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治疗创伤后应激障碍和酒精使用障碍共病:当前的药物治疗和 MDMA 整合心理治疗的未来。

Treating posttraumatic stress disorder and alcohol use disorder comorbidity: Current pharmacological therapies and the future of MDMA-integrated psychotherapy.

机构信息

Center for Alcohol and Addiction Studies, Brown University, Providence, RI, USA.

Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, RI, USA.

出版信息

J Psychopharmacol. 2023 Dec;37(12):1182-1189. doi: 10.1177/02698811231200880. Epub 2023 Nov 27.

Abstract

Posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) frequently co-occur in patients who have experienced trauma. This comorbidity leads to a vicious cycle where PTSD symptoms beget heavy drinking and vice versa. There are no FDA-approved medications to treat PTSD-AUD; therefore, individuals suffering from this comorbidity are treated with medication approved to treat the disorders separately or with off-label pharmacological interventions. However, these medications are limited in their efficacy for treating PTSD-AUD comorbidity. Emerging research on the nonclassical psychedelic drug 3,4-methylenedioxymethamphetamine (MDMA) suggests that it may be an effective drug used in conjunction with psychotherapy. The following reviews the current research for clinical pharmacotherapies, as well as MDMA-integrative psychotherapy as they pertain to PTSD and AUD in isolation and co-occurrence. Future directions for the role of psychedelic-integrative therapy for the treatment of this comorbidity are discussed.

摘要

创伤后应激障碍(PTSD)和酒精使用障碍(AUD)在经历过创伤的患者中经常同时发生。这种共病导致了一个恶性循环,即 PTSD 症状导致酗酒,反之亦然。目前还没有美国食品和药物管理局(FDA)批准的药物来治疗 PTSD-AUD;因此,患有这种共病的患者接受的治疗是分别用批准用于治疗这些疾病的药物或使用非标签药理学干预。然而,这些药物在治疗 PTSD-AUD 共病方面的疗效有限。关于非典型迷幻药物 3,4-亚甲基二氧甲基苯丙胺(MDMA)的新兴研究表明,它可能是一种与心理治疗结合使用的有效药物。以下综述了目前关于临床药物治疗的研究,以及 MDMA 整合心理治疗,因为它们分别涉及 PTSD 和 AUD 的孤立和共病。讨论了迷幻药整合疗法在治疗这种共病中的作用的未来方向。

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