DOUBLE-BLIND-STUDY OF ALPRAZOLAM, DIAZEPAM, CLONIDINE, AND PLACEBO IN THE ALCOHOL-WITHDRAWAL SYNDROME - PRELIMINARY FINDINGS
DOUBLE-BLIND-STUDY OF ALPRAZOLAM, DIAZEPAM, CLONIDINE, AND PLACEBO IN THE ALCOHOL-WITHDRAWAL SYNDROME - PRELIMINARY FINDINGS
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DOI：
10.1111/j.1530-0277.1994.tb00053.x
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发表时间：
1994-08-01
影响因子：
3.2
通讯作者：
ADINOFF, B
中科院分区：
文献类型：
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作者：
ADINOFF, B
在酒精戒断综合征期间，表现出GABA抑制作用的减少（去抑制）和交感神经系统的激活。本研究旨在探索不同影响这两种生物系统的药物的相对疗效：苯二氮卓类药物（可减弱GABA能去抑制）和α（2）-肾上腺素能受体激动剂（可降低交感神经激活）。评价了苯二氮卓类药物地西泮（n = 6）、α（2）-受体激动剂可乐定（n = 7）、苯二氮卓类药物阿普唑仑（据称也具有α（2）-受体激动剂特性）（n = 6）和安慰剂（n = 6）在减少酒精戒断症状和体征方面的有效性。在双盲设计中，无药物的酒精依赖患者接受4种药物中的1种，直至成功治疗戒断症状（通过酒精临床仪器戒断评估-修订版测量）。阿普唑仑在减少戒断症状方面明显比可乐定和安慰剂更有效。地西泮在某些戒断措施上比可乐定和安慰剂更有效。可乐定降低收缩压的作用明显大于其他两种活性药物和安慰剂，但在减少其他戒断症状方面并不比安慰剂更有效。与地西泮或安慰剂相比，阿普唑仑没有显著降低血压。尽管样本量较小，但这些初步结果表明阿普唑仑治疗酒精戒断的疗效与其对苯二氮卓类受体的作用有关，而与其α（2）受体激动剂特性无关。
Both a reduction in the inhibitory effects of GABA (disinhibition) and activation of the sympathetic nervous system are manifested during the alcohol withdrawal syndrome. This study was designed to explore the relative efficacy of medications that differentially affects these two biological systems: the benzodiazepines, which attenuate GABAergic disinhibition, and the alpha(2)-adrenergic receptor agonists, which decrease sympathetic activation. The benzodiazepine diazepam (n = 6), the alpha(2)-receptor agonist clonidine (n = 7), the benzodiazepine alprazolam (that is also purported to have alpha(2)-receptor agonist properties) (n = 6), and placebo (n = 6) were evaluated in their effectiveness in decreasing signs and symptoms of alcohol withdrawal. Drug-free, alcohol dependent patients were administered 1 of the 4 medications in a double-blind design until symptoms of withdrawal, as measured by the Clinical Instrument Withdrawal Assessment for Alcohol-Revised, were successfully treated. Alprazolam was significantly more efficacious than both clonidine and placebo in decreasing withdrawal symptoms. Diazepam was more effective than clonidine and placebo on some measures of withdrawal. Clonidine decreased systolic blood pressure significantly more than the other two active drugs and placebo, but was no more effective than placebo in decreasing other symptoms of withdrawal. Alprazolam did not significantly decrease blood pressure compared with diazepam or placebo. Despite the small sample size, these preliminary findings suggest that the efficacy of alprazolam in the treatment of alcohol withdrawal is related to its effect at the benzodiazepine receptor and not its alpha(2)-receptor agonist properties.