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[酒精戒断综合征的治疗]

[Treatment of alcohol withdrawal syndrome].

作者信息

Sivolap Y P

机构信息

Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.

出版信息

Zh Nevrol Psikhiatr Im S S Korsakova. 2021;121(6):139-144. doi: 10.17116/jnevro2021121061139.

Abstract

Alcohol withdrawal arises in result of long-lasting or short, but massive, alcohol abuse, manifests itself with oppressive symptoms and in some cases is complicated by seizures, hallucinosis and delirium tremens that may be life-threatening for patients. The leading neurochemical factors underlying alcohol withdrawal syndrome and its complications are lack of GABA and excessive glutamate activity, which is important for therapy choice. The first-line drugs in the treatment of alcohol withdrawal syndrome and alcoholic delirium are benzodiazepines, which have the maximum pharmacological similarity with ethanol. Other medications, including barbiturates, anticonvulsants, propofol, dexmedetomidine, and antipsychotics, may be used as alternatives to and in addition to benzodiazepines, especially in the case of protracted delirium with therapeutic resistance. Certain prospects in the treatment of alcohol withdrawal syndrome are associated with ethylmethylhydroxypyridine succinate, which is a bit similar to benzodiazepines in its pharmacology.

摘要

酒精戒断是长期或短期大量酗酒的结果,表现为压抑症状,在某些情况下会并发癫痫、幻觉和震颤谵妄,这些对患者可能是危及生命的。酒精戒断综合征及其并发症的主要神经化学因素是γ-氨基丁酸(GABA)缺乏和谷氨酸活性过高,这对治疗方案的选择很重要。治疗酒精戒断综合征和酒精性谵妄的一线药物是苯二氮䓬类药物,它们与乙醇具有最大的药理学相似性。其他药物,包括巴比妥类药物、抗惊厥药、丙泊酚、右美托咪定和抗精神病药物,可作为苯二氮䓬类药物的替代品或补充药物使用,特别是在伴有治疗抵抗的持续性谵妄的情况下。琥珀酸乙甲基羟基吡啶在治疗酒精戒断综合征方面有一定前景,其药理学与苯二氮䓬类药物有点相似。

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