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双硫仑作为重度酒精使用障碍患者成瘾针对性治疗辅助手段的有效性。

Effectiveness of Disulfiram as Adjunct to Addiction-Focused Treatment for Persons With Severe Alcohol Use Disorder.

作者信息

Schallenberg Max, Vogel-Blaschka Diana, Spreer Maik, Göstl Julia, Petzold Johannes, Pilhatsch Maximilian

机构信息

Department of Psychiatry and Psychotherapy, University Hospital, Technische Universität Dresden, Dresden, Germany.

Clinic for Psychiatry and Psychotherapy, Elblandklinikum Radebeul, Radebeul, Germany.

出版信息

Addict Biol. 2025 Apr;30(4):e70035. doi: 10.1111/adb.70035.

Abstract

The consumption of alcohol affects 400 million people worldwide, where it is responsible for 7% of deaths. Treatment success rates in this field remain limited. Only 15% of those who need treatment get it. Despite treatment, alcohol intake reoccurs in up to 90% of the cases. The use of disulfiram in preventing alcohol reoccurrence is attributed to its unique mechanism of action as an aversive agent, which causes the patient to experience unpleasant physical symptoms when they consume alcohol. The objective of this study is to confirm and illustrate the efficacy of disulfiram in combination with non-pharmacological intervention for persons with severe AUD. Clinical data from 45 patients of an outpatient treatment programme, including the application of disulfiram (2011-2023) were analysed to assess abstinence rates, craving impact, and demographic factors. Moreover, our analyses aimed to identify predictors and moderators of continuous abstinence duration. The study cohort comprised patients with severe AUD and high rates of comorbidities, the majority of which were affective disorders. During treatment, 50% of patients remained abstinent for at least 1 year. No significant differences were identified in craving, sex or comorbidities compared with those who experienced a return to substance use after treatment initiation. Disulfiram underlined its efficacy and tolerability as an adjunct to addiction-focused treatment in a typical clinical cohort of patients severely affected by AUD. Moreover, our analyses align with previous research indicating that disulfiram appears to allow patients with AUD to resist craving episodes, therefore avoiding impulsive reoccurrences of alcohol intake.

摘要

全球有4亿人饮酒,饮酒导致的死亡占总死亡人数的7%。该领域的治疗成功率仍然有限。只有15%需要治疗的人得到了治疗。尽管接受了治疗,但高达90%的病例仍会再次饮酒。双硫仑用于预防酒精复发,这归因于其作为一种厌恶剂的独特作用机制,当患者饮酒时会使其出现不适的身体症状。本研究的目的是证实并说明双硫仑联合非药物干预对重度酒精使用障碍患者的疗效。分析了一个门诊治疗项目中45名患者的临床数据(包括双硫仑的应用情况,时间为2011年至2023年),以评估戒酒率、渴望影响和人口统计学因素。此外,我们的分析旨在确定持续戒酒时间的预测因素和调节因素。研究队列包括重度酒精使用障碍且合并症发生率高的患者,其中大多数为情感障碍。治疗期间,50%的患者至少戒酒1年。与治疗开始后恢复使用物质的患者相比,在渴望、性别或合并症方面未发现显著差异。在一个受酒精使用障碍严重影响的典型临床患者队列中,双硫仑突显了其作为成瘾聚焦治疗辅助手段的疗效和耐受性。此外,我们的分析与先前的研究一致,表明双硫仑似乎能让酒精使用障碍患者抵抗渴望发作,从而避免冲动性地再次饮酒。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9bc9/12012990/987cc86b641e/ADB-30-e70035-g001.jpg

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