效的选择，继续研究这种疾病的治疗方法的必要性显而易见。本综述描述了适合治疗的AUD神经生物学机制以及针对AUD病理生理状况以减少饮酒的药物疗法。此外，还综述了美国和其他地方提供的关于AUD的药理学（包括已批准和未批准的）治疗选择的当前文献。目的是让临床医生了解酒精滥用治疗的选择，同时要记住并非所有治疗在减少渴望或重度饮酒或增加戒酒方面都能完全成功。
