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酒精使用障碍的实用门诊药物治疗

Practical outpatient pharmacotherapy for alcohol use disorder.

作者信息

Kim Youngjung, Hack Laura M, Ahn Elizabeth S, Kim Jungjin

机构信息

Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

Department of Psychiatry, Emory University School of Medicine, Atlanta, GA, USA.

出版信息

Drugs Context. 2018 Feb 7;7:212308. doi: 10.7573/dic.212308. eCollection 2018.

Abstract

Alcohol use disorder (AUD) is commonly encountered in clinical practice. A combination of psychosocial intervention and pharmacotherapy is the cornerstone of AUD treatment. Despite their efficacy, safety and cost-effectiveness, clinicians are reluctant to prescribe medications to treat individuals with AUD. Given the high rate of relapse with psychosocial intervention alone, increasing patient access to this underutilized treatment has the potential to improve clinical outcome in this difficult-to-treat population. Herein, we provide practical pharmacotherapy strategies to improve treatment outcome for AUD. We review the efficacy and side effects of both on- and off-label agents with a particular focus on clinical applicability. Recommendations are supported by findings from randomized controlled trials (RCT) and meta-analyses selected to be representative, where possible, of current treatment guidelines. The goal of this paper is to help readers use pharmacotherapy with greater confidence when treating patients with AUD.

摘要

酒精使用障碍(AUD)在临床实践中较为常见。心理社会干预与药物治疗相结合是AUD治疗的基石。尽管这些治疗方法有效、安全且具有成本效益,但临床医生却不愿为患有AUD的个体开处方用药。鉴于仅靠心理社会干预复发率较高,增加患者获得这种未充分利用的治疗方法的机会,有可能改善这一难以治疗人群的临床结局。在此,我们提供实用的药物治疗策略以改善AUD的治疗效果。我们回顾了已获批和未获批药物的疗效及副作用,尤其关注临床适用性。建议得到了随机对照试验(RCT)和荟萃分析结果的支持,在可能的情况下,这些试验和分析代表了当前的治疗指南。本文的目的是帮助读者在治疗AUD患者时更有信心地使用药物治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1445/5804871/05173fa44ea4/dic-7-212308-g001.jpg

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