Bohn M J
Outpatient Substance Abuse Treatment Program, W.S. Middleton Veterans Affairs Hospital, Madison, Wisconsin.
Psychiatr Clin North Am. 1993 Dec;16(4):679-92.
Several medications may help improve treatment of alcoholic patients. Medications that effectively and specifically reverse symptoms of alcohol intoxication or coma currently are lacking. Benzodiazepines remain the most effective medications for the treatment of alcohol withdrawal and for the prevention of withdrawal seizures and delirium, even though the adrenergic agents clonidine or atenolol may hasten resolution of withdrawal symptoms and facilitate outpatient detoxification. Psychosocial rehabilitation of alcoholics may be improved by judicious addition of the alcohol-sensitizing agents disulfiram and carbimide, the serotonergic drugs fluoxetine and buspirone, the opiate antagonist naltrexone, and, for primarily depressed alcoholics, tricyclic antidepressants. As in psychosocial alcohol rehabilitation, patient-treatment matching may improve results of pharmacotherapeutic intervention.
几种药物可能有助于改善对酒精依赖患者的治疗。目前缺乏能有效且特异性逆转酒精中毒或昏迷症状的药物。苯二氮䓬类药物仍然是治疗酒精戒断以及预防戒断性癫痫发作和谵妄最有效的药物,尽管肾上腺素能药物可乐定或阿替洛尔可能会加速戒断症状的缓解并促进门诊脱毒。通过明智地添加酒精增敏剂双硫仑和卡比咪胺、5-羟色胺能药物氟西汀和丁螺环酮、阿片拮抗剂纳曲酮,以及对于主要为抑郁型酒精依赖患者使用三环类抗抑郁药,可能会改善酒精依赖者的心理社会康复。与心理社会酒精康复一样,患者与治疗的匹配可能会改善药物治疗干预的效果。