کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
2564671 1561024 2016 14 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Treatment-refractory substance use disorder: Focus on alcohol, opioids, and cocaine
ترجمه فارسی عنوان
اختلال مصرف مواد مخدر درمان: تمرکز بر الکل، مواد مخدر و کوکائین
کلمات کلیدی
موضوعات مرتبط
علوم زیستی و بیوفناوری علم عصب شناسی روانپزشکی بیولوژیکی
چکیده انگلیسی


• Nalmefene is an as-needed medication for reduction of alcohol intake.
• Depot/implant buprenorphine, i.v. methadone may be options for opioid use disorder.
• Neuromodulation techniques such as TMS and DBS are emerging treatment options.
• Disulfiram, methylphenidate, and modafinil are being studied for cocaine use disorder.

Substance use disorders are common, but only a small minority of patients receive adequate treatment. Although psychosocial therapies are effective, relapse is common. This review focusses on novel pharmacological and other treatments for patients with alcohol, opioid, or cocaine use disorders who do not respond to conventional treatments.Disulfiram, acamprosate, and the opioid antagonist naltrexone have been approved for the treatment of alcoholism. A novel, “as needed” approach is the use of the mu-opioid antagonist and partial kappa agonist nalmefene to reduce alcohol consumption. Other novel pharmacological approaches include the GABA-B receptor agonist baclofen, anticonvulsants such as topiramate and gabapentin, the partial nicotine receptor agonist varenicline, and other drugs. For opioid dependence, opioid agonist therapy with methadone or buprenorphine is the first-line treatment option. Other options include oral or depot naltrexone, morphine sulfate, depot or implant formulations, and heroin (diacetylmorphine) in treatment-refractory patients. To date, no pharmacological treatment has been approved for cocaine addiction; however, 3 potential pharmacological treatments are being studied, disulfiram, methylphenidate, and modafinil. Pharmacogenetic approaches may help to optimize treatment response in otherwise treatment-refractory patients and to identify which patients are more likely to respond to treatment, and neuromodulation techniques such as repeated transcranial magnetic stimulation and deep brain stimulation also may play a role in the treatment of substance use disorders.Although no magic bullet is in sight for treatment-refractory patients, some novel medications and brain stimulation techniques have the potential to enrich treatment options at least for some patients.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Progress in Neuro-Psychopharmacology and Biological Psychiatry - Volume 70, 3 October 2016, Pages 148–161
نویسندگان
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