Internal Medicine and Alcohol Related Disease Unit, Columbus-Gemelli Hospital, Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Internal Medicine and Alcohol Related Disease Unit, Columbus-Gemelli Hospital, Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; CEMAD Digestive Disease Center, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Roma, Italy.
Eur J Intern Med. 2022 Sep;103:13-22. doi: 10.1016/j.ejim.2022.05.016. Epub 2022 May 18.
In the last decades, many medications have been tested for the treatment of Alcohol Use Disorder (AUD). Among them, disulfiram, acamprosate, naltrexone, nalmefene, sodium oxybate and baclofen have been approved in different countries, with different specific indications. Topiramate is not approved for the treatment of AUD, however, it is suggested as a therapeutic option by the American Psychiatric Association for patients who do not tolerate or respond to approved therapies.
In this narrative review we have analyzed the main studies available in literature, investigating the efficacy and safety of these medications, distinguishing whether they were oriented towards abstinence or not. Randomized controlled studies, analyzing larger populations for longer periods were the main focus of our analysis.
The medications currently available for the treatment of AUD are quite effective, yet further progress can still be achieved through the personalized strategies. Also, these medications are still markedly underutilized in clinical practice and many patients do not have access to specialized treatment.
在过去的几十年中，已经有许多药物被测试用于治疗酒精使用障碍（AUD）。其中，双硫仑、安非他酮、纳曲酮、纳美芬、羟丁酸钠和巴氯芬已在不同国家获得批准，具有不同的特定适应证。托吡酯虽未获准用于治疗 AUD，但美国精神病学协会建议对不能耐受或对已批准的治疗方法无反应的患者将其作为一种治疗选择。
在这篇叙述性综述中，我们分析了文献中可获得的主要研究，研究了这些药物的疗效和安全性，区分了它们是否针对戒断。我们的分析主要集中在随机对照研究，这些研究分析了更大的人群，时间更长。
目前可用于治疗 AUD 的药物非常有效，但通过个性化策略仍可以取得进一步的进展。此外，这些药物在临床实践中仍明显未得到充分利用，许多患者无法获得专业治疗。
