对伴随性酒精依赖和PTSD患者的同时使用纳尔特雷克松和长期暴露治疗:一项随机临床试验
Edna B Foa1, David A Yusko, Carmen P McLean
1Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA. foa@mail.med.upenn.edu
JAMA
|August 9, 2013
概括
纳尔特雷克松有效地减少了酒精依赖和创伤后应激障碍 (PTSD) 患者的饮酒日数. 长期暴露治疗并没有恶化酒精使用,为联合治疗提供了希望.
科学领域:
- 精神病学是一个精神病学.
- 临床心理学 临床心理学
- 成 药物 药物 药物 药物
背景情况:
- 伴随性酒精依赖和PTSD存在治疗挑战.
- 人们担心长期暴露治疗可能会加剧酒精使用.
研究的目的:
- 为了比较纳尔特雷和长期暴露治疗 (PET) 对酒精依赖和PTSD的疗效.
- 为了评估纳尔特雷和PET的组合与支持性咨询相比.
主要方法:
- 一个单盲随机临床试验,涉及165名患有PTSD和酒精依赖的参与者.
- 参与者被分配到长期暴露治疗加上纳尔特雷克松,长期暴露治疗加上安慰剂,支持性咨询加上纳尔特雷克松或支持性咨询加上安慰剂.
- 评估包括饮酒日的百分比,PTSD严重程度,以及在基线,治疗后和6个月后续的酒精渴望.
主要成果:
- 所有组都显示出饮酒日数显著减少;纳尔特雷克森组的饮酒日数比安慰剂组少 (平均差异7.93%;P=.008).
- 在所有组中,PTSD症状的严重程度都下降了,长期暴露治疗没有统计学上显著的主要影响.
- 在6个月的随访中,所有组都出现了饮酒日数的增加,但纳尔特雷克松加长期暴露治疗组显示出最小的增加.
结论:
- 在患有酒精依赖和PTSD的患者中,纳尔特雷克松治疗降低了饮酒日的百分比.
- 在这个人群中,长期暴露治疗没有加剧酒精使用障碍.
- 结合纳尔特雷和长期暴露治疗可能为伴随性疾病提供持续的益处.
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