Hersh D, Van Kirk J R, Kranzler H R
University of Connecticut Health Center, Department of Psychiatry, Farmington CT 06030-2103, USA.
Psychopharmacology (Berl). 1998 Sep;139(1-2):44-52. doi: 10.1007/s002130050688.
Naltrexone (NTX) has been shown to be efficacious for the treatment of alcohol dependence. Since alcohol and cocaine use disorders commonly co-occur, we conducted a randomized, double-blind, placebo-controlled trial of NTX 50 mg/day in 64 subjects with comorbid alcohol and cocaine use disorders. Although subjects in both groups reduced their consumption of both alcohol and cocaine during the 8-week trial, there was no consistent advantage to NTX over placebo treatment. We conclude that, due to behavioral, neurochemical, or other factors, individuals with both alcohol and cocaine use disorders are distinct from those dependent on alcohol alone, and that NTX at a dosage of 50 mg/day is not efficacious in this patient population. Several factors, including medication dosage, length of treatment, sample size and attrition rate, limit the interpretation of these findings. Consequently, we recommend that subsequent trials of NTX to reduce the risk of relapse in patients with comorbid alcohol and cocaine use disorders take these issues into account.
纳曲酮（NTX）已被证明对治疗酒精依赖有效。由于酒精使用障碍和可卡因使用障碍通常同时出现，我们对64名患有酒精和可卡因共病使用障碍的受试者进行了一项随机、双盲、安慰剂对照试验，给予50毫克/天的NTX。尽管两组受试者在为期8周的试验中都减少了酒精和可卡因的摄入量，但与安慰剂治疗相比，NTX并没有持续的优势。我们得出结论，由于行为、神经化学或其他因素，同时患有酒精和可卡因使用障碍的个体与仅依赖酒精的个体不同，并且50毫克/天剂量的NTX对该患者群体无效。包括药物剂量、治疗时长、样本量和损耗率在内的几个因素限制了对这些研究结果的解读。因此，我们建议，后续关于NTX降低酒精和可卡因共病使用障碍患者复发风险的试验应考虑这些问题。
