CBT And Venlafaxine Treatments For Anxiety In Alcoholism

CBT 和文拉法辛治疗酗酒焦虑

• 批准号: 6806477
• 负责人: DOMENIC A CIRAULO
• 金额: $ 49.54万
• 依托单位: BOSTON MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-09-30 至 2008-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6806477
• 关键词: agoraphobia; alcoholism /alcohol abuse; anxiety disorders; clinical research; clinical trials; cognitive behavior therapy; combination therapy; comorbidity; drug /alcohol abstinence; human subject; human therapy evaluation; longitudinal human study; mental disorder chemotherapy; panic disorder; patient oriented research; venlafaxine

DESCRIPTION (provided by applicant): Deficits in anxiety management skills are frequent causes of relapse to alcohol use. Empirical data support the role of anxiety in alcohol relapse. Psychosocial and pharmacological treatments for alcohol problems increasingly address the role of negative affect in alcohol use disorders. Due to the lack of large, well-controlled treatment outcome trials, the optimal treatment (or combination of treatments) remains unknown. Real world practice in the treatment of alcohol use disorders frequently begins brief, intensive detoxification and stabilization, and is often followed by some combination of CBT and pharmacotherapy for patients complaining of mood difficulties while attempting early abstinence from alcohol. The proposed project is written as a "typical clinical practice" test in response to the Program Announcement PA-98-003, and is a fully-controlled trial of a combined anxiety-focused CBT and pharmacotherapy (venlafaxine; CBT-VEN) delivered for patients with comorbid alcohol-use and anxiety disorders. The CBT-VEN package will be administered in three forms depending upon the primary presenting anxiety disorder (i.e., PD, GAD, or SP) and will be contrasted with two single-active treatment conditions (CBT-PLA and REL-VEN), and one fully-controlled condition (relaxation training and placebo medication; REL-PLAC). One hundred and twenty eight participants will be recruited and, subsequent to a platform of intensive outpatient treatment for alcoholism, will be randomly assigned to a 12-week treatment condition. Both conditions will begin with a 1-week placebo run-in, and conclude with a 3-week medication taper. Follow-up assessments will be conducted at post-treatment and at 3, 6, 9, and 12-months. The long-term objectives of this research are to develop a real-world combination of psychosocial and pharmacological treatments for patients with comorbid alcohol-use and anxiety disorders that compromise prognosis, and to evaluate the effectiveness of combined psychosocial and pharmacological treatments that target anxiety among patients with this comorbidity.

描述（由申请人提供）：焦虑管理技能的缺陷是酒精使用复发的常见原因。经验数据支持焦虑在酒精复吸中的作用。心理社会和药物治疗酒精问题越来越多地解决酒精使用障碍的负面影响的作用。由于缺乏大型的、对照良好的治疗结果试验，最佳治疗（或治疗组合）仍然未知。真实的世界实践中，酒精使用障碍的治疗通常从短暂的、密集的解毒和稳定开始，然后通常是CBT和药物治疗的某种组合，用于抱怨情绪困难的患者，同时尝试早期戒酒。拟议的项目被写为响应计划公告PA-98-003的“典型临床实践”测试，并且是一项针对合并酒精使用和焦虑障碍患者的以焦虑为中心的CBT和药物治疗（文拉法辛; CBT-VEN）的完全对照试验。CBT-VEN包将根据原发性焦虑症以三种形式施用（即，PD、GAD或SP），并将与两种单一活性治疗条件（CBT-PLA和EST-VEN）和一种完全对照条件（放松训练和安慰剂药物; EST-PLAC）进行对比。将招募128名参与者，并在酒精中毒的强化门诊治疗平台之后，将随机分配到12周的治疗条件。两种情况都将从1周安慰剂导入期开始开始，并以3周药物逐渐减量结束。将在治疗后以及3、6、9和12个月时进行随访评估。 本研究的长期目标是开发一种现实世界的心理社会和药物治疗的组合，用于合并酒精使用和焦虑障碍的患者，这些患者的预后受到影响，并评估心理社会和药物联合治疗的有效性，这些治疗针对合并酒精使用和焦虑障碍的患者。