Naltrexone effects on alcohol consumption in a clinical laboratory paradigm: temporal effects of drinking
Naltrexone effects on alcohol consumption in a clinical laboratory paradigm: temporal effects of drinking
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DOI：
10.1007/s00213-003-1720-7
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发表时间：
2004-04-01
影响因子：
3.4
通讯作者：
Moak, D
中科院分区：
文献类型：
--
作者：
Anton, RF;Drobes, DJ;Moak, D
背景这项临床实验室研究评估了阿片类拮抗剂纳洛酮如何影响饮酒时间和对酒精的主观反应。方法. 40名非寻求治疗的酗酒者被随机分配到50 mg纳洛酮或匹配的安慰剂治疗7天。在第7天，他们在酒吧般的环境中被给予酒精的“初始饮料”（血液酒精水平在20和30 mg%之间）。以随机方式，每组（纳洛酮和安慰剂）中一半的受试者在2小时内立即或延迟（40分钟）获得多达8种额外的迷你饮料。在延迟组中，在获得更多饮料之前测量对酒精的主观反应。结果在直接接触条件下，受试者有相似的饮酒模式，无论他们是否服用纳洛酮或安慰剂。然而，在延迟条件下，纳洛酮治疗的受试者饮酒较少，饮酒进展较慢。酒精诱导的刺激与安慰剂受试者的饮酒次数呈正相关，但与纳洛酮受试者呈负相关。结论.这些数据表明，纳洛酮对酒精消费的有效性可能在某种程度上取决于消费模式。由于纳洛酮似乎破坏了酒精诱导的刺激和进一步饮酒之间的联系，因此酗酒者从其影响中获益所需的饮料之间可能存在一个关键的时间段。这些发现与临床试验数据一致，表明复发预防治疗和阿片拮抗剂药物治疗之间存在潜在的协同作用。
Background. This clinical laboratory study evaluated how the timing of drinking and subjective responses to alcohol are effected by the opioid antagonist naltrexone. Methods. Forty non-treatment seeking alcoholics were randomly assigned to treatment with 50 mg naltrexone or matching placebo for 7 days. On day 7, they were administered an "initial drink" of alcohol (blood alcohol levels of between 20 and 30 mg%) in a bar-like setting. In a random fashion, half of the subjects in each group (naltrexone and placebo) had either immediate or delayed (40 min) access to up to 8 additional mini-drinks over a 2-h period. In the delayed group subjective reactions to alcohol were measured prior to access to more drinks. Results. In the immediate access condition, subjects had similar drinking patterns, irrespective of whether they were taking naltrexone or placebo. However, in the delayed condition, naltrexone-treated subjects consumed fewer drinks and had a slower progression of drinking. There was a positive relationship between alcohol-induced stimulation and the number of drinks consumed in the placebo subjects but a negative correlation in the naltrexone subjects. Conclusions. These data suggest that the effectiveness of naltrexone on alcohol consumption may be somewhat dependent on pattern of consumption. Since naltrexone seems to disrupt the connection between alcohol-induced stimulation and further alcohol consumption, there may be a time-critical period between drinks necessary for alcoholics to benefit from its effects. These findings are consistent with clinical trial data that suggest a potential synergistic effect between relapse prevention therapies and opiate antagonist pharmacotherapy.