Martinotti Giovanni, Orsolini Laura, Fornaro Michele, Vecchiotti Roberta, De Berardis Domenico, Iasevoli Felice, Torrens Marta, Di Giannantonio Massimo
a Department of Neuroscience, Imaging and Clinical Science , University of 'G. D'Annunzio' , Chieti , Italy.
b School of Life and Medical Sciences , University of Hertfordshire , Herts , UK.
Expert Opin Investig Drugs. 2016 Jun;25(6):719-28. doi: 10.1080/13543784.2016.1175431. Epub 2016 Apr 21.
Among other approaches, the modulation of the dopaminergic pathway has been advocated in the therapeutic management of Alcohol Use Disorders (AUD). A potential avenue toward the modulation of the dopaminergic pathway across varying substance disorders seems to be provided by aripiprazole, a second-generation antipsychotic characterized by a peculiar pharmacodynamics signature.
In this review, the authors provided a qualitative synthesis and a critical perspective on the efficacy of aripiprazole in relapse prevention and craving in AUD. A systematic search was carried out through MEDLINE/Embase/PsycINFO/Cochrane Library from inception until September 2015, combining free terms and MESH headings for the topics of AUD and aripiprazole as following: (((Alcohol use Disorder) OR (Alcohol use)) AND aripiprazole).
Based both on a qualitative synthesis and a critical interpretation of the evidence, the authors submit that aripiprazole would promote alcohol abstinence and reduce the alcohol seeking behaviour possibly via dopaminergic and serotoninergic modulations at the fronto-subcortical circuits underpinning alcohol reward and craving, impulsive behaviour as well as reduce alcohol-related anxiety/low mood and anhedonia. However, due to the lack of published studies, a conclusive statement about any direct effect of aripiprazole in the prevention of craving and/or alcohol consumption is not possible.
在诸多治疗方法中，多巴胺能通路的调节已被提倡用于酒精使用障碍（AUD）的治疗管理。阿立哌唑似乎为跨不同物质使用障碍调节多巴胺能通路提供了一条潜在途径，它是一种具有独特药效学特征的第二代抗精神病药物。
在本综述中，作者对阿立哌唑在预防AUD复发及减少渴求方面的疗效进行了定性综合分析并给出批判性观点。从创刊至2015年9月，通过MEDLINE/Embase/PsycINFO/考克兰图书馆进行了系统检索，将AUD和阿立哌唑主题的自由词与医学主题词相结合，检索式如下：(((酒精使用障碍) 或 (酒精使用)) 且 阿立哌唑)。
基于定性综合分析及对证据的批判性解读，作者认为阿立哌唑可能通过对支持酒精奖赏、渴求、冲动行为的额-皮质下环路进行多巴胺能和5-羟色胺能调节，促进戒酒并减少觅酒行为，同时还能减轻与酒精相关的焦虑/情绪低落及快感缺失。然而，由于缺乏已发表的研究，关于阿立哌唑在预防渴求及/或减少酒精消费方面的任何直接作用，都无法得出结论性陈述。
