Littleton J, Little H
Division of Biomedical Science, Kings College, London, UK.
Addiction. 1994 Nov;89(11):1397-412. doi: 10.1111/j.1360-0443.1994.tb03736.x.
Alcohol dependence is considered to be divisible into two types (although the divisions between these are indistinct). These are psychological dependence, in which the rewarding effects of alcohol play a primary role, and chemical dependence, in which adaptive changes in the brain initiate punishing effects on withdrawal of alcohol, and suppression of these becomes the primary motive for using the drug. The neurochemical basis for the rewarding effects of alcohol may be the potentiation of GABA at GABAA receptors (causing relaxation) and release of dopamine from mesolimbic neurones (causing euphoria). The adaptive changes which cause the alcohol withdrawal syndrome are not known for certain, but alterations in GABAA receptors, NMDA receptors and voltage-operated calcium channels all have a claim. However, it is distinctly doubtful whether these all contribute to the negatively reinforcing effects of alcohol that are important in chemical dependence, although they may be important in other pathological effects of alcohol abuse. Current research badly needs better communication between basic scientists and clinicians to establish research goals and to improve current models.
酒精依赖被认为可分为两种类型（尽管这两种类型之间的区分并不明显）。一种是心理依赖，其中酒精的奖赏效应起主要作用；另一种是化学依赖，大脑中的适应性变化会引发戒酒时的惩罚效应，而抑制这些效应就成为使用该药物的主要动机。酒精奖赏效应的神经化学基础可能是GABAA受体处GABA的增强（导致放松）以及中脑边缘神经元释放多巴胺（导致欣快感）。导致酒精戒断综合征的适应性变化尚不确定，但GABAA受体、NMDA受体和电压门控钙通道的改变都有可能。然而，尽管它们可能在酒精滥用的其他病理效应中很重要，但这些是否都对化学依赖中重要的酒精负性强化作用有贡献，显然值得怀疑。当前的研究迫切需要基础科学家和临床医生之间更好的沟通，以确立研究目标并改进当前模型。
