Pettinati Helen M, Kampman Kyle M, Lynch Kevin G, Dundon William D, Mahoney Elizabeth M, Wierzbicki Michael R, O'Brien Charles P
Department of Psychiatry, Center for the Studies of Addiction, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania.
Am J Addict. 2014 Nov-Dec;23(6):591-7. doi: 10.1111/j.1521-0391.2014.12146.x. Epub 2014 Sep 22.
There is a high co-occurrence of cocaine and alcohol use disorders, and patients with both of these problems are difficult to treat. There is a reasonable rationale and some empirical data to justify a pilot trial of an injectable, extended-release formulation of naltrexone for treating co-occurring cocaine and alcohol addiction.
Eighty cocaine (n = 80) and alcohol dependent, treatment-seeking subjects were randomly assigned to receive either two monthly extended-release injections of naltrexone or two matching placebo injections in an 8-week clinical trial, with weekly medical management plus cognitive behavioral therapy visits.
No differences in reduction in cocaine or alcohol use were observed between the injectable naltrexone and placebo groups during the 8-week trial.
Injectable extended-release naltrexone, while an ideal method for ensuring medication adherence in these traditionally hard-to-treat patients, did not result in any measurable reduction in cocaine or alcohol use over the course of 8 weeks of treatment.
可卡因使用障碍和酒精使用障碍同时出现的情况很常见,同时患有这两种问题的患者很难治疗。有合理的理论依据和一些实证数据支持开展一项关于注射用缓释纳曲酮治疗可卡因和酒精成瘾共病的试点试验。
在一项为期8周的临床试验中,80名寻求治疗的可卡因依赖和酒精依赖受试者被随机分配接受每月两次的缓释纳曲酮注射或两次匹配的安慰剂注射,同时每周进行医疗管理并接受认知行为疗法问诊。
在为期8周的试验中,注射用纳曲酮组和安慰剂组在可卡因或酒精使用减少方面未观察到差异。
注射用缓释纳曲酮虽然是确保这些传统上难以治疗的患者坚持用药的理想方法,但在8周的治疗过程中,并未使可卡因或酒精的使用出现任何可测量的减少。