Gottlieb L D, Horwitz R I, Kraus M L, Segal S R, Viscoli C M
Department of Internal Medicine, St Mary's Hospital, Waterbury, Connecticut.
J Subst Abuse Treat. 1994 May-Jun;11(3):253-8. doi: 10.1016/0740-5472(94)90083-3.
Previous studies suggest that beta-adrenergic blockers reduce craving levels during acute alcohol withdrawal. We conducted a new study to assess whether the daily use of atenolol by the abstinent alcoholic could maintain a blunted craving for alcohol and result in a decreased rate of relapse for alcohol abuse. The study was designed as a randomized, controlled, double-blind clinical trial. Among all 100 patients (50 atenolol, 50 placebo), only 15 stayed in the trial and remained fully abstinent for 1 year (7 atenolol, 8 placebo). Of the remaining 85 patients, 30 withdrew early while still abstinent (17 atenolol, 13 placebo). In the 57 high-risk patients who reported craving for alcohol at baseline, the treatment failure rates were 90% for patients receiving placebo, and was reduced to 65% in those who received atenolol (risk reduction = 28%, 95% confidence interval, -3% to 49%). The data from this trial also support the observation that poorer levels of treatment adherence are strongly associated with adverse outcomes for alcoholics during follow-up. This relationship was present both for patients who received atenolol and for those who received placebo.
先前的研究表明，β-肾上腺素能阻滞剂可降低急性酒精戒断期间的渴望程度。我们开展了一项新研究，以评估戒酒的酗酒者每日服用阿替洛尔是否能持续减轻对酒精的渴望，并降低酒精滥用的复发率。该研究设计为一项随机、对照、双盲临床试验。在全部100名患者（50名服用阿替洛尔，50名服用安慰剂）中，只有15名患者完成试验并持续戒酒1年（7名服用阿替洛尔，8名服用安慰剂）。其余85名患者中，30名提前退出试验，但仍保持戒酒状态（17名服用阿替洛尔，13名服用安慰剂）。在57名基线时报告有酒精渴望的高风险患者中，服用安慰剂患者的治疗失败率为90%，而服用阿替洛尔患者的治疗失败率降至65%（风险降低 = 28%，95%置信区间，-3%至49%）。该试验的数据还支持以下观察结果，即治疗依从性较差与酗酒者随访期间的不良结局密切相关。服用阿替洛尔的患者和服用安慰剂的患者均存在这种关系。
