알코올 의존의 치료에서 Naltrexone의 사용

Use of Naltrexone in the Treatment of Alcohol Dependence

Two double-blind placebo controlled clinical trials have demonstrated that naltrexone, a pure opioid antagonist, appears to be an effective adjunct to treatment of alcohol dependence. Naltrexone alters endogenous opioids receptor activity, and its alteration blocks a positive reinforcing effect of alcohol in dopaminergic system. As a result, naltrexone reduces craving for alcohol and alcoholic high. Clinically, naltrexone, which is more compliant than disulfiram in alcoholics, results in fewer drinking days, less drinking amount and lower rate of relapse for alcoholic patients. Especially, those patients who initiatied drinking, patients who received naltrexone and concurrent coping skill/relapse prevention therapy are the least likely to relapse. In addition, a recommendation for morning dosing and the development of a pill taking routine are likely to increase the patients compliance with naltrexone and ultimately the outcome of their treatment for alcoholic dependence. In conclusion, the combined effects of naltrexone, psychosocial therapy and our patient support system need to be explored so that an optimal approach to the treatment of alcoholism, which is suitable for our own situation, should be developed.