Comparing topiramate with naltrexone in the treatment of alcohol dependence
Comparing topiramate with naltrexone in the treatment of alcohol dependence
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DOI：
10.1111/j.1360-0443.2008.02355.x
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发表时间：
2008-12-01
期刊：
影响因子：
6
通讯作者：
de Andrade, Arthur Guerra
中科院分区：
文献类型：
--
作者：
Baltieri, Danilo Antonio;Daro, Fabio Ruiz;de Andrade, Arthur Guerra
比较托吡酯与纳曲酮治疗酒精依赖的疗效。该调查是一项在巴西圣保罗大学进行的双盲、安慰剂对照、为期 12 周的研究。共有 155 名患者，年龄 18-60 岁，经国际疾病分类 (ICD-10) 诊断为酒精依赖。经过 1 周的戒毒期后，患者被随机分配接受托吡酯治疗（诱导至 300 毫克/天）、纳曲酮（50 毫克/天）或安慰剂。首次复发时间（摄入 > 60 克乙醇）、累积戒酒持续时间和重度饮酒周数。在意向治疗分析中，托吡酯在多项指标上均优于安慰剂，包括首次复发时间（7.8 周与 5.0 周）、累积戒酒时间（8.2 周与 5.6 周）、重度饮酒周数（3.4 比 5.9）以及 4 周（67.3 比 42.6）和 8 周（61.5 比 31.5）但不是 12 周（46.2 比 27.8）时戒酒的受试者百分比。在控制戒酒互诫协会的出席率后，结果仍然显着，托吡酯组的出席率高于其他组。纳曲酮与安慰剂组或纳曲酮与托吡酯组之间没有显着差异，但与托吡酯相比，纳曲酮显示出结局较差的趋势。本研究的结果支持托吡酯在预防酒精中毒复发方面的功效。还获得了托吡酯相对于纳曲酮的优越性的提示性证据，但这需要在未来更大样本量的研究中进行验证。
To compare the efficacy of topiramate with naltrexone in the treatment of alcohol dependence.The investigation was a double-blind, placebo-controlled, 12-week study carried out at the University of Sao Paulo, Brazil.A total of 155 patients, 18-60 years of age, with an International Classification of Diseases (ICD-10) diagnosis of alcohol dependence.After a 1-week detoxification period, patients were assigned randomly to receive topiramate (induction to 300 mg/day), naltrexone (50 mg/day) or placebo.Time to first relapse (consumption of > 60 g ethyl alcohol), cumulative abstinence duration and weeks of heavy drinking.In intention-to-treat analyses, topiramate was statistically superior to placebo on a number of measures including time to first relapse (7.8 versus 5.0 weeks), cumulative abstinence duration (8.2 versus 5.6 weeks), weeks of heavy drinking (3.4 versus 5.9) and percentage of subjects abstinent at 4 weeks (67.3 versus 42.6) and 8 weeks (61.5 versus 31.5), but not 12 weeks (46.2 versus 27.8). Results remained significant after controlling for Alcoholics Anonymous attendance, which was higher in topiramate than in other groups. There were no significant differences between naltrexone versus placebo or naltrexone versus topiramate groups, but naltrexone showed trends toward inferior outcomes when compared to topiramate.The results of this study support the efficacy of topiramate in the relapse prevention of alcoholism. Suggestive evidence was also obtained for superiority of topiramate versus naltrexone, but this needs to be verified in future research with larger sample sizes.