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題名 Lack of efficacy of dextromethorphan in managing alcohol withdrawal: A preliminary report of a randomized, double-blind, placebo-controlled trial
作者 Huang, M.-C.;Chen, C.-H.;Pan, Chun-Hung;Lin, S.-K.
潘俊宏
貢獻者 心理系
關鍵詞 alcohol; dextromethorphan; lorazepam; multivitamin; placebo; thiamine; adult; alcohol consumption; alcohol withdrawal; alcoholism; article; clinical assessment; Clinical Institute Withdrawal Assessment for Alcohol; controlled study; detoxification; dizziness; double blind procedure; drinking behavior; drug efficacy; drug megadose; drug safety; fatigue; hospital admission; human; neurological complication; Obsessive Compulsive Drinking Scale; outcome assessment; priority journal; psychometry; randomized controlled trial; rating scale; scoring system; somnolence; symptom; treatment duration; treatment outcome; Adult; Alcohol Abstinence; Alcohol Drinking; Alcoholism; Brain; Dextromethorphan; Double-Blind Method; Drug Therapy; Combination; Excitatory Amino Acid Antagonists; Humans; Lorazepam; Middle Aged; Psychiatric Status Rating Scales; Receptors; N-Methyl-D-Aspartate; Substance Withdrawal Syndrome; Taiwan; Time Factors; Treatment Failure
日期 2014-02
上傳時間 11-六月-2015 12:05:02 (UTC+8)
摘要 Alcohol withdrawal syndrome is associated with increased central N-methyl-D-aspartate (NMDA) glutamate transmission. Medications that reduce glutamate release or block NMDA overactivation have shown efficacy for treating alcohol withdrawal syndrome. Dextromethorphan (DXM), a widely used antitussive drug, is a low-affinity, noncompetitive NMDA antagonist with potential neuroprotective properties. This study, using a randomized, double-blind, placebo-controlled study design, examined the benefit of DXM in the management of acute alcohol withdrawal. Alcohol-dependent patients admitted for detoxification treatment and experiencing moderate alcohol withdrawal, as measured by a score greater than 10 on the revised Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar), were randomly assigned to receive either DXM 360 mg/d or an identical placebo for 7 days in a double-blind manner. All subjects received a concurrent dose of lorazepam 2 mg along with the initial administration of DXM or placebo and were given additional lorazepam (1 mg) as a rescue medication according to the symptom-triggered detoxification protocol. Outcome measures consisted of the mean total dose of lorazepam received, the sequential scores on the CIWA-Ar, and craving assessed by the Obsessive-Compulsive Drinking Scale. Forty subjects completed the study, 18 in the DXM group and 22 in the placebo group. We found that compared with placebo, DXM use was not associated with lower lorazepam doses to control alcohol withdrawal symptoms. The progression in CIWA-Ar and Obsessive-Compulsive Drinking Scale scores was also comparable between the 2 groups. Our preliminary results do not support the efficacy of high-dose DXM in reducing the need of benzodiazepines to treat withdrawal symptoms in alcohol-dependent patients. © 2014 Lippincott Williams & Wilkins.
關聯 Journal of Clinical Psychopharmacology, 34(1), 149-152
資料類型 article
DOI http://dx.doi.org/10.1097/JCP.0000000000000052
dc.contributor 心理系
dc.creator (作者) Huang, M.-C.;Chen, C.-H.;Pan, Chun-Hung;Lin, S.-K.
dc.creator (作者) 潘俊宏zh_TW
dc.date (日期) 2014-02
dc.date.accessioned 11-六月-2015 12:05:02 (UTC+8)-
dc.date.available 11-六月-2015 12:05:02 (UTC+8)-
dc.date.issued (上傳時間) 11-六月-2015 12:05:02 (UTC+8)-
dc.identifier.uri (URI) http://nccur.lib.nccu.edu.tw/handle/140.119/75661-
dc.description.abstract (摘要) Alcohol withdrawal syndrome is associated with increased central N-methyl-D-aspartate (NMDA) glutamate transmission. Medications that reduce glutamate release or block NMDA overactivation have shown efficacy for treating alcohol withdrawal syndrome. Dextromethorphan (DXM), a widely used antitussive drug, is a low-affinity, noncompetitive NMDA antagonist with potential neuroprotective properties. This study, using a randomized, double-blind, placebo-controlled study design, examined the benefit of DXM in the management of acute alcohol withdrawal. Alcohol-dependent patients admitted for detoxification treatment and experiencing moderate alcohol withdrawal, as measured by a score greater than 10 on the revised Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar), were randomly assigned to receive either DXM 360 mg/d or an identical placebo for 7 days in a double-blind manner. All subjects received a concurrent dose of lorazepam 2 mg along with the initial administration of DXM or placebo and were given additional lorazepam (1 mg) as a rescue medication according to the symptom-triggered detoxification protocol. Outcome measures consisted of the mean total dose of lorazepam received, the sequential scores on the CIWA-Ar, and craving assessed by the Obsessive-Compulsive Drinking Scale. Forty subjects completed the study, 18 in the DXM group and 22 in the placebo group. We found that compared with placebo, DXM use was not associated with lower lorazepam doses to control alcohol withdrawal symptoms. The progression in CIWA-Ar and Obsessive-Compulsive Drinking Scale scores was also comparable between the 2 groups. Our preliminary results do not support the efficacy of high-dose DXM in reducing the need of benzodiazepines to treat withdrawal symptoms in alcohol-dependent patients. © 2014 Lippincott Williams & Wilkins.
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dc.relation (關聯) Journal of Clinical Psychopharmacology, 34(1), 149-152
dc.subject (關鍵詞) alcohol; dextromethorphan; lorazepam; multivitamin; placebo; thiamine; adult; alcohol consumption; alcohol withdrawal; alcoholism; article; clinical assessment; Clinical Institute Withdrawal Assessment for Alcohol; controlled study; detoxification; dizziness; double blind procedure; drinking behavior; drug efficacy; drug megadose; drug safety; fatigue; hospital admission; human; neurological complication; Obsessive Compulsive Drinking Scale; outcome assessment; priority journal; psychometry; randomized controlled trial; rating scale; scoring system; somnolence; symptom; treatment duration; treatment outcome; Adult; Alcohol Abstinence; Alcohol Drinking; Alcoholism; Brain; Dextromethorphan; Double-Blind Method; Drug Therapy; Combination; Excitatory Amino Acid Antagonists; Humans; Lorazepam; Middle Aged; Psychiatric Status Rating Scales; Receptors; N-Methyl-D-Aspartate; Substance Withdrawal Syndrome; Taiwan; Time Factors; Treatment Failure
dc.title (題名) Lack of efficacy of dextromethorphan in managing alcohol withdrawal: A preliminary report of a randomized, double-blind, placebo-controlled trial
dc.type (資料類型) articleen
dc.identifier.doi (DOI) 10.1097/JCP.0000000000000052
dc.doi.uri (DOI) http://dx.doi.org/10.1097/JCP.0000000000000052