Comparing and combining naltrexone and acamprosate in relapse prevention of alcoholism -: A double-blind, placebo-controlled study
Comparing and combining naltrexone and acamprosate in relapse prevention of alcoholism -: A double-blind, placebo-controlled study
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DOI：
10.1001/archpsyc.60.1.92
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发表时间：
2003-01-01
影响因子：
--
通讯作者：
Wiedemann, K
中科院分区：
文献类型：
--
作者：
Kiefer, F;Jahn, H;Wiedemann, K
背景：纳曲酮和阿坎普罗酸通过不同的药理学机制有效预防酒精中毒复发。由于尚不确定这两种物质是否同样有效，以及两种药物联合使用是否会增强疗效，我们进行了首次发表的对照研究，比较和联合使用这两种化合物。方法：解毒后，160例酒精中毒患者参加了一个随机、双盲、安慰剂对照的方案。患者接受纳曲酮、阿坎普罗酸、纳曲酮加阿坎普罗酸或1种安慰剂治疗12周。每周通过访谈、自我报告、问卷调查和实验室筛查对患者进行评估。首次饮酒时间、复发时间和累计戒酒时间是主要的结果测量指标。结果：纳曲酮、阿坎前列酸及联合用药均显著优于安慰剂。比较纳曲酮和阿坎普罗酸之间的非复发率过程，纳曲酮组在首次饮酒时间和复发时间方面表现出更好的结果趋势。联合用药最有效，复发率明显低于安慰剂和阿坎前列酸，但不低于纳曲酮。结论：本研究结果支持药物治疗策略对酒精中毒的疗效。纳曲酮和阿坎前列酸，前列酸，特别是联合使用，大大提高了预防复发的潜力。
Background: Naltrexone and acamprosate have been shown to be effective in relapse prevention of alcoholism via different pharmacologic mechanisms. Since it remains uncertain whether both substances are equally efficient and whether a combination of both drugs potentiates the efficacy, we conducted the first published controlled study comparing and combining both compounds.Methods: After detoxification, 160 patients with alcoholism participated in a randomized, double-blind, placebo-controlled protocol. Patients received naltrexone, acamprosate, naltrexone plus acamprosate, or 1 placebo for 12 weeks. Patients were assessed weekly by interview, self-report, questionnaires, and laboratory screening. Time to first drink, time to relapse, and the cumulative abstinence time were the primary outcome measures.Results: Naltrexone, acamprosate, and the combined medication were significantly more effective than placebo. Comparing the course of non relapse rates between naltrexone and acamprosate, the naltrexone group showed a tendency for a better outcome regarding time to first drink and time to relapse. The combined medication was most effective with significantly lower relapse rates than placebo and acamprosate but not naltrexone.Conclusions: The, results of this study support the efficacy of pharmacotherapeutic strategies in the rela of alcoholism. Naltrexone and acamprosate, prosate, especially in combination, considerably enhance the potential of relapse prevention.