Acamprosate。回顾其药理学和临床潜在的解毒后的酒精依赖管理。
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王尔德MI,瓦格斯塔夫AJ
Acamprosate。回顾其药理学和临床潜在的解毒后的酒精依赖管理。
药。1997年6月,53 (6):1038 - 53。
- PubMed ID
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9179530 (在PubMed]
- 文摘
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Acamprosate(钙acetylhomotaurinate),合成化合物与γ-氨基丁酸的相似的化学结构,通过几种机制被认为行为影响多个神经递质系统;抑制拮抗兴奋性氨基酸的神经兴奋过度活动和减少钙离子通量被建议作为其主要的作用机制。药物是第一个代理专门设计来保持禁欲酒精(乙醇)解毒后端依赖患者。自愿口服乙醇消费ethanol-preferring或ethanol-dependent老鼠是剂量依赖性降低acamprosate:液体摄入量和食物消费总量不受影响。药物不加强的急性或慢性毒性影响乙醇和没有催眠,抗抑郁、抗焦虑药或在动物肌肉松弛剂的影响。目前没有证据表明与acamprosate滥用潜力。口服acamprosate 1.3或2 g /天,分3次服用3到12个月后酒精依赖症患者解毒是比安慰剂更有效防止酒精复发根据禁欲率,持续时间禁欲,gamma-glutamyl转移酶水平和/或各种其他临床或生物端点。伴随的心理/行为疗法被用于一些试验。与安慰剂组相比,上级禁欲利率和期限的禁欲acamprosate期间维持6至12个月的治疗后的随访时间,和更大的禁欲率与acamprosate被确认来自11个随机安慰剂对照试验的数据汇总分析涉及酒精依赖患者共计3338。acamprosate似乎是剂量依赖性的功效和增强的戒酒硫。 Acamprosate was generally well tolerated in placebo-controlled trials. The most common adverse events were gastrointestinal (especially diarrhoea) or dermatological and were mostly mild and transient. The percentage of patient withdrawals because of adverse events was similar in acamprosate and placebo groups. No trials have compared the efficacy or tolerability of acamprosate with those of other treatment approaches (including opiate antagonists or selective serotonin reuptake inhibitors) aimed at maintaining abstinence in detoxified alcohol-dependent patients. Thus, acamprosate, as an adjunct to psychosocial/behavioural therapies, represents a novel advance for the management of alcohol-dependent patients in the postdetoxification period. Longer term and comparative trials with other active therapies are required to confirm these promising results.
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- 药物