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DNP – Die Neurologie & Psychiatrie
Erschienen in: DNP - Der Neurologe & Psychiater 11/2013

30.10.2013 | Fortbildung

Wichtige Ergänzung zur Rezidivprophylaxe und Trinkmengenreduktion

Pharmakotherapie der Alkoholabhängigkeit

verfasst von: Dr. med. Wenzel Schicho, Prof. Dr. med. Oliver Pogarell

Erschienen in: DNP – Die Neurologie & Psychiatrie | Ausgabe 11/2013

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Zusammenfassung

Bei der Behandlung der Alkoholabhängigkeit werden mit qualifizierter Entgiftung und suchtspezifischer Therapie Abstinenzraten von 40–70 % erzielt. Trotzdem ist die langfristige Erfolgsrate hinsichtlich dauerhafter Abstinenz gering. Zum Entzug, zur Rezidivprophylaxe sowie zur Trinkmengenreduktion stellen pharmakotherapeutische Strategien eine wichtige Ergänzung psychotherapeutischer und psychosozialer Therapien dar.
Literatur
1.
Pirkola, S.P., K. Poikolainen, and J.K. Lonnqvist, Currently active and remitted alcohol dependence in a nationwide adult general population—results from the Finnish Health 2000 study. Alcohol and alcoholism, 2006. 41(3): p. 315–20.PubMedCrossRef
2.
Hasin, D.S., et al., Five-year course of major depression: effects of comorbid alcoholism. Journal of affective disorders, 1996. 41(1): p. 63–70.PubMedCrossRef
3.
Rehm, J., et al., Global burden of disease and injury and economic cost attributable to alcohol use and alcohol-use disorders. Lancet, 2009. 373(9682): p. 2223–33.PubMedCrossRef
4.
Saxena, S., Alcohol, Europe and the developing countries. Addiction, 1997. 92 Suppl 1: p. S43–8.PubMedCrossRef
5.
Berglund, M., et al., Treatment of alcohol abuse: an evidence-based review. Alcoholism, clinical and experimental research, 2003. 27(10): p. 1645–56.PubMedCrossRef
6.
Aubin, H.J. and J.B. Daeppen, Emerging pharmacotherapies for alcohol dependence: A systematic review focusing on reduction in consumption. Drug and alcohol dependence, 2013.
7.
Gastfriend, D.R., et al., Reduction in heavy drinking as a treatment outcome in alcohol dependence. Journal of substance abuse treatment, 2007. 33(1): p. 71–80.PubMedCrossRef
8.
Adamson, S.J., et al., Initial preference for drinking goal in the treatment of alcohol problems: II. Treatment outcomes. Alcohol and alcoholism, 2010. 45(2): p. 136–42.PubMedCrossRef
9.
Soyka, M., et al., World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for Biological Treatment of Substance Use and Related Disorders, Part 1: Alcoholism. The world journal of biological psychiatry: the official journal of the World Federation of Societies of Biological Psychiatry, 2008. 9(1): p. 6–23.CrossRef
10.
Vaillant, G.E., A long-term follow-up of male alcohol abuse. Archives of general psychiatry, 1996. 53(3): p. 243–9.PubMedCrossRef
11.
Mann, K., et al., The long-term course of alcoholism, 5, 10 and 16 years after treatment. Addiction, 2005. 100(6): p. 797–805.PubMedCrossRef
12.
Mayo-Smith, M.F., Pharmacological management of alcohol withdrawal. A meta-analysis and evidence-based practice guideline. American Society of Addiction Medicine Working Group on Pharmacological Management of Alcohol Withdrawal. JAMA: the journal of the American Medical Association, 1997. 278(2): p. 144–51.CrossRef
13.
Thiercelin, N., et al., [Risk factors for delirium tremens: a literature review]. La Revue de medecine interne / fondee ... par la Societe nationale francaise de medecine interne, 2012. 33(1): p. 18–22.PubMedCrossRef
14.
Mayo-Smith, M.F., et al., Management of alcohol withdrawal delirium. An evidence-based practice guideline. Archives of internal medicine, 2004. 164(13): p. 1405–12.PubMedCrossRef
15.
Ait-Daoud, N., R.J. Malcolm, Jr., and B.A. Johnson, An overview of medications for the treatment of alcohol withdrawal and alcohol dependence with an emphasis on the use of older and newer anticonvulsants. Addictive behaviors, 2006. 31(9): p. 1628–49.PubMedCrossRef
16.
Mueller, T.I., et al., A double-blind, placebo-controlled pilot study of carbamazepine for the treatment of alcohol dependence. Alcoholism, clinical and experimental research, 1997. 21(1): p. 86–92.PubMedCrossRef
17.
Malcolm, R., et al., The effects of carbamazepine and lorazepam on single versus multiple previous alcohol withdrawals in an outpatient randomized trial. Journal of general internal medicine, 2002. 17(5): p. 349–55.PubMed
18.
Hillbom, M., I. Pieninkeroinen, and M. Leone, Seizures in alcohol-dependent patients: epidemiology, pathophysiology and management. CNS drugs, 2003. 17(14): p. 1013–30.PubMedCrossRef
19.
Regier, D.A., et al., Comorbidity of mental disorders with alcohol and other drug abuse. Results from the Epidemiologic Catchment Area (ECA) Study. JAMA: the journal of the American Medical Association, 1990. 264(19): p. 2511–8.CrossRef
20.
Agosti, V. and F.R. Levin, The effects of alcohol and drug dependence on the course of depression. The American journal on addictions / American Academy of Psychiatrists in Alcoholism and Addictions, 2006. 15(1): p. 71–5.PubMedCrossRef
21.
Sullivan, L.E., D.A. Fiellin, and P.G. O’Connor, The prevalence and impact of alcohol problems in major depression: a systematic review. The American journal of medicine, 2005. 118(4): p. 330–41.PubMedCrossRef
22.
Kessler, R.C., et al., Lifetime co-occurrence of DSM-III-R alcohol abuse and dependence with other psychiatric disorders in the National Comorbidity Survey. Archives of general psychiatry, 1997. 54(4): p. 313–21.PubMedCrossRef
23.
Soyka, M. and S. Roesner, New pharmacological approaches for the treatment of alcoholism. Expert opinion on pharmacotherapy, 2006. 7(17): p. 2341–53.PubMedCrossRef
24.
Salloum, I.M., et al., Efficacy of valproate maintenance in patients with bipolar disorder and alcoholism: a double-blind placebo-controlled study. Archives of general psychiatry, 2005. 62(1): p. 37–45.PubMedCrossRef
25.
Soyka, M., et al., Prevalence of alcohol and drug abuse in schizophrenic inpatients. European archives of psychiatry and clinical neuroscience, 1993. 242(6): p. 362–72.PubMedCrossRef
26.
Drake, R.E., Management of substance use disorder in schizophrenia patients: current guidelines. CNS spectrums, 2007. 12(10 Suppl 17): p. 27–32.PubMed
27.
Green, A.I., et al., Schizophrenia and co-occurring substance use disorder. The American journal of psychiatry, 2007. 164(3): p. 402–8.PubMedCrossRef
28.
Green, A.I., et al., Substance abuse and schizophrenia: pharmacotherapeutic intervention. Journal of substance abuse treatment, 2008. 34(1): p. 61–71.PubMedCrossRef
29.
Brewer, C. and E. Streel, 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. Substance abuse: official publication of the Association for Medical Education and Research in Substance Abuse, 2003. 24(3): p. 157–73.
30.
Mutschler, J., et al., Supervised disulfiram in relapse prevention in alcohol-dependent patients suffering from comorbid borderline personality disorder—a case series. Alcohol and alcoholism, 2010. 45(2): p. 146–50.PubMedCrossRef
31.
Madamba, S.G., et al., Acamprosate (calcium acetylhomotaurinate) enhances the N-methyl-D-aspartate component of excitatory neurotransmission in rat hippocampal CA1 neurons in vitro. Alcoholism, clinical and experimental research, 1996. 20(4): p. 651–8.PubMedCrossRef
32.
Littleton, J., Acamprosate in alcohol dependence: how does it work? Addiction, 1995. 90(9): p. 1179–88.PubMedCrossRef
33.
Harris, B.R., et al., Acamprosate inhibits the binding and neurotoxic effects of trans-ACPD, suggesting a novel site of action at metabotropic glutamate receptors. Alcoholism, clinical and experimental research, 2002. 26(12): p. 1779–93.PubMedCrossRef
34.
Spanagel, R., et al., The clock gene Per2 influences the glutamatergic system and modulates alcohol consumption. Nature medicine, 2005. 11(1): p. 35–42.PubMedCrossRef
35.
Sass, H., et al., Relapse prevention by acamprosate. Results from a placebo-controlled study on alcohol dependence. Archives of general psychiatry, 1996. 53(8): p. 673–80.PubMedCrossRef
36.
Soyka, M. and S. Rosner, Emerging drugs to treat alcoholism. Expert opinion on emerging drugs, 2010. 15(4): p. 695–711.PubMedCrossRef
37.
O’Malley, S.S. and J.C. Froehlich, Advances in the use of naltrexone: an integration of preclinical and clinical findings. Recent developments in alcoholism: an official publication of the American Medical Society on Alcoholism, the Research Society on Alcoholism, and the National Council on Alcoholism, 2003. 16: p. 217–45.
38.
Bouza, C., et al., Efficacy and safety of naltrexone and acamprosate in the treatment of alcohol dependence: a systematic review. Addiction, 2004. 99(7): p. 811–28.PubMedCrossRef
39.
Rosner, S., et al., Acamprosate supports abstinence, naltrexone prevents excessive drinking: evidence from a meta-analysis with unreported outcomes. Journal of psychopharmacology, 2008. 22(1): p. 11–23.PubMedCrossRef
40.
Gastfriend, D.R., Intramuscular extended-release naltrexone: current evidence. Annals of the New York Academy of Sciences, 2011. 1216: p. 144–66.PubMedCrossRef
41.
Kiefer, F., et al., Comparing and combining naltrexone and acamprosate in relapse prevention of alcoholism: a double-blind, placebo-controlled study. Archives of general psychiatry, 2003. 60(1): p. 92–9.PubMedCrossRef
42.
Arias, A.J., et al., Effects of opioid receptor gene variation on targeted nalmefene treatment in heavy drinkers. Alcoholism, clinical and experimental research, 2008. 32(7): p. 1159–66.PubMedCrossRef
43.
Soyka, M. and S. Rosner, Nalmefene for treatment of alcohol dependence. Expert opinion on investigational drugs, 2010. 19(11): p. 1451–9.PubMedCrossRef
44.
Mann, K., et al., Extending the treatment options in alcohol dependence: a randomized controlled study of as-needed nalmefene. Biological psychiatry, 2013. 73(8): p. 706–13.PubMedCrossRef
45.
Gual, A., et al., A randomised, double-blind, placebo-controlled, efficacy study of nalmefene, as-needed use, in patients with alcohol dependence. European neuropsychopharmacology: the journal of the European College of Neuropsychopharmacology, 2013.
46.
Johnson, B.A., Role of the serotonergic system in the neurobiology of alcoholism: implications for treatment. CNS drugs, 2004. 18(15): p. 1105–18.PubMedCrossRef
47.
Mann, K., Pharmacotherapy of alcohol dependence: a review of the clinical data. CNS drugs, 2004. 18(8): p. 485–504.PubMedCrossRef
48.
Ait-Daoud, N., et al., Combining ondansetron and naltrexone reduces craving among biologically predisposed alcoholics: preliminary clinical evidence. Psychopharmacology, 2001. 154(1): p. 23–7.PubMedCrossRef
49.
Johnson, B.A., et al., Ondansetron for reduction of drinking among biologically predisposed alcoholic patients: A randomized controlled trial. JAMA: the journal of the American Medical Association, 2000. 284(8): p. 963–71.CrossRef
50.
Johnson, B.A., et al., Ondansetron reduces the craving of biologically predisposed alcoholics. Psychopharmacology, 2002. 160(4): p. 408–13.PubMedCrossRef
51.
Kenna, G.A., et al., Review of topiramate: an antiepileptic for the treatment of alcohol dependence. Current drug abuse reviews, 2009. 2(2): p. 135–42.PubMedCrossRef
52.
Johnson, B.A., Progress in the development of topiramate for treating alcohol dependence: from a hypothesis to a proof-of-concept study. Alcoholism, clinical and experimental research, 2004. 28(8): p. 1137–44.PubMedCrossRef
53.
Johnson, B.A., et al., Topiramate for treating alcohol dependence: a randomized controlled trial. JAMA: the journal of the American Medical Association, 2007. 298(14): p. 1641–51.CrossRef
54.
Volkow, N.D., Imaging the addicted brain: from molecules to behavior. Journal of nuclear medicine: official publication, Society of Nuclear Medicine, 2004. 45(11): p. 13N–16N, 19N-20N, 22N passim.
55.
Martinotti, G., et al., Quetiapine decreases alcohol consumption, craving, and psychiatric symptoms in dually diagnosed alcoholics. Human psychopharmacology, 2008. 23(5): p. 417–24.PubMedCrossRef
56.
Croissant, B., et al., Quetiapine in relapse prevention in alcoholics suffering from craving and affective symptoms: a case series. European psychiatry: the journal of the Association of European Psychiatrists, 2006. 21(8): p. 570–3.CrossRef
57.
Gorsane, M.A., et al., Is baclofen a revolutionary medication in alcohol addiction management? Review and recent updates. Substance abuse: official publication of the Association for Medical Education and Research in Substance Abuse, 2012. 33(4): p. 336–49.CrossRef
58.
Liu, J. and L.N. Wang, Baclofen for alcohol withdrawal. The Cochrane database of systematic reviews, 2013. 2: p. CD008502.PubMed
59.
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. 370(9603): p. 1915–22.PubMedCrossRef
60.
Addolorato, G., et al., Understanding and treating patients with alcoholic cirrhosis: an update. Alcoholism, clinical and experimental research, 2009. 33(7): p. 1136–44.PubMedCrossRef
61.
Ameisen, O., Treatment of alcohol-use disorders. Lancet, 2009. 373(9674): p. 1519; author reply 1519-20.PubMedCrossRef
62.
Ericson, M., et al., The smoking cessation medication varenicline attenuates alcohol and nicotine interactions in the rat mesolimbic dopamine system. The Journal of pharmacology and experimental therapeutics, 2009. 329(1): p. 225–30.PubMedCrossRef
63.
Tizabi, Y., et al., Effects of combined systemic alcohol and central nicotine administration into ventral tegmental area on dopamine release in the nucleus accumbens. Alcoholism, clinical and experimental research, 2002. 26(3): p. 394–9.PubMedCrossRef
64.
Litten, R.Z., et al., A Double-Blind, Placebo-Controlled Trial Assessing the Efficacy of Varenicline Tartrate for Alcohol Dependence. Journal of addiction medicine, 2013. 7(4): p. 277–286.PubMedCrossRef
Metadaten
Titel
Wichtige Ergänzung zur Rezidivprophylaxe und Trinkmengenreduktion
Pharmakotherapie der Alkoholabhängigkeit
verfasst von
Dr. med. Wenzel Schicho
Prof. Dr. med. Oliver Pogarell
Publikationsdatum
30.10.2013
Verlag
Urban & Vogel
Erschienen in
DNP – Die Neurologie & Psychiatrie / Ausgabe 11/2013
Print ISSN: 2731-8168
Elektronische ISSN: 2731-8176
DOI
https://doi.org/10.1007/s15202-013-0509-8

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