Pharmacotherapy for Alcohol-Related Disorders: What Clinicians Should Know
Department of Psychiatry, Division on Substance Abuse, Columbia University, College of Physicians and Surgeons, USA. Harvard Review of Psychiatry
(Impact Factor: 1.73).
11/2004; 12(6):351-66. DOI: 10.1080/10673220490905697
Alcohol-related disorders are a major public health problem in the United States. Alcohol interacts with several neurotransmitter systems causing both acute and chronic effects in the brain. While the mainstay of treatment of alcohol-related disorders, with the exception of alcohol withdrawal, has historically been psychosocial, pharmacotherapy is increasingly being investigated and incorporated into standard clinical practice. Patients with alcohol use disorders and comorbid psychiatric conditions, most commonly depressive and anxiety disorders, can benefit from symptom-targeted pharmacotherapy, even if the patient fails to achieve abstinence from alcohol. Although benzodiazepines remain the treatment of choice to treat alcohol withdrawal, a variety of other agents is being investigated, particularly in the outpatient setting. Further randomized clinical trials of alcohol-related disorder pharmacotherapy, particularly of comorbid subpopulations, are needed to better inform clinical decision making. The routine exclusion of alcohol-dependent patients from pharmacotherapy trials of psychiatric disorders presents a barrier to gathering more data. Recommendations for future research are discussed.
Available from: Athanasios Douzenis
- "It modifies the γ-aminobutyric acid (GABA)ergic neurotransmitter (type A: GABA-A), which is an inhibitory neurotransmitter, and also acts on the N-methyl-D-aspartic acid (NMDA) receptors of glutaminergic neurotransmission and on the NMDA subgroups on the glutaminergic receptor-stimulating neurotransmitter. Furthermore alcohol inhibits the δ-opiate receptors while long-term exposure to the alcohol increases the density of μ and δ receptors and generally increases endogenous opiate levels in opioid neurotransmission [23,24]. "
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ABSTRACT: Alcoholism is a chronic remitting and relapsing condition; its aetiology and pathophysiology remains largely obscure despite recent advances. This review summarises the current knowledge about the causation (biological or psychological) of alcohol addiction. This involves heredity, candidate genes, alcohol metabolism regulation and the influence of alcohol in the pathophysiology of the different neurotransmitter systems. Alcohol addiction is a multifactorial phenomenon where personality structure, individual state of mind and social influences are in constant interaction with brain neurobiology and pathophysiology. This disorder influences different sexes in different ways and causes major problems, especially in developed societies.
Available from: pharmactuel.com
Available from: unsworks.unsw.edu.au
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