Haass-Koffler Carolina L, Goodyear Kimberly, Zywiak William H, Leggio Lorenzo, Kenna George A, Swift Robert M
Center for Alcohol and Addiction Studies, Department of Psychiatry and Human Behavior, Brown University, 121 South Main Street, Providence, RI 02912, USA.
Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, 121 South Main Street, Providence, RI 02912, USA.
Alcohol Alcohol. 2018 May 1;53(3):268-276. doi: 10.1093/alcalc/agx108.
The goal of this study was to evaluate the efficacy of topiramate up to 200 mg/day and of aripiprazole up to 15 mg/day, alone and combined, in reducing alcohol-related outcomes in a human laboratory study.
This was a 5 week, between-subject, double-blind, placebo-controlled human laboratory study with topiramate [0 mg/day (placebo), 100 mg/day, 200 mg/day] and aripiprazole [0 mg/day (placebo), 7.5 mg/day, 15 mg/day] in 90 non-treatment seeking, heavy drinking, alcohol-dependent individuals. Main outcomes were the efficacy of 200 mg/day topiramate and 15 mg/day aripiprazole, alone and combined, in reducing drinks consumed during an alcohol self-administration procedure (human laboratory phase) and while receiving the study medications prior to the laboratory session (naturalistic drinking phase). Other outcomes in the laboratory phase included alcohol craving, and alcohol biphasic effects.
In the human laboratory phase, topiramate 200 mg/day reduced alcohol craving [**P < 0.01] and amplified alcohol-induced stimulation [*P < 0.05], but did not reduce the number of drinks consumed. Topiramate 200 mg/day was also effective in reducing drinking days [*P < 0.05], and alcohol craving [*P < 0.05], in the naturalistic drinking phase. No significant findings were found for aripiprazole for any of the outcomes analyzed.
Participants receiving 200 mg/day topiramate reported reduced alcohol drinking and craving, and increased alcohol-related stimulation. These findings provide further support for the role of topiramate as a pharmacological treatment for AUD.
CLINICALTRIAL.GOV IDENTIFIER: NCT00884884.
This study tested topiramate and aripiprazole alone and in combination. The results replicate past findings and suggest that topiramate may be an effective treatment for alcohol use disorder. The present results suggest that the combination of topiramate and aripiprazole do not warrant further evaluation.
本研究的目的是在一项人体实验室研究中,评估每日剂量高达200毫克的托吡酯和每日剂量高达15毫克的阿立哌唑单独使用及联合使用时,在减少与酒精相关的结果方面的疗效。
这是一项为期5周的、受试者间、双盲、安慰剂对照的人体实验室研究,研究对象为90名未寻求治疗、重度饮酒、酒精依赖的个体,使用托吡酯[0毫克/天(安慰剂)、100毫克/天、200毫克/天]和阿立哌唑[0毫克/天(安慰剂)、7.5毫克/天、15毫克/天]。主要结果是每日剂量200毫克的托吡酯和每日剂量15毫克的阿立哌唑单独使用及联合使用时,在减少酒精自我给药程序(人体实验室阶段)以及在实验室环节前接受研究药物期间(自然饮酒阶段)所饮用的饮料量方面的疗效。实验室阶段的其他结果包括对酒精的渴望以及酒精的双相效应。
在人体实验室阶段,每日200毫克的托吡酯可减少对酒精的渴望[**P < 0.01],并增强酒精引起的兴奋感[*P < 0.05],但并未减少饮用的饮料量。每日200毫克的托吡酯在自然饮酒阶段也能有效减少饮酒天数[*P < 0.05]和对酒精的渴望[*P < 0.05]。对于所分析的任何结果,阿立哌唑均未发现显著结果。
接受每日200毫克托吡酯治疗的参与者报告饮酒量和对酒精的渴望减少,且与酒精相关的兴奋感增加。这些发现为托吡酯作为酒精使用障碍的药物治疗的作用提供了进一步支持。
NCT00884884。
本研究对托吡酯和阿立哌唑单独使用及联合使用进行了测试。结果重复了过去的发现,并表明托吡酯可能是治疗酒精使用障碍的有效方法。目前的结果表明,托吡酯和阿立哌唑的联合使用不值得进一步评估。