Faehrmann Till, Zernig Gerald, Mechtcheriakov Sergei
Department Psychiatrie, Psychotherapie und Psychosomatik, Medizinische Universität Innsbruck, Anichstraße 35, 6020, Innsbruck, Österreich.
Department Psychiatrie, Psychotherapie und Psychosomatik, Abteilung für Experimentelle Psychiatrie, Medizinische Universität Innsbruck, Anichstraße 35, 6020, Innsbruck, Österreich.
Neuropsychiatr. 2018 Mar;32(1):1-8. doi: 10.1007/s40211-017-0229-y. Epub 2017 Jun 21.
One of the crucial purposes of treating alcohol-dependent patients is to enhance their ability to stay abstinent after detoxification therapy. Anxiety and stress vulnerability are the main factors provoking alcohol craving and relapse. In the first months of abstinence, alcohol-dependent patients frequently show sleep disturbances, irritability and depression, indicating chronic activation of stress pathways. In addition, the loss of confidence in interpersonal interactions results in social withdrawal and reduced willingness to participate in therapeutic programs.Current research shows that the peptide hormone oxytocin exerts substantial anxiolytic effects and facilitates prosocial behavior. Oxytocin can be safely applied as intranasal preparation. Oxytocin acts by inhibiting the effects of the corticotropin-releasing factor on GABAergic interneurons in the amygdala and paraventricular nucleus of hypothalamus.Recent research strongly suggests that application of oxytocin may beneficially influence the mechanisms of relapse and craving by reduction of anxiety, stress vulnerability and social withdrawal in abstinent alcohol-dependent patients.This article reviews neurobiological mechanisms of oxytocin effects on stress-related pathways and discusses the potential use of oxytocin in the treatment of alcohol addiction.
治疗酒精依赖患者的关键目的之一是提高他们在脱毒治疗后保持戒酒的能力。焦虑和应激易感性是引发酒精渴望和复发的主要因素。在戒酒的头几个月里，酒精依赖患者经常出现睡眠障碍、易怒和抑郁，这表明应激途径的慢性激活。此外，人际互动中信心的丧失导致社交退缩和参与治疗项目的意愿降低。目前的研究表明，肽激素催产素具有显著的抗焦虑作用，并促进亲社会行为。催产素可以作为鼻内制剂安全使用。催产素通过抑制促肾上腺皮质激素释放因子对杏仁核和下丘脑室旁核中γ-氨基丁酸能中间神经元的作用来发挥作用。最近的研究强烈表明，应用催产素可能通过减少戒酒的酒精依赖患者的焦虑、应激易感性和社交退缩，对复发和渴望机制产生有益影响。本文综述了催产素对应激相关途径的神经生物学作用机制，并讨论了催产素在酒精成瘾治疗中的潜在应用。
