Naltrexone for the management of alcohol dependence
Naltrexone for the management of alcohol dependence
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DOI：
10.1056/nejmct0801733
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发表时间：
2008-08-14
影响因子：
158.5
通讯作者：
Anton, Raymond F.
中科院分区：
文献类型：
--
作者：
Anton, Raymond F.
一位有高血压病史的44岁商人在接受评估时报告说，他在工作和家庭中承受着压力，这导致了“不满意”的睡眠。虽然有一些沮丧，筛查抑郁症是消极的。他的血压是158/ 98毫米汞柱。实验室检查结果包括平均红细胞体积为102 fl（正常范围，80 - 100），丙氨酸转氨酶水平为60 U/L（正常范围，7 - 41），天冬氨酸转氨酶水平为45 U/L（正常范围，12 - 38），γ-谷氨酰转移酶水平为110 U/L（正常范围，9 - 58）。他的医生询问了他的饮酒情况，病人承认，也许他喝得“比他应该喝的多”，因为他经常宿醉醒来，上班迟到。周末打完高尔夫球后，他醉醺醺地回到家，导致与妻子争吵，在孩子们面前尴尬。他一直在静静地思考是否需要减少或停止饮酒，并希望得到一些建议。他的医生讨论药物治疗或转诊到酒精诊所进行进一步评估。纳洛酮被提议作为一种治疗选择。
A 44- year-old businessman with a history of hypertension presents for evaluation with a report of being under stress at work and home, which has led to "unsatisfactory" sleep. Although there is some despondency, screening for depression is negative. His blood pressure is 158/ 98 mm Hg. Laboratory results include a mean corpuscular volume of 102 fl ( normal range, 80 to 100), an alanine aminotransferase level of 60 U per liter ( normal range, 7 to 41), an aspartate aminotransferase level of 45 U per liter ( normal range, 12 to 38), and a gamma-glutamyltransferase level of 110 U per liter ( normal range, 9 to 58). His physician asks about alcohol consumption, and the patient admits that perhaps he drinks "more than he should," since he often wakes up with a hangover and arrives late to work. After weekend golf outings, he comes home intoxicated, leading to arguments with his wife and embarrassment in front of his children. He has been quietly wondering about the need to cut down or stop drinking and wants some advice. His physician discusses medication or a referral to an alcohol clinic for further evaluation. Naltrexone is proposed as a treatment option.