Disulfiram: An Old Therapeutic with New Applications
Disulfiram: An Old Therapeutic with New Applications
复制标题
DOI：
10.2174/187152710790966678
复制
发表时间：
2010-03-01
影响因子：
3
通讯作者：
Malcolm, Robert J.
中科院分区：
文献类型：
--
作者：
Barth, Kelly S.;Malcolm, Robert J.
尽管有其局限性，但双硫仑治疗仍然是治疗酒精依赖的可行选择，并且最近在治疗(1)合并酒精依赖和创伤后应激障碍的患者，(2)合并可卡因和酒精依赖的患者，以及(3)单独可卡因依赖的患者方面显示出希望。虽然双硫仑对酒精依赖的作用机制长期以来被认为是它的心理威慑作用，但最近的研究发现了双硫仑对可卡因滥用的潜在抗渴望作用和直接作用，强调了双硫仑通过抑制多巴胺β -羟化酶可能具有的许多潜在和独特的益处。本文将回顾近60年来双硫仑的主要临床试验。我们将讨论双硫仑的药效学和药代动力学，其使用的适应症和局限性，对合适患者群体的建议，以及对依从性和不良反应的监测。我们还将回顾最近关于双硫仑对多巴胺-羟化酶的独特作用的新潜在应用的文献。
Disulfiram treatment, despite its limitations, remains a viable option as a treatment for alcohol dependence and has shown recent promise in treating (1) those with co-morbid alcohol dependence and post-traumatic stress disorder, (2) those with co-morbid cocaine- and alcohol-dependence, and (3) those with cocaine- dependence alone. Although disulfiram's mechanism of action in alcohol dependence was long thought to be its effects as a psychological deterrent, more recent studies have uncovered potential anti-craving effects as well as direct effects of disulfiram on cocaine abuse, highlighting a few of the many potential and unique benefits disulfiram may have through its inhibition of dopamine beta-hydroxylase. This article will review the major clinical trials of disulfiram spanning nearly 60 years. We will discuss the pharmacodynamics and pharmacokinetics of disulfiram, indications and limitations of its use, suggestions for appropriate patient populations, and monitoring for compliance and adverse effects. We will also review recent literature on newer potential applications for disulfiram use via its unique action on dopamine beta-hydroxylase.