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Erschienen in: InFo Neurologie + Psychiatrie 12/2023

15.12.2023 | Sucht | Zertifizierte Fortbildung Psychatrie

Suchttherapie

Anticraving-Substanzen in der Therapie der Alkoholabhängigkeit

verfasst von: Dr. med. Johannes Kramer, PD Dr. med. Gabriele Koller, Prof. Dr. med. Oliver Pogarell

Erschienen in: InFo Neurologie + Psychiatrie | Ausgabe 12/2023

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Suchterkrankungen sind weltweit eine bedeutende sozialmedizinische Herausforderung. Sie können nicht nur unmittelbar zu schweren, oft dauerhaften Beeinträchtigungen der psychischen und körperlichen Gesundheit führen, sondern sind auch in hohem Maß mit komorbiden psychischen und körperlichen Störungen assoziiert. Pharmakotherapeutische Strategien können zur Abstinenzaufrechterhaltung und Prognoseverbesserung eine wichtige Ergänzung darstellen.
Literatur
1.
Zurück zum Zitat Rauschert C et al. The use of psychoactive substances in Germany. Dtsch Arztebl Int. 2022;119(31-32):527-34 Rauschert C et al. The use of psychoactive substances in Germany. Dtsch Arztebl Int. 2022;119(31-32):527-34
2.
Zurück zum Zitat Deutsche Hauptstelle für Suchtfragen e.V. Das DHS Jahrbuch Sucht 2023. Pabst Science Publishers; 2023 Deutsche Hauptstelle für Suchtfragen e.V. Das DHS Jahrbuch Sucht 2023. Pabst Science Publishers; 2023
3.
Zurück zum Zitat World Health Organization (2021). Internationale statistische Klassifikation der Krankheiten und verwandter Gesundheitsprobleme, 10. Revision, German Modification, Version 2021, mit Aktualisierungen vom 11.11.2020 und 10.03.2021. In: Bundesinstitut für Arzneimittel und Medizinprodukte World Health Organization (2021). Internationale statistische Klassifikation der Krankheiten und verwandter Gesundheitsprobleme, 10. Revision, German Modification, Version 2021, mit Aktualisierungen vom 11.11.2020 und 10.03.2021. In: Bundesinstitut für Arzneimittel und Medizinprodukte
4.
Zurück zum Zitat Deutsche Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde (Dgppn), Deutsche Gesellschaft für Suchtforschung und Suchttherapie e.V. (Dg-Sucht) (2021). S3 Leitlinie „Screening, Diagnose und Behandlung alkoholbezogener Störungen”. In: Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften Deutsche Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde (Dgppn), Deutsche Gesellschaft für Suchtforschung und Suchttherapie e.V. (Dg-Sucht) (2021). S3 Leitlinie „Screening, Diagnose und Behandlung alkoholbezogener Störungen”. In: Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften
5.
Zurück zum Zitat Yeung EW, Craggs JG, Gizer IR. Comorbidity of alcohol use disorder and chronic pain: Genetic influences on brain reward and stress systems. Alcohol Clin Exp Res. 2017;1831-48 Yeung EW, Craggs JG, Gizer IR. Comorbidity of alcohol use disorder and chronic pain: Genetic influences on brain reward and stress systems. Alcohol Clin Exp Res. 2017;1831-48
6.
Zurück zum Zitat Soyka M et al. Guidelines for biological treatment of substance use and related disorders, part 1: Alcoholism, first revision. World J Biol Psychiatry. 2017;86-119 Soyka M et al. Guidelines for biological treatment of substance use and related disorders, part 1: Alcoholism, first revision. World J Biol Psychiatry. 2017;86-119
7.
Zurück zum Zitat Sliedrecht W et al. Alcohol use disorder relapse factors: A systematic review. Psychiatry Res. 2019;97-115 Sliedrecht W et al. Alcohol use disorder relapse factors: A systematic review. Psychiatry Res. 2019;97-115
8.
Zurück zum Zitat Heinz A et al. Reward craving and withdrawal relief craving: assessment of different motivational pathways to alcohol intake. Alcohol Alcohol. 2003;35-9 Heinz A et al. Reward craving and withdrawal relief craving: assessment of different motivational pathways to alcohol intake. Alcohol Alcohol. 2003;35-9
9.
Zurück zum Zitat Littleton J. Acamprosate in alcohol dependence: how does it work? Addiction. 1995;1179-88 Littleton J. Acamprosate in alcohol dependence: how does it work? Addiction. 1995;1179-88
10.
Zurück zum Zitat Spanagel R et al. The clock gene Per2 influences the glutamatergic system and modulates alcohol consumption. Nat Med. 2005;35-42 Spanagel R et al. The clock gene Per2 influences the glutamatergic system and modulates alcohol consumption. Nat Med. 2005;35-42
11.
Zurück zum Zitat Rosner S et al. Acamprosate for alcohol dependence. Cochrane Database Syst Rev. 2010;CD004332 Rosner S et al. Acamprosate for alcohol dependence. Cochrane Database Syst Rev. 2010;CD004332
12.
Zurück zum Zitat Sass H et al. Relapse prevention by acamprosate. Results from a placebo-controlled study on alcohol dependence. Arch Gen Psychiatry. 1996;673-680 Sass H et al. Relapse prevention by acamprosate. Results from a placebo-controlled study on alcohol dependence. Arch Gen Psychiatry. 1996;673-680
13.
Zurück zum Zitat O'malley SS, Froehlich JC. Advances in the use of naltrexone: an integration of preclinical and clinical findings. Recent Dev Alcohol. 2003;217-45 O'malley SS, Froehlich JC. Advances in the use of naltrexone: an integration of preclinical and clinical findings. Recent Dev Alcohol. 2003;217-45
14.
Zurück zum Zitat Bouza C et al. Efficacy and safety of naltrexone and acamprosate in the treatment of alcohol dependence: a systematic review. Addiction. 2004;811-28 Bouza C et al. Efficacy and safety of naltrexone and acamprosate in the treatment of alcohol dependence: a systematic review. Addiction. 2004;811-28
15.
Zurück zum Zitat Rosner S et al. Acamprosate supports abstinence, naltrexone prevents excessive drinking: evidence from a meta-analysis with unreported outcomes. J Psychopharmacol. 2008; 11-23 Rosner S et al. Acamprosate supports abstinence, naltrexone prevents excessive drinking: evidence from a meta-analysis with unreported outcomes. J Psychopharmacol. 2008; 11-23
16.
Zurück zum Zitat Maisel NC, Blodgett JC, Wilbourne PL et al. Meta-analysis of naltrexone and acamprosate for treating alcohol use disorders: when are these medications most helpful? Addiction. 2013;275-93 Maisel NC, Blodgett JC, Wilbourne PL et al. Meta-analysis of naltrexone and acamprosate for treating alcohol use disorders: when are these medications most helpful? Addiction. 2013;275-93
17.
Zurück zum Zitat Kiefer F et al. Comparing and combining naltrexone and acamprosate in relapse prevention of alcoholism: a double-blind, placebo-controlled study. Arch Gen Psychiatry. 2003;92-9 Kiefer F et al. Comparing and combining naltrexone and acamprosate in relapse prevention of alcoholism: a double-blind, placebo-controlled study. Arch Gen Psychiatry. 2003;92-9
18.
Zurück zum Zitat Arias AJ et al. Effects of opioid receptor gene variation on targeted nalmefene treatment in heavy drinkers. Alcohol Clin Exp Res. 2008;1159-66 Arias AJ et al. Effects of opioid receptor gene variation on targeted nalmefene treatment in heavy drinkers. Alcohol Clin Exp Res. 2008;1159-66
19.
Zurück zum Zitat Soyka M, Rosner S. Nalmefene for treatment of alcohol dependence. Expert Opin Investig Drugs. 2010; 1451-9 Soyka M, Rosner S. Nalmefene for treatment of alcohol dependence. Expert Opin Investig Drugs. 2010; 1451-9
20.
Zurück zum Zitat Mann K, Bladstrom A, Torup L et al. Extending the treatment options in alcohol dependence: a randomized controlled study of as-needed nalmefene. Biol Psychiatry. 2013;706-13 Mann K, Bladstrom A, Torup L et al. Extending the treatment options in alcohol dependence: a randomized controlled study of as-needed nalmefene. Biol Psychiatry. 2013;706-13
21.
Zurück zum Zitat Goodman A. Neurobiology of addiction. An integrative review. Biochem Pharmacol. 2008;266-322 Goodman A. Neurobiology of addiction. An integrative review. Biochem Pharmacol. 2008;266-322
22.
Zurück zum Zitat Nutt D et al. Alcohol and the Brain. Nutrients. 2021; doi: 10.3390/nu13113938 Nutt D et al. Alcohol and the Brain. Nutrients. 2021; doi: 10.3390/nu13113938
23.
Zurück zum Zitat Johnson BA. Role of the serotonergic system in the neurobiology of alcoholism: implications for treatment. CNS Drugs. 2004;1105-18 Johnson BA. Role of the serotonergic system in the neurobiology of alcoholism: implications for treatment. CNS Drugs. 2004;1105-18
24.
Zurück zum Zitat Mann K. Pharmacotherapy of alcohol dependence: a review of the clinical data. CNS Drugs. 2004;485-504 Mann K. Pharmacotherapy of alcohol dependence: a review of the clinical data. CNS Drugs. 2004;485-504
25.
Zurück zum Zitat Nunes EV, Levin FR. Treatment of co-occurring depression and substance dependence: Using meta-analysis to guide clinical recommendations. Psychiatr Ann. 2008;38(11):nihpa128505 Nunes EV, Levin FR. Treatment of co-occurring depression and substance dependence: Using meta-analysis to guide clinical recommendations. Psychiatr Ann. 2008;38(11):nihpa128505
26.
Zurück zum Zitat Hashimoto E et al. Influence of comorbid alcohol use disorder on treatment response of depressive patients. J Neural Transm (Vienna). 2015;301-6 Hashimoto E et al. Influence of comorbid alcohol use disorder on treatment response of depressive patients. J Neural Transm (Vienna). 2015;301-6
27.
Zurück zum Zitat Johnson BA et al. Ondansetron for reduction of drinking among biologically predisposed alcoholic patients: A randomized controlled trial. JAMA. 2000;963-71 Johnson BA et al. Ondansetron for reduction of drinking among biologically predisposed alcoholic patients: A randomized controlled trial. JAMA. 2000;963-71
28.
Zurück zum Zitat Johnson BA et al. Ondansetron reduces the craving of biologically predisposed alcoholics. Psychopharmacology (Berl). 2002;408-13 Johnson BA et al. Ondansetron reduces the craving of biologically predisposed alcoholics. Psychopharmacology (Berl). 2002;408-13
29.
Zurück zum Zitat Moore CF et al. Acute and chronic administration of a low-dose combination of topiramate and ondansetron reduces ethanol's reinforcing effects in male alcohol preferring (P) rats. Exp Clin Psychopharmacol. 2014; 35-42 Moore CF et al. Acute and chronic administration of a low-dose combination of topiramate and ondansetron reduces ethanol's reinforcing effects in male alcohol preferring (P) rats. Exp Clin Psychopharmacol. 2014; 35-42
30.
Zurück zum Zitat Lynch WJ et al. Severity of drinking as a predictor of efficacy of the combination of ondansetron and topiramate in rat models of ethanol consumption and relapse. Psychopharmacology (Berl). 2011;3-12 Lynch WJ et al. Severity of drinking as a predictor of efficacy of the combination of ondansetron and topiramate in rat models of ethanol consumption and relapse. Psychopharmacology (Berl). 2011;3-12
31.
Zurück zum Zitat Johnson BA. Update on neuropharmacological treatments for alcoholism: scientific basis and clinical findings. Biochem Pharmacol. 2008;34-56 Johnson BA. Update on neuropharmacological treatments for alcoholism: scientific basis and clinical findings. Biochem Pharmacol. 2008;34-56
32.
Zurück zum Zitat Johnson BA et al. Topiramate for treating alcohol dependence: a randomized controlled trial. JAMA. 2007;1641-51 Johnson BA et al. Topiramate for treating alcohol dependence: a randomized controlled trial. JAMA. 2007;1641-51
33.
Zurück zum Zitat Pani PP et al. Anticonvulsants for alcohol dependence. Cochrane Database Syst Rev. 2014;2014(2):CD008544 Pani PP et al. Anticonvulsants for alcohol dependence. Cochrane Database Syst Rev. 2014;2014(2):CD008544
34.
Zurück zum Zitat Heinz A et al. Correlation of alcohol craving with striatal dopamine synthesis capacity and D2/3 receptor availability: a combined [18F]DOPA and [18F]DMFP PET study in detoxified alcoholic patients. Am J Psychiatry. 2005; 1515-20 Heinz A et al. Correlation of alcohol craving with striatal dopamine synthesis capacity and D2/3 receptor availability: a combined [18F]DOPA and [18F]DMFP PET study in detoxified alcoholic patients. Am J Psychiatry. 2005; 1515-20
35.
Zurück zum Zitat Volkow ND. Imaging the addicted brain: from molecules to behavior. J Nucl Med. 2004;45(11):13N-16N, 19N-20N, 22N passim Volkow ND. Imaging the addicted brain: from molecules to behavior. J Nucl Med. 2004;45(11):13N-16N, 19N-20N, 22N passim
36.
Zurück zum Zitat Kishi T et al. Antipsychotics for primary alcohol dependence: a systematic review and meta-analysis of placebo-controlled trials. J Clin Psychiatry. 2013;e642-54 Kishi T et al. Antipsychotics for primary alcohol dependence: a systematic review and meta-analysis of placebo-controlled trials. J Clin Psychiatry. 2013;e642-54
37.
Zurück zum Zitat Croissant B et al. Quetiapine in relapse prevention in alcoholics suffering from craving and affective symptoms: a case series. Eur Psychiatry. 2006;570-3 Croissant B et al. Quetiapine in relapse prevention in alcoholics suffering from craving and affective symptoms: a case series. Eur Psychiatry. 2006;570-3
38.
Zurück zum Zitat Martinotti G et al. Quetiapine decreases alcohol consumption, craving, and psychiatric symptoms in dually diagnosed alcoholics. Hum Psychopharmacol. 2008;417-24 Martinotti G et al. Quetiapine decreases alcohol consumption, craving, and psychiatric symptoms in dually diagnosed alcoholics. Hum Psychopharmacol. 2008;417-24
39.
Zurück zum Zitat Guardia J et al. A double-blind, placebo-controlled, randomized pilot study comparing quetiapine with placebo, associated to naltrexone, in the treatment of alcohol-dependent patients. Addict Behav. 2011;265-9 Guardia J et al. A double-blind, placebo-controlled, randomized pilot study comparing quetiapine with placebo, associated to naltrexone, in the treatment of alcohol-dependent patients. Addict Behav. 2011;265-9
40.
Zurück zum Zitat Voronin K et al. Aripiprazole effects on alcohol consumption and subjective reports in a clinical laboratory paradigm - possible influence of self-control. Alcohol Clin Exp Res. 2008;1954-61 Voronin K et al. Aripiprazole effects on alcohol consumption and subjective reports in a clinical laboratory paradigm - possible influence of self-control. Alcohol Clin Exp Res. 2008;1954-61
41.
Zurück zum Zitat Anton RF et al. Aripiprazole suppression of drinking in a clinical laboratory paradigm: Influence of impulsivity and self-control. Alcohol Clin Exp Res. 2017;1370-80 Anton RF et al. Aripiprazole suppression of drinking in a clinical laboratory paradigm: Influence of impulsivity and self-control. Alcohol Clin Exp Res. 2017;1370-80
42.
Zurück zum Zitat Fischler PV et al. Off-label and investigational drugs in the treatment of alcohol use disorder: A critical review. Front Pharmacol. 2022;927703 Fischler PV et al. Off-label and investigational drugs in the treatment of alcohol use disorder: A critical review. Front Pharmacol. 2022;927703
43.
Zurück zum Zitat Soyka M et al. Cannabinoid receptor 1 blocker rimonabant (SR 141716) for treatment of alcohol dependence: results from a placebo-controlled, double-blind trial. J Clin Psychopharmacol. 2008;317-24 Soyka M et al. Cannabinoid receptor 1 blocker rimonabant (SR 141716) for treatment of alcohol dependence: results from a placebo-controlled, double-blind trial. J Clin Psychopharmacol. 2008;317-24
44.
Zurück zum Zitat Addolorato G et al. Role of the GABA(B) receptor system in alcoholism and stress: focus on clinical studies and treatment perspectives. Alcohol. 2009;559-63 Addolorato G et al. Role of the GABA(B) receptor system in alcoholism and stress: focus on clinical studies and treatment perspectives. Alcohol. 2009;559-63
45.
Zurück zum Zitat Addolorato G et al. Effectiveness and safety of baclofen for maintenance of alcohol abstinence in alcohol-dependent patients with liver cirrhosis: randomised, double-blind controlled study. Lancet. 2007;1915-22 Addolorato G et al. Effectiveness and safety of baclofen for maintenance of alcohol abstinence in alcohol-dependent patients with liver cirrhosis: randomised, double-blind controlled study. Lancet. 2007;1915-22
46.
Zurück zum Zitat Ameisen O. Treatment of alcohol-use disorders. Lancet. 2009;1519; author reply 1519-20 Ameisen O. Treatment of alcohol-use disorders. Lancet. 2009;1519; author reply 1519-20
47.
Zurück zum Zitat Agabio R et al. Baclofen for alcohol use disorder. Cochrane Database Syst Rev. 2023; CD012557 Agabio R et al. Baclofen for alcohol use disorder. Cochrane Database Syst Rev. 2023; CD012557
48.
Zurück zum Zitat Skinner MD et al. Disulfiram efficacy in the treatment of alcohol dependence: a meta-analysis. PLoS One. 2014; e87366 Skinner MD et al. Disulfiram efficacy in the treatment of alcohol dependence: a meta-analysis. PLoS One. 2014; e87366
49.
Zurück zum Zitat Mutschler J et al. Supervised disulfiram in relapse prevention in alcohol-dependent patients suffering from comorbid borderline personality disorder--a case series. Alcohol Alcohol. 2010; 146-50 Mutschler J et al. Supervised disulfiram in relapse prevention in alcohol-dependent patients suffering from comorbid borderline personality disorder--a case series. Alcohol Alcohol. 2010; 146-50
50.
Zurück zum Zitat Brewer C, Streel E. Learning the language of abstinence in addiction treatment: some similarities between relapse-prevention with disulfiram, naltrexone, and other pharmacological antagonists and intensive „immersion” methods of foreign language teaching. Subst Abus. 2003;157-73 Brewer C, Streel E. Learning the language of abstinence in addiction treatment: some similarities between relapse-prevention with disulfiram, naltrexone, and other pharmacological antagonists and intensive „immersion” methods of foreign language teaching. Subst Abus. 2003;157-73
51.
Zurück zum Zitat Mutschler J et al. Current findings and mechanisms of action of disulfiram in the treatment of alcohol dependence. Pharmacopsychiatry. 2016; 137-41 Mutschler J et al. Current findings and mechanisms of action of disulfiram in the treatment of alcohol dependence. Pharmacopsychiatry. 2016; 137-41
52.
Zurück zum Zitat Soyka M, Lieb M. Komorbidität von Depression und Alkoholabhängigkeit: Klinische und neurobiologische Aspekte. Nervenheilkunde. 2004;13-20 Soyka M, Lieb M. Komorbidität von Depression und Alkoholabhängigkeit: Klinische und neurobiologische Aspekte. Nervenheilkunde. 2004;13-20
53.
Zurück zum Zitat Colpaert K et al. Impact of addiction severity and psychiatric comorbidity on the quality of life of alcohol-, drug- and dual-dependent persons in residential treatment. Eur Addict Res. 2013;173-83 Colpaert K et al. Impact of addiction severity and psychiatric comorbidity on the quality of life of alcohol-, drug- and dual-dependent persons in residential treatment. Eur Addict Res. 2013;173-83
54.
Zurück zum Zitat Berglund M et al. Treatment of alcohol abuse: an evidence-based review. Alcohol Clin Exp Res. 2003;1645-56 Berglund M et al. Treatment of alcohol abuse: an evidence-based review. Alcohol Clin Exp Res. 2003;1645-56
55.
Zurück zum Zitat Green AI et al. Substance abuse and schizophrenia: pharmacotherapeutic intervention. J Subst Abuse Treat. 2008;61-71 Green AI et al. Substance abuse and schizophrenia: pharmacotherapeutic intervention. J Subst Abuse Treat. 2008;61-71
56.
Zurück zum Zitat Drake RE. Management of substance use disorder in schizophrenia patients: current guidelines. CNS Spectr. 2007;27-32 Drake RE. Management of substance use disorder in schizophrenia patients: current guidelines. CNS Spectr. 2007;27-32
57.
Zurück zum Zitat Green AI et al. Schizophrenia and co-occurring substance use disorder. Am J Psychiatry. 2007; 402-8 Green AI et al. Schizophrenia and co-occurring substance use disorder. Am J Psychiatry. 2007; 402-8
58.
Zurück zum Zitat Soyka M et al. Prevalence of alcohol and drug abuse in schizophrenic inpatients. Eur Arch Psychiatry Clin Neurosci. 1993;362-72 Soyka M et al. Prevalence of alcohol and drug abuse in schizophrenic inpatients. Eur Arch Psychiatry Clin Neurosci. 1993;362-72
Metadaten
Titel
Suchttherapie
Anticraving-Substanzen in der Therapie der Alkoholabhängigkeit
verfasst von
Dr. med. Johannes Kramer
PD Dr. med. Gabriele Koller
Prof. Dr. med. Oliver Pogarell
Publikationsdatum
15.12.2023

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