Serotonin-altering medications and desire, consumption and effects of alcohol-treatment implications.
Serotonin-altering medications and desire, consumption and effects of alcohol-treatment implications.
复制标题
改变血清素的药物以及酒精治疗影响的欲望、消费和影响。
DOI：
10.1007/978-3-0348-7330-7_21
复制
发表时间：
1994
期刊：
影响因子：
--
通讯作者：
K. Bremner
中科院分区：
文献类型：
--
作者：
C. Naranjo;K. Bremner
血清素神经传递与酒精消耗（AC）之间的关系在临床前研究中首次确定。在降低血清素活性的治疗后，AC通常会增加，嗜酒大鼠大脑某些区域的5-羟色胺和代谢物水平较低。增强5 -羟色胺能神经传递的药物治疗（摄取抑制剂、释放剂、激动剂）持续降低大鼠的AC。5 -羟色胺摄取抑制剂（SUI，如西酞普兰，氟西汀）已在人类中广泛研究。在几项双盲随机、安慰剂对照试验中，在未接受其他治疗的非抑郁轻度/中度依赖酗酒者中，SUI持续降低短期（2-4周）AC平均15%至20%。一些受试者的交流电下降了60%。SUI对AC的影响是剂量依赖性的，与副作用（少量和轻微）或焦虑或抑郁的变化（未观察到）无关。SUI降低了饮酒欲望和喜欢酒精，这表明在开发减少AC和预防复发的治疗方法时应考虑其作用机制。然而，虽然辅助的短期社会心理干预增强了SUI的短期效果，但SUI和安慰剂的长期（12周）效果相似。其他作用于5-羟色胺系统的药物已经在人体中进行了测试，但结果尚无定论。例如，丁螺环酮，一种5-HT1A受体部分激动剂，可以减少焦虑和酒精渴望，但不能减少AC；5-羟色胺部分激动剂m-CPP增加戒断性酗酒者的渴望；使用5-HT3拮抗剂昂丹司琼（0.5 mg/天，而不是4mg /天）可以观察到AC的适度降低。利坦色林是一种5- ht2拮抗剂，在一项小型（n = 5）研究中，利坦色林降低了饮酒欲望，防止了复发。在另一项研究中，有一些迹象表明，利坦色林在不降低AC的情况下降低了饮酒欲望，增强了酒精效应。目前正在研究这些药物的治疗潜力。SUI和其他改变血清素的药物是治疗AC的有希望的新神经药理学疗法。
The relationship between serotonin neurotransmission and alcohol consumption (AC) was first determined in preclinical studies. AC generally increases following treatments which decrease serotonin activity, and levels of 5-HT and metabolites are low in some brain regions of alcohol-preferring rats. Pharmacological treatments which enhance serotonergic neurotransmission (uptake inhibitors, releasers, agonists) consistently reduce AC in rats. Serotonin uptake inhibitors (SUI; e.g., citalopram, fluoxetine) have been studied extensively in humans. In several double-blind randomized, placebo-controlled trials, SUI consistently decreased short-term (2-4 weeks) AC by averages of 15% to 20% in nondepressed mildly/moderately dependent alcoholics who received no other treatment. Some subjects decreased AC by up to 60%. The effects of SUI on AC were dose-dependent and not related to side effects (few and mild) or changes in anxiety or depression (not observed). SUI decreased desire to drink and liking for alcohol, suggesting a mechanism of action, to be considered in the development of treatments to reduce AC and prevent relapse. However, while an adjunctive brief psychosocial intervention enhanced the short-term effect of a SUI, the long-term (12-week) effects of SUI and placebo were similar. Other drugs acting on the 5-HT system have been tested in humans, but results are inconclusive. For example, buspirone, a 5-HT1A receptor partial agonist, reduced anxiety and alcohol craving, but not AC; a 5-HT partial agonist, m-CPP, increased craving in abstinent alcoholics; modest reductions in AC were observed with a 5-HT3 antagonist, ondansetron (0.5 mg/day, but not 4 mg/day). Ritanserin, a 5-HT2 antagonist, reduced desire to drink and prevented relapse in a small (n = 5) study, and there was some indication that it reduced desire to drink and enhanced alcohol effects without reducing AC, in another study. The therapeutic potential of these medications is being studied. SUI and other serotonin-altering medications are promising new neuropharmacological treatments for AC.