Substitution therapy for alcoholism: time for a reappraisal? (Journal of Psychopharmacology, 2012)
Autoren: Jonathan Chick & David J. Nutt
(pp, 11.10.2014)
Struktur des Inhalts
Abstract im englischen Original
A number of compounds already in use as medications for various indications substitute for ethanol at clinically relevant brain pathways, in
particular, at gamma-aminobutyric acid (GABA) receptors. Nevertheless, although substitute medications have been recognized for heroin and
tobacco dependence, patients with alcohol dependence are rarely offered an analogous approach. Benzodiazepines may have paradoxical
effects, and abuse and dependence are known. Baclofen (GABAB agonist) has not been associated with dependence or misuse and has been effective
in several trials in preventing relapse, although research is required to establish the optimal dosing regimen. GABA-ergic anticonvulsants,
helpful in treating withdrawal, have yet to emerge as effective in relapse prevention. Clomethiazole and sodium oxybate, the latter having been
shown to be effective in relapse prevention, have incurred a reputation for dependence and abuse. However, data have emerged showing that the risk
of abuse of sodium oxybate is lower than many clinicians had foreseen. For a condition where existing therapies are only effective in a proportion
of patients, and which has high morbidity and mortality, the time now seems right for reappraising the use of substitute prescribing for
alcohol dependence.
Link zum englischen Abstract
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Olivier Ameisen hat auf diese Veröffentlichung mit einem „Letter to the Editor“ reagiert, den Sie ebenfalls auf Anfrage bekommen können.
