Pan Jeffrey, Rehm Jürgen, Wood Evan
British Columbia Centre on Substance Use, Vancouver, Canada.
Institute for Mental Health Policy Research & Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), Toronto, Canada.
Addict Sci Clin Pract. 2025 Mar 25;20(1):30. doi: 10.1186/s13722-025-00552-3.
Insomnia is a common condition experienced by many individuals with excessive alcohol use and alcohol use disorder, and the serotonin antagonist and reuptake inhibitor trazodone has emerged as a mainstay of treatment for insomnia in this population.
However, an underappreciated literature has demonstrated potential for an increase in alcohol use while persons with alcohol use disorder are taking trazodone for sleep challenges. Additionally, multiple trials have identified trazodone's metabolite meta-Chlorophenylpiperazine as a pharmaceutical inducer of increased alcohol craving and use.
Increased awareness in the potential of worsening drinking behaviour with trazodone accompanied by the preferential use of safer alternative treatment strategies can likely improve outcomes for patients with heavy drinking and alcohol use disorder.
失眠是许多过度饮酒和患有酒精使用障碍的人常见的情况，5-羟色胺拮抗剂及再摄取抑制剂曲唑酮已成为该人群失眠治疗的主要药物。
然而，有一些未得到充分重视的文献表明，患有酒精使用障碍的人在服用曲唑酮应对睡眠问题时，有饮酒量增加的可能性。此外，多项试验已确定曲唑酮的代谢物间氯苯哌嗪是导致酒精渴望和饮酒量增加的药物诱导剂。
提高对曲唑酮可能使饮酒行为恶化的认识，并优先使用更安全的替代治疗策略，可能会改善重度饮酒和酒精使用障碍患者的治疗效果。
