Angelone S M, Bellini L, Di Bella D, Catalano M
Istituto di Ricovero e Cura a Carattere Scientifico H. San Raffaele, Dipartimento di Scienze Neuropsichiche, Centro di Alcologia, Milano, Italy.
Alcohol Alcohol. 1998 Mar-Apr;33(2):151-6. doi: 10.1093/oxfordjournals.alcalc.a008371.
A 16-week, randomized study was performed to test the efficacy of two selective serotonin reuptake inhibitors (SSRIs) fluvoxamine and citalopram, in decreasing relapse and craving in alcoholics, and to investigate possible differences in their clinical profile. After detoxification, each of the 81 patients (55 males and 26 females) was randomly assigned to one of three groups: 23 subjects did not receive any pharmacological treatment, 25 were treated with fluvoxamine, 150mg/day, and 33 with citalopram, 20 mg/day. All patients received standard cognitive-behavioural therapy. Craving was assessed twice a month using a 10-step scale. Every intake of alcohol was considered a relapse and the subject was taken out of the study. At the end of the study, both the fluvoxamine and citalopram groups showed a statistically higher rate of continuous abstinence (63.6 and 60.7%, respectively) compared to the group without pharmacological treatment (30.4%). Relapse severity did not differ among the three groups. Only citalopram showed a significant effect on craving throughout the study period. This study confirmed the efficacy of SSRIs as an adjunct to psychotherapy to prevent relapse in alcoholics. The relationship between the effects of these SSRIs on abstinence and craving, as well as the differences between their profiles, are discussed.
一项为期16周的随机研究旨在测试两种选择性5-羟色胺再摄取抑制剂（SSRI）——氟伏沙明和西酞普兰，在减少酒精成瘾者复发和渴求方面的疗效，并调查它们临床特征的可能差异。脱毒后，81名患者（55名男性和26名女性）中的每一位被随机分配到三组之一：23名受试者未接受任何药物治疗，25名接受氟伏沙明治疗，150毫克/天，33名接受西酞普兰治疗，20毫克/天。所有患者均接受标准认知行为疗法。每月使用10级量表对渴求进行两次评估。每次饮酒均被视为复发，该受试者将退出研究。研究结束时，与未接受药物治疗的组（30.4%）相比，氟伏沙明组和西酞普兰组的持续戒酒率在统计学上均较高（分别为63.6%和60.7%）。三组之间的复发严重程度无差异。在整个研究期间，只有西酞普兰对渴求显示出显著效果。本研究证实了SSRI作为心理治疗辅助手段预防酒精成瘾者复发的疗效。讨论了这些SSRI对戒酒和渴求影响之间的关系，以及它们特征之间的差异。
