Dosing issues in the pharmacotherapy of alcoholism.
Pharmacological treatments for alcohol dependence have focused increasingly on agents that reduce alcohol craving and consumption or that treat psychiatric disorders associated with drinking relapse. Clinicians who treat alcohol-dependent patients must find the optimal dose of these agents to maximize response. Determining the best dosing strategy has been the goal of recent treatment studies with alcohol-dependent patients. One study, for example, showed that an opiate antagonist medication had a dose-dependent relationship with patient outcome and retention in treatment. Another dosing consideration involves the effect of long-term alcohol abuse on drug metabolism (e.g., when treating alcohol-dependent patients for comorbid psychiatric disorders). This was demonstrated in a study of recently abstinent patients who were taking the antidepressant desipramine for major depression. Alcohol-dependent patients had higher hepatic enzyme activities and lower plasma levels of desipramine relative to oral dose than did a comparison group of depressed patients without an alcohol use disorder.
Alcohol Disorders Research Unit, University of Miami School of Medicine, FL 33136, USA.
B J
BJ
Mason
D000284:Administration, Oral; D000328:Adult; D000437:Alcoholism / Q000523:psychology / Q000534:rehabilitation*; D000929:Antidepressive Agents, Tricyclic / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics; D015897:Comorbidity; D003866:Depressive Disorder / Q000523:psychology / Q000534:rehabilitation; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007099:Imipramine / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics; D008297:Male; D008875:Middle Aged; D009271:Naltrexone / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000493:pharmacokinetics; D009292:Narcotic Antagonists / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D016032:Randomized Controlled Trials as Topic
D000929:Antidepressive Agents, Tricyclic; D009292:Narcotic Antagonists; D009271:Naltrexone; D007099:Imipramine; C038981:nalmefene