Emerging approaches to managing alcohol dependence.
Emerging approaches to managing alcohol dependence.
复制标题
管理酒精依赖的新兴方法。
DOI：
10.2146/ajhp060644
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发表时间：
2007
期刊：
影响因子：
--
通讯作者：
R. Swift
中科院分区：
文献类型：
--
作者：
R. Swift
目的
回顾酒精依赖的药物治疗和心理社会干预，包括最大限度地减少不依从性的最新进展。
总结
酒精依赖是一种广泛的慢性疾病，对健康造成巨大影响。心理和行为疗法一直是治疗的主要手段，并被证明是有效的，但它们并不能减少所有患者的饮酒或戒酒。神经生物学的进步导致了药物靶点的确定和治疗酒精依赖的新型药物的开发，许多患者将受益于在治疗方案中加入药物治疗。与心理治疗结合使用的药物治疗选择包括基于厌恶的治疗双硫仑、阿片受体拮抗剂纳洛酮和阿坎酸，阿坎酸被认为通过使谷氨酸和γ-氨基丁酸神经递质系统正常化而起作用。药物治疗的有效性取决于依从性，这在酒精依赖患者中往往很差。最近，纳洛酮的每月缓释制剂已被批准用于酒精依赖，这有望最大限度地减少不依从性，这是酒精依赖管理中的一个问题因素。
结论
药物治疗加心理社会治疗可以提高治疗效果。药物输送机制的进步，如注射剂和缓释制剂，可能会提高酒精依赖患者的药物依从率，从而提高患者的治疗效果。
PURPOSE
To review pharmacotherapies and psychosocial interventions for the treatment of alcohol dependence, including recent developments that may minimize nonadherence.
SUMMARY
Alcohol dependence is a widespread, chronic disorder with enormous health consequences. Psychological and behavioral therapies have been the mainstay of treatment and are demonstrated to be effective, but they do not lead to reduced drinking or abstinence in all patients. Advances in neurobiology have led to the identification of drug targets and the development of novel drugs to treat alcohol dependence, and many patients will benefit from the addition of pharmacotherapy to their treatment regimen. Pharmacologic treatment options for use in conjunction with psychotherapy include the aversion-based therapy disulfiram, the opioid receptor antagonist naltrexone, and acamprosate, which is thought to act by normalizing the glutamate and gamma-aminobutyric acid neurotransmitter systems. The effectiveness of pharmacotherapies depends on adherence, which is often poor in alcohol-dependent patients. Recently, a monthly, extended-release formulation of naltrexone has been approved for alcohol dependence, which promises to minimize nonadherence, a problematic factor in the management of alcohol dependence.
CONCLUSION
Pharmacotherapy added to psychosocial therapy can improve treatment effectiveness. Advances in drug delivery mechanisms, such as injectable and extended-release formulations, may improve medication adherence rates in patients with alcohol dependence, thereby enhancing patient outcomes.
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影响因子：
--
作者：
Volpicelli,JR;Rhines,KC;Rhines,JS;Volpicelli,LA;Alterman,AI;O'Brien,CP
通讯作者：
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DOI：
10.1176/ajp.153.2.281
发表时间：
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期刊：
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影响因子：
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作者：
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DOI：
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发表时间：
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影响因子：
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作者：
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通讯作者：
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DOI：
--
发表时间：
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期刊：
Alcoholism, clinical and experimental research.
影响因子：
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作者：
Fawcett,J;Kravitz,HM;McGuire,M;Easton,M;Ross,J;Pisani,V;Fogg,LF;Clark,D;Whitney,M;Kravitz,G;Javaid,J;Teas,G
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