Almost10%oftheworld'spopulationisaffectedbyalcoholusedisorders,andthetreatmentof alcoholdependence(AD)stillremainsachallenge.PatientswithADcandifferinmanytraits.Three drugs (disulfiram,naltrexone,andacamprosate)havebeenapprovedbytheFDAforthetreatmentof AD,andinsomeEuropeancountriessodiumoxybate isalsoapprovedforthispurpose.Combined pharmacologicaltherapyhasnotprovidedsuchconvincingresults.Consideringthefactthatthe “ideal” andeffectivedrugforalltypesofalcoholicpatientsdoesnotexists,thefuturechallengewill be toidentifyapersonalizedapproach.Recentdata hasshownthatthisobjectivecanbeachievedby investigatingthegeneticvariabilityofthepatient.Moreover,theuseofreplacementmoleculescan probablybeconsideredanadvantageoustherapeuticopportunity(i.e.sodiumoxybate).Inaddition, reductionofalcoholconsumptionisincreasinglyacceptedasaviabletreatmentgoal,andtheuseof nalmefene “as-needed” (a pharmacologicalapproachsimilartonaltrexone,but,possibly,with lowerhepatotoxicity)mayhelpinthetreatmentofAD.Thus,itisimportanttostressthata pharmacologicalapproachtotreatADshouldbeprecededbythedefinitionofpatientcharacteristics; this mayhelpinthechoiceofthemostappropriate druganditcanbedonemoreeasilywhenmore pharmacologicaloptionsapprovedforthetreatmentofADarealsoavailable.
Caputo F, Vignoli T, Grignaschi A, Cibin M, Addolorato G, Bernardi M. (2014). Pharmacological management of alcohol dependence: from mono-therapy to pharmacogenetics and beyond. EUROPEAN NEUROPSYCHOPHARMACOLOGY, 24, 181-191 [10.1016/j.euroneuro.2013.10.004].
Pharmacological management of alcohol dependence: from mono-therapy to pharmacogenetics and beyond.
GRIGNASCHI, ALICE;BERNARDI, MAURO
2014
Abstract
Almost10%oftheworld'spopulationisaffectedbyalcoholusedisorders,andthetreatmentof alcoholdependence(AD)stillremainsachallenge.PatientswithADcandifferinmanytraits.Three drugs (disulfiram,naltrexone,andacamprosate)havebeenapprovedbytheFDAforthetreatmentof AD,andinsomeEuropeancountriessodiumoxybate isalsoapprovedforthispurpose.Combined pharmacologicaltherapyhasnotprovidedsuchconvincingresults.Consideringthefactthatthe “ideal” andeffectivedrugforalltypesofalcoholicpatientsdoesnotexists,thefuturechallengewill be toidentifyapersonalizedapproach.Recentdata hasshownthatthisobjectivecanbeachievedby investigatingthegeneticvariabilityofthepatient.Moreover,theuseofreplacementmoleculescan probablybeconsideredanadvantageoustherapeuticopportunity(i.e.sodiumoxybate).Inaddition, reductionofalcoholconsumptionisincreasinglyacceptedasaviabletreatmentgoal,andtheuseof nalmefene “as-needed” (a pharmacologicalapproachsimilartonaltrexone,but,possibly,with lowerhepatotoxicity)mayhelpinthetreatmentofAD.Thus,itisimportanttostressthata pharmacologicalapproachtotreatADshouldbeprecededbythedefinitionofpatientcharacteristics; this mayhelpinthechoiceofthemostappropriate druganditcanbedonemoreeasilywhenmore pharmacologicaloptionsapprovedforthetreatmentofADarealsoavailable.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
