Roche Daniel J O, Yardley Megan M, Lunny Katy F, Louie Stan G, Davies Daryl L, Miotto Karen, Ray Lara A
Department of Psychology, University of California, Los Angeles, California.
Titus Family Department of Clinical Pharmacy, University of Southern California, Los Angeles, California.
Alcohol Clin Exp Res. 2016 Jun;40(6):1312-20. doi: 10.1111/acer.13064. Epub 2016 Apr 18.
Ivermectin (IVM) is an antiparasitic agent that has been shown to reduce alcohol intake in mice, suggesting IVM as a potential treatment for alcohol use disorder (AUD). However, the safety profile of IVM administered in combination with an intoxicating dose of alcohol has not been characterized in humans.
This pilot project sought to provide the first clinical evidence that IVM could be repositioned as an AUD pharmacotherapy by examining (i) the safety of combining IVM (30 mg oral , once a day [QD]) with an intoxicating dose of intravenous alcohol (0.08 g/dl) and (ii) the effects of IVM on alcohol cue-induced craving and subjective response to alcohol. Eleven individuals with AUD participated in a randomized, placebo-controlled, crossover study in which they received the study medication, participated in a cue exposure paradigm followed by intravenous alcohol administration, and remained in an inpatient unit overnight for observation.
IVM treatment, versus placebo, did not increase the number or severity of adverse effects during alcohol administration or throughout the visit. However, IVM did not reduce cue-induced craving nor did it significantly affect subjective response to alcohol.
These results suggest that IVM (30 mg oral, QD) is safe in combination with an intoxicating dose of alcohol, but do not provide evidence that this dose of IVM is effective in reducing alcohol craving or its reinforcing effects. Given the preclinical data suggesting IVM is effective in reducing alcohol consumption in mice, additional studies testing larger samples and alternate dosing regimens are warranted to further characterize the potential efficacy of IVM as an AUD treatment.
伊维菌素(IVM)是一种抗寄生虫药物,已被证明可减少小鼠的酒精摄入量,这表明IVM可能是治疗酒精使用障碍(AUD)的潜在药物。然而,IVM与中毒剂量酒精联合使用时的安全性在人类中尚未得到明确。
本试点项目旨在通过研究(i)将IVM(口服30毫克,每日一次[QD])与中毒剂量的静脉酒精(0.08克/分升)联合使用的安全性,以及(ii)IVM对酒精线索诱导的渴望和对酒精的主观反应的影响,提供首个临床证据,证明IVM可重新定位为AUD的药物治疗方法。11名患有AUD的个体参与了一项随机、安慰剂对照、交叉研究,他们接受了研究药物,参与了线索暴露范式,随后进行静脉酒精给药,并在住院单元过夜观察。
与安慰剂相比,IVM治疗在酒精给药期间或整个就诊过程中并未增加不良反应的数量或严重程度。然而,IVM并未减少线索诱导的渴望,也未显著影响对酒精的主观反应。
这些结果表明,IVM(口服30毫克,QD)与中毒剂量酒精联合使用是安全的,但没有证据表明该剂量的IVM在减少酒精渴望或其强化作用方面有效。鉴于临床前数据表明IVM可有效减少小鼠的酒精摄入量,有必要进行更多研究,测试更大样本和不同给药方案,以进一步明确IVM作为AUD治疗方法的潜在疗效。