Gabapentin Combined With Naltrexone for the Treatment of Alcohol Dependence
Gabapentin Combined With Naltrexone for the Treatment of Alcohol Dependence
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DOI：
10.1176/appi.ajp.2011.10101436
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发表时间：
2011-07-01
影响因子：
17.7
通讯作者：
Randall, Patrick K.
中科院分区：
文献类型：
--
作者：
Anton, Raymond F.;Myrick, Hugh;Randall, Patrick K.
目的：纳洛酮是一种有效的酒精依赖药物，但并非对所有人都有效。在早期戒断期间最明显的失眠和情绪不稳定等症状可能对不同的药物治疗反应更好。加巴喷丁可以减轻这些症状，并有助于防止早期复发。这项临床试验评估了在早期戒酒阶段，纳洛酮和加巴喷丁联合治疗是否优于纳洛酮单药和/或安慰剂（前6周），如果是，这种影响是否持续。方法：共有150名酒精依赖者被随机分配到一个16周的疗程，（50 mg/天[N= 50]），纳洛酮（50 mg/天）加加巴喷丁（高达1，200 mg/天[N= 50]），或双重安慰剂（N= 50）。结果：在前6周内，纳洛酮加巴喷丁组与纳洛酮单药组相比，出现重度饮酒的时间间隔较长，而纳洛酮单药组与安慰剂组相比，出现重度饮酒的时间间隔相似，出现重度饮酒的天数少于纳洛酮单药组，而纳洛酮单药组则多于安慰剂组，加巴喷丁组与纳洛酮单药组相比，出现重度饮酒的时间间隔较长，而纳洛酮单药组与安慰剂组相比，出现重度饮酒的时间间隔较短。每天饮酒量少于单用纳洛酮组和安慰剂组。这些差异在剩下的几周研究中逐渐消失。睡眠不佳与更多的饮酒在纳洛酮单独组，但不是在纳洛酮加巴喷丁组，而酒精戒断的历史与更好的反应在纳洛酮加巴喷丁group.Conclusions：除了加巴喷丁纳洛酮改善饮酒的结果，在第一个6周停止饮酒后单独纳洛酮。加巴喷丁停药后，这种作用没有持续。
Objective: Naltrexone, an efficacious medication for alcohol dependence, does not work for everyone. Symptoms such as insomnia and mood instability that are most evident during early abstinence might respond better to a different pharmacotherapy. Gabapentin may reduce these symptoms and help prevent early relapse. This clinical trial evaluated whether the combination of naltrexone and gabapentin was better than naltrexone alone and/or placebo during the early drinking cessation phase (first 6 weeks), and if so, whether this effect persisted.Method: A total of 150 alcohol-dependent individuals were randomly assigned to a 16-week course of naltrexone alone (50 mg/day [N= 50]), naltrexone (50 mg/day) with gabapentin (up to 1,200 mg/day [N= 50]) added for the first 6 weeks, or double placebo (N= 50). All participants received medical management.Results: During the first 6 weeks, the naltrexone-gabapentin group had a longer interval to heavy drinking than the naltrexone-alone group, which had an interval similar to that of the placebo group; had fewer heavy drinking days than the naltrexone-alone group, which in turn had more than the placebo group; and had fewer drinks per drinking day than the naltrexonealone group and the placebo group. These differences faded over the remaining weeks of the study. Poor sleep was associated with more drinking in the naltrexone-alone group but not in the naltrexone-gabapentin group, while a history of alcohol withdrawal was associated with better response in the naltrexone-gabapentin group.Conclusions: The addition of gabapentin to naltrexone improved drinking outcomes over naltrexone alone during the first 6 weeks after cessation of drinking. This effect did not endure after gabapentin was discontinued.