Capurso Noah A
Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.
United States Department of Veterans Affairs, VA Connecticut Healthcare System, West Haven, Connecticut.
Am J Addict. 2017 Mar;26(2):115-117. doi: 10.1111/ajad.12501. Epub 2017 Jan 20.
Co-occurring addictive disorders are common, however treatment strategies for this population have not been extensively studied. This is especially the case for behavioral addictions.
We present a patient (N = 1) with tobacco use disorder and problematic pornography use treated with naltrexone.
Naltrexone treatment resulted in a decrease in pornography viewing and cigarette smoking, however had the adverse effect of anhedonia. A lower dose modestly impacted pornography viewing but not smoking.
Relevant literature regarding co-occurring addictions as well as use of naltrexone is reviewed.
This report represents the first case of tobacco and pornography co-addiction in the literature and supports the assertion that treatment of one addictive disorder can benefit another in the dually addicted patient. The efficacy of naltrexone for smoking is notable as previous studies of naltrexone in smoking have been disappointing. This case suggests future treatment strategies for comorbid addictions. (Am J Addict 2017;26:115-117).
成瘾性障碍共病情况常见，但针对这一群体的治疗策略尚未得到广泛研究。行为成瘾方面尤其如此。
我们报告一例（N = 1）患有烟草使用障碍和问题性色情制品使用问题的患者，接受了纳曲酮治疗。
纳曲酮治疗使色情制品观看量和吸烟量减少，但产生了快感缺失这一不良反应。较低剂量对色情制品观看有一定影响，但对吸烟无影响。
对关于成瘾性障碍共病以及纳曲酮使用的相关文献进行了综述。
本报告是文献中首例烟草与色情制品共成瘾病例，支持了在双重成瘾患者中治疗一种成瘾性障碍可使另一种受益的观点。纳曲酮对吸烟的疗效值得关注，因为此前纳曲酮在吸烟治疗方面的研究结果令人失望。该病例为共病成瘾的未来治疗策略提供了参考。（《美国成瘾杂志》2017年；26:115 - 117）
