Department of Psychiatry, Harbor-UCLA Medical Center, Los Angeles, California.
Department of Psychiatry and Biobehavioral Science, UCLA, Los Angeles, California.
Int J Neuropsychopharmacol. 2019 Apr 1;22(4):286-291. doi: 10.1093/ijnp/pyz010.
Selective serotonin reuptake inhibitors are often used in alcohol use disorders. Clinical trials with selective serotonin reuptake inhibitors for alcohol use disorders, however, have yielded mixed results. The goal of this project was to assess whether a single i.v. dose of a selective serotonin reuptake inhibitor reduces craving for alcohol and/or simultaneously increases striatal dopamine concentration in individuals with alcohol dependence.
Alcohol-dependent (DSM-IV-TR criteria) volunteers and matched controls (n = 10/group) underwent a double-blind, placebo-controlled, within-subjects study. Participants received i.v. citalopram (40 mg) or saline (counter-balanced) followed by a cue-induced craving assessment and [18F]-fallypride positron emission tomography scanning.
In the alcohol-dependent individuals, the citalopram (compared with saline) resulted in decreased cue-induced craving for alcohol. For the whole study group, cue-induced alcohol craving was inversely correlated with thalamic (but not striatal) dopamine D2/3 receptor availability.
Acute serotonin reuptake inhibition reduces cue-induced alcohol craving. Furthermore, thalamic dopamine abnormalities and the striatal hyperdopaminergic hypothesis of alcohol use disorder are supported.
选择性 5-羟色胺再摄取抑制剂常用于治疗酒精使用障碍。然而，针对酒精使用障碍的选择性 5-羟色胺再摄取抑制剂的临床试验结果喜忧参半。本项目旨在评估单剂量静脉注射选择性 5-羟色胺再摄取抑制剂是否能降低酒精依赖者对酒精的渴望，同时增加纹状体多巴胺浓度。
酒精依赖者（DSM-IV-TR 标准）志愿者和匹配的对照者（每组 10 人）接受了一项双盲、安慰剂对照、自身对照的研究。参与者接受静脉注射西酞普兰（40mg）或生理盐水（平衡对照），然后进行线索诱发的渴求评估和 [18F]-氟丙嗪正电子发射断层扫描。
在酒精依赖者中，西酞普兰（与生理盐水相比）降低了线索诱发的对酒精的渴望。对于整个研究组，线索诱发的酒精渴求与丘脑（而非纹状体）多巴胺 D2/3 受体可用性呈负相关。
急性 5-羟色胺再摄取抑制可降低线索诱发的酒精渴求。此外，还支持了丘脑多巴胺异常和酒精使用障碍的纹状体多巴胺亢进假说。
