O'Malley S S
Department of Psychiatry, School of Medicine, Yale University, New Haven, CT 06511, USA.
Alcohol Alcohol. 1996 Mar;31 Suppl 1:77-81.
Placebo-controlled studies have demonstrated that patients treated with opioid antagonists had fewer drinking days, lower rates of resumed heavy drinking, and reduced alcohol craving, when compared with placebo-treated patients. Patients who received an opioid antagonist were also less likely to drink heavily if they sampled alcohol during treatment. One study also demonstrated that patients who were treated with the opioid antagonist naltrexone had lower serum aspartate aminotransferase and alanine aminotransferase levels than placebo-treated patients. This is consistent with self-reported decreases in alcohol consumption. These patients also had less severe alcohol-related problems than placebo-treated patients, as indicated by the Addiction Severity Index. Opioid antagonists might act by reducing the reinforcing effects of alcohol and the incentive to drink. These agents, when combined with comprehensive treatment programmes, are an effective adjunctive treatment for alcohol-dependent patients.
安慰剂对照研究表明，与接受安慰剂治疗的患者相比，接受阿片类拮抗剂治疗的患者饮酒天数减少，恢复大量饮酒的比率降低，对酒精的渴望也有所减轻。在治疗期间饮酒的患者中，接受阿片类拮抗剂治疗的患者大量饮酒的可能性也较小。一项研究还表明，接受阿片类拮抗剂纳曲酮治疗的患者血清天冬氨酸氨基转移酶和丙氨酸氨基转移酶水平低于接受安慰剂治疗的患者。这与自我报告的饮酒量减少相一致。如成瘾严重程度指数所示，这些患者与酒精相关的问题也比接受安慰剂治疗的患者轻。阿片类拮抗剂可能通过降低酒精的强化作用和饮酒动机来发挥作用。这些药物与综合治疗方案相结合，是酒精依赖患者有效的辅助治疗方法。
