Holtyn August F, Kaminski Barbara J, Weerts Elise M
Johns Hopkins University School of Medicine, USA.
Johns Hopkins University School of Medicine, USA.
Drug Alcohol Depend. 2017 Oct 1;179:47-54. doi: 10.1016/j.drugalcdep.2017.06.019. Epub 2017 Jul 18.
Baclofen, a GABA receptor agonist, is under investigation as a pharmacotherapy for alcohol use disorder. Treatment with a pharmacotherapeutic can be initiated during alcohol abstinence or active drinking, which may influence treatment outcomes. This study examined whether baclofen treatment initiated and maintained during alcohol abstinence would reduce alcohol seeking and self-administration upon return to alcohol access, and whether effects differed from treatment initiated and maintained during ongoing alcohol access. Naltrexone was tested under similar conditions for comparison.
Five baboons self-administered alcohol under a three-component chained schedule of reinforcement that modeled periods of anticipation (Component 1), seeking (Component 2), and consumption (Component 3). Alcohol was only available in Component 3. In Experiment 1, baclofen (0.1-1.8mg/kg) or naltrexone (1.0-5.6mg/kg) was administered daily beginning on the first day of a 5-day abstinence period and treatment was continued for 5days of alcohol access. In Experiment 2, selected doses of both drugs were administered during ongoing alcohol access.
When treatment was initiated during alcohol abstinence, baclofen and naltrexone did not significantly reduce total alcohol intake (g/kg) or alcohol seeking. In comparison, when treatment was initiated during ongoing alcohol access, both baclofen (1.8mg/kg) and naltrexone (3.2 and 5.6mg/kg) significantly reduced total alcohol intake (g/kg). Naltrexone (5.6mg/kg), but not baclofen, significantly reduced alcohol seeking.
Initiation of baclofen treatment (or other alcohol use disorder treatments) during abstinence or active drinking may be an important factor in influencing efficacy and appropriate dose selection.
巴氯芬是一种γ-氨基丁酸(GABA)受体激动剂,正作为酒精使用障碍的药物疗法进行研究。药物治疗可在戒酒期间或饮酒时开始,这可能会影响治疗结果。本研究探讨了在戒酒期间开始并维持的巴氯芬治疗是否会在恢复饮酒后减少觅酒行为和自我给药,以及其效果是否与在持续饮酒期间开始并维持的治疗不同。为作比较,纳曲酮在类似条件下进行了测试。
五只狒狒在一个三分段链式强化程序下自我给药酒精,该程序模拟了预期期(第1段)、觅酒期(第2段)和饮酒期(第3段)。酒精仅在第3段可用。在实验1中,从5天戒酒期的第一天开始每天给予巴氯芬(0.1 - 1.8毫克/千克)或纳曲酮(1.0 - 5.6毫克/千克),并在饮酒5天期间持续治疗。在实验2中,在持续饮酒期间给予两种药物的选定剂量。
当在戒酒期间开始治疗时,巴氯芬和纳曲酮均未显著降低总酒精摄入量(克/千克)或觅酒行为。相比之下,当在持续饮酒期间开始治疗时,巴氯芬(1.8毫克/千克)和纳曲酮(3.2和5.6毫克/千克)均显著降低了总酒精摄入量(克/千克)。纳曲酮(5.6毫克/千克)而非巴氯芬显著减少了觅酒行为。
在戒酒或饮酒时开始巴氯芬治疗(或其他酒精使用障碍治疗)可能是影响疗效和适当剂量选择的重要因素。