Randomized double-blind pilot trial of gabapentin versus placebo to treat alcohol dependence and comorbid insomnia
Randomized double-blind pilot trial of gabapentin versus placebo to treat alcohol dependence and comorbid insomnia
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DOI：
10.1111/j.1530-0277.2008.00706.x
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发表时间：
2008-08-01
影响因子：
3.2
通讯作者：
Zucker, Robert A.
中科院分区：
文献类型：
--
作者：
Brower, Kirk J.;Kim, Hyungjin Myra;Zucker, Robert A.
背景：失眠和其他睡眠障碍是常见的，持续的，并与酒精依赖患者复发。这个试点研究的目的是比较加巴喷丁与安慰剂的治疗失眠和预防复发的酒精依赖patients.Methods：21名受试者，其中包括10名妇女谁符合研究标准的酒精依赖和失眠，并表示希望戒酒，被招募到这项研究。在1至2周的安慰剂导入和筛选阶段，进行完整的病史、体格检查、血液检查、尿液药物检查和结构化访谈，以确定饮酒和睡眠的资格和模式。由于中毒或急性戒断、精神病或内科疾病、药物和其他睡眠障碍引起的不适被排除。然后，受试者随机接受安慰剂（n = 11）或加巴喷丁（n = 10）治疗6周，并在10天内滴定至1,500 mg或睡前5片。经过4天的锥度，受试者进行了重新评估6周后结束treatment.Results：加巴喷丁显着延迟发作，大量饮酒，效果持续6周后，治疗结束。在两个治疗组在药物治疗阶段的inflammatory改善，但加巴喷丁对睡眠没有差异的影响，无论是主观报告或polysomnography.Conclusion测量：由于加巴喷丁是一种短效药物，仅在夜间在这项研究中，它可能会发挥夜间的作用，防止复发酗酒的生理机制，而不是在这个试点研究。
Background: Insomnia and other sleep disturbances are common, persistent, and associated with relapse in alcohol-dependent patients. The purpose of this pilot Study was to compare gabapentin versus placebo for the treatment of insomnia and prevention of relapse in alcohol-dependent patients.Methods: Twenty-one subjects, including 10 women who met study criteria for alcohol dependence and insomnia and expressed a desire to abstain from alcohol, were recruited to the study. During a 1 to 2 week placebo lead-in and screening phase, a complete medical history, physical exam, blood tests, urine drug test, and structured interviews were performed to determine eligibility and patterns of alcohol use and sleep. Insomnia due to intoxication or acute withdrawal, psychiatric or medical illness, medications, and other sleep disorders were ruled out. Subjects were then randomized to either placebo (n = 11) or gabapentin (n = 10) for 6 weeks and titrated over a 10-day period to 1,500 mg or 5 pills at bedtime. After a 4-day taper, subjects were reassessed 6 weeks after ending treatment.Results: Gabapentin significantly delayed the onset to heavy drinking, an effect which persisted for 6 weeks after treatment ended. Insomnia improved in both treatment groups during the medication phase, but gabapentin had no differential effects on sleep as measured by either Subjective report or polysomnography.Conclusion: Because gabapentin is a short-acting medication that was taken only at nighttime in this study, it may possibly exert a nocturnal effect that prevents relapse to heavy drinking by a physiological mechanism not measured in this pilot study.