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治疗酒精使用障碍的药物治疗前景:近期人体研究的更新。

Prospects for pharmacotherapies to treat alcohol use disorder: an update on recent human studies.

机构信息

Section on Clinical Psychoneuroendocrinology and Neuropsychopharmacology, National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research and National Institute on Drug Abuse Intramural Research Program, National Institutes of Health.

Center on Compulsive Behaviors, National Institutes of Health, Bethesda.

出版信息

Curr Opin Psychiatry. 2019 Jul;32(4):255-265. doi: 10.1097/YCO.0000000000000519.

Abstract

PURPOSE OF REVIEW

The aim of this study was to provide an update on medication development efforts for alcohol use disorder (AUD) by reviewing recently published (past 2 years) human studies that evaluated medications' effects on alcohol-related outcomes.

RECENT FINDINGS

Forty-five publications were found suitable for this review. A variety of compounds have been tested in the past 2 years as potential pharmacological options for AUD, including medications that act on multiple targets (topiramate, aripiprazole, quetiapine), calcium channels (gabapentin), gamma-Aminobutyric acid receptors (baclofen, diazepam), glutamate receptors (ifenprodil, memantine, glycine), nicotinic acetylcholine receptors (varenicline, mecamylamine), α1 adrenergic receptors (prazosin, doxazosin), neuroendocrine pathways (oxytocin, a vasopressin receptor 1b antagonist, a ghrelin receptor inverse agonist) and others (samidorphan, ibudilast, N-acetylcysteine, citoline). Important findings and limitations regarding the effects of these medications on alcohol-related outcomes are discussed.

SUMMARY

There is a critical need to increase the armamentarium of medications for AUD. Human laboratory studies may help screen and prioritize promising targets and compounds before running large clinical trials. Given the complexity of AUD and the heterogeneity of afflicted patients, future studies should also investigate potential moderators and predictors of response to each pharmacological intervention.

摘要

目的综述

本研究旨在通过综述最近发表的(过去 2 年)评估药物对酒精相关结局影响的人类研究,为酒精使用障碍(AUD)的药物研发进展提供最新信息。

研究进展

共发现 45 篇符合条件的文献。在过去的 2 年中,已经测试了多种化合物作为 AUD 的潜在药物选择,包括作用于多个靶点的药物(托吡酯、阿立哌唑、喹硫平)、钙通道(加巴喷丁)、γ-氨基丁酸受体(巴氯芬、地西泮)、谷氨酸受体(ifenprodil、美金刚、甘氨酸)、烟碱型乙酰胆碱受体(伐伦克林、美卡拉明)、α1 肾上腺素能受体(普萘洛尔、多沙唑嗪)、神经内分泌途径(催产素、血管加压素受体 1b 拮抗剂、胃饥饿素受体反向激动剂)和其他药物(萨米多弗、伊布地尔、N-乙酰半胱氨酸、胞磷胆碱)。讨论了这些药物对酒精相关结局影响的重要发现和局限性。

总结

急需增加 AUD 的药物治疗手段。人体实验室研究可以帮助筛选和优先考虑有前途的靶点和化合物,然后再进行大型临床试验。鉴于 AUD 的复杂性和受影响患者的异质性,未来的研究还应研究每种药物干预的潜在调节因素和预测因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a838/6673672/98c3495b9de5/nihms-1534061-f0001.jpg

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