Florey Institute of Neuroscience and Mental Health, Melbourne Brain Centre, The University of Melbourne, Parkville, VIC, Australia.
Department of Addiction Medicine, St Vincent's Hospital Melbourne, The University of Melbourne, Parkville, VIC, Australia.
Pharmacol Res Perspect. 2021 May;9(3):e00767. doi: 10.1002/prp2.767.
Alcohol use disorder (AUD) and methamphetamine use disorder (MUD) are prevalent and have high adverse impacts on both the individual and society. Current treatment strategies for these disorders are ineffective at a population level. Lorcaserin, a 5-HT receptor agonist, has shown potential at reducing the symptoms of substance use disorder. This pilot study (initiated prior to market withdrawal) examined feasibility and safety of lorcaserin treatment in people undergoing residential detoxification and treatment for AUD and MUD. This was an open label pilot study of lorcaserin where participants (n = 10 AUD; n = 8 MUD) received 10-mg lorcaserin daily for 4 days then twice daily for 1 month. Primary outcome measures included recruitment and retention rate, incidence of treatment-emergent events, incidence of methamphetamine or alcohol withdrawal-related events, heart rate, and blood pressure. Secondary measures included pharmacokinetic data and self-reported alcohol or methamphetamine use, craving, and psychological distress. AUD participants were recruited faster and had a greater retention rate compared with MUD participants. Lorcaserin did not alter vital signs, was well tolerated, and had a similar pharmacokinetic profile to individuals with obesity. Lorcaserin reduced self-reported alcohol and amphetamine-type substance use and craving in AUD and MUD participants, respectively. Self-reported psychological health also improved over the treatment period for all participants. Despite the pilot nature of this study, our data support the notion of 5-HT receptors as a therapeutic target for drug and alcohol abuse.
酒精使用障碍（AUD）和甲基苯丙胺使用障碍（MUD）普遍存在，对个人和社会都有很大的负面影响。目前针对这些障碍的治疗策略在人群层面上效果不佳。Lorcaserin 是一种 5-HT 受体激动剂，已显示出在减轻物质使用障碍症状方面的潜力。这项试点研究（在市场撤出之前启动）旨在研究 lorcaserin 治疗在接受住院戒毒和 AUD 和 MUD 治疗的人群中的可行性和安全性。这是一项 lorcaserin 的开放标签试点研究，参与者（n=10 AUD；n=8 MUD）每天接受 10mg lorcaserin 治疗 4 天，然后每天两次治疗 1 个月。主要观察指标包括招募和保留率、治疗中出现的不良事件发生率、甲基苯丙胺或酒精戒断相关不良事件的发生率、心率和血压。次要测量指标包括药代动力学数据以及自我报告的酒精或甲基苯丙胺使用、渴望和心理困扰。与 MUD 参与者相比，AUD 参与者的招募速度更快，保留率更高。Lorcaserin 未改变生命体征，耐受性良好，与肥胖个体的药代动力学特征相似。Lorcaserin 分别降低了 AUD 和 MUD 参与者自我报告的酒精和苯丙胺类物质使用和渴望。所有参与者在治疗期间的自我报告心理健康状况也有所改善。尽管这项研究是试点性质的，但我们的数据支持 5-HT 受体作为治疗药物和酒精滥用的靶点的观点。
