患有暴饮暴食行为的患者中阿片类对抗剂的有效性:系统性审查和元分析
Yi-Ya Fang1, Yi-Chun Yeh2, Tai-Ling Liu2
1Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Neuroscience and biobehavioral reviews
|March 17, 2025
概括
阿片类药物对抗剂显著降低了暴饮暴食的频率,并促进了体重减轻. 纳尔特雷的剂量是导致暴饮暴食障碍 (BED) 的这些积极结果的一个关键因素.
科学领域:
- 神经科学是一个神经科学.
- 精神病学是一个精神病学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 过度饮食 (BE) 是以消费大量食物和失去控制为特征的,与奖励和抑制系统失调有关.
- 内源性阿片类系统在BE神经生物学中发挥着至关重要的作用.
- 阿片类药物抗剂和组合疗法显示出降低BE的潜力,但需要进一步证据.
研究的目的:
- 系统地审查随机对照试验 (RCT) 关于阿片类药物对抗剂在暴饮暴食中的有效性.
- 评估阿片类药物对抗剂对BE频率,严重程度,体重和情绪的影响.
- 探索潜在的调节剂,如纳尔特雷剂量,影响治疗结果.
主要方法:
- 在主要数据库 (PubMed,Embase,Cochrane CENTRAL,Web of Science,ClinicalTrials.gov) 的系统文献搜索,截至2023年5月14日.
- 包括评估阿片类药物对抗剂在暴饮暴食障碍 (BED) 的RCT.
- 主要结局:BE的严重程度和频率;次要结局:体重变化和抑郁症状.
主要成果:
- 分析了8个RCT,显示阿片类抗体显著降低了BE频率 (SMD = -0.624) 和百分比体重变化 (SMD = -0.981).
- 在BE严重程度或抑郁症状方面没有观察到显著改善.
- 转基因回归表示的纳尔特雷克松剂量缓和了BE频率和体重的减少.
结论:
- 阿片类药物对抗剂在减少暴饮暴食频率方面表现出有效性.
- 阿片类药物对抗剂有助于减轻体重的百分比.
- 纳尔特雷的剂量是影响阿片类药物对抗剂在治疗BED中的有效性的重要因素.
相关概念视频
Drug-Receptor Interaction: Agonist
2.3K
Agonists are drugs that interact with specific receptors in the body to produce a biological response. When an agonist binds to a receptor, it activates or enhances the receptor's function, leading to physiological effects. The interaction between agonist drugs and receptors is crucial for their therapeutic action in various medical treatments.
Agonists can bind to receptors in different ways. Some agonists bind directly to the receptor's active site, mimicking the endogenous...
Agonists can bind to receptors in different ways. Some agonists bind directly to the receptor's active site, mimicking the endogenous...
2.3K
Opioid Receptors: Overview
413
Opioid receptors, including the mu (μ, MOR), delta (δ, DOR), and kappa (κ, KOR) types, belong to the rhodopsin family of G protein-coupled receptors. These receptors are located throughout the central and peripheral nervous systems and in non-neuronal tissues such as macrophages and astrocytes. Opioid receptor ligands can be categorized into agonists or antagonists. Highly selective agonists include [d-Ala2, MePhe4, Gly(ol)5]-enkephalin or DAMGO for MOR, [D-Pen2,...
413
Analgesia and Pain Management
415
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
415
Opioid Analgesics: Synthetic and Semisynthetic Opioids
200
Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
200
Drugs Affecting GI Tract Motility: Opioids as Antidiarrheal Agents
150
Diarrhea, a condition marked by frequent loose or watery bowel movements, can be triggered by multiple factors such as viral or bacterial infections, food intolerances, anxiety, medications, and digestive disorders. Symptoms may include abdominal pain, bloating, nausea, and cramping. Severe or prolonged diarrhea can lead to complications like electrolyte imbalances, malnutrition, and dehydration if left untreated.
Opioids, widely used antidiarrheal agents, mitigate diarrhea by slowing down...
Opioids, widely used antidiarrheal agents, mitigate diarrhea by slowing down...
150
Binge Eating Disorders
45
Binge eating disorder is a significant mental health condition characterized by recurrent episodes of excessive food consumption within a short period, accompanied by a perceived loss of control over eating behavior. Unlike occasional overeating, binge eating disorder is marked by distressing emotions such as guilt, shame, and anxiety following binge episodes. The disorder affects individuals across different ages and backgrounds, with profound implications for physical and psychological...
45


