Department of Family Medicine and Community Health, University of Minnesota, Mankato.
Department of Pharmacy, Mayo Clinic Health System, Southwest Minnesota Region and Mayo Clinic College of Medicine and Science, Mankato.
Mayo Clin Proc. 2020 Sep;95(9):1964-1977. doi: 10.1016/j.mayocp.2020.01.030. Epub 2020 May 20.
Pathologic alcohol use affects more than 2 billion people and accounts for nearly 6% of all deaths worldwide. There are three medications approved for the treatment of alcohol use disorder by the US Food and Drug Administration (FDA): disulfiram, naltrexone (oral and long-acting injectable), and acamprosate. Of growing interest is the use of anticonvulsants for the treatment of alcohol use disorder, although currently none are FDA approved for this indication. Baclofen, a γ-aminobutyric acid B receptor agonist used for spasticity and pain, received temporary approval for alcohol use disorder in France. Despite effective pharmacotherapies, less than 9% of patients who undergo any form of alcohol use disorder treatment receive pharmacotherapies. Current evidence does not support the use of pharmacogenetic testing for treatment individualization. The objective of this review is to provide knowledge on practice parameters for evidenced-based pharmacologic treatment approaches in patients with alcohol use disorder.
病理性饮酒影响超过 20 亿人，占全球所有死亡人数的近 6%。 美国食品和药物管理局 (FDA) 批准了三种用于治疗酒精使用障碍的药物：双硫仑、纳曲酮（口服和长效注射）和安非他酮。越来越受到关注的是使用抗惊厥药治疗酒精使用障碍，尽管目前没有一种药物被 FDA 批准用于该适应症。用于治疗痉挛和疼痛的 γ-氨基丁酸 B 受体激动剂巴氯芬在法国获得了酒精使用障碍的临时批准。尽管有有效的药物治疗，但接受任何形式的酒精使用障碍治疗的患者中，不到 9%接受药物治疗。目前的证据不支持使用药物遗传学检测来实现个体化治疗。 本综述的目的是提供有关酒精使用障碍患者基于证据的药物治疗方法的实践参数的知识。
