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Fortschr Neurol Psychiatr 2007; 75(1): 26-32
DOI: 10.1055/s-2006-944309
Originalarbeit
© Georg Thieme Verlag Stuttgart · New York

Neurobiologische Mechanismen und Pharmakologische Behandlungsansätze des Alkohol-Craving

Neurobiological Mechanisms and Pharmacological Treatment Options for Alcohol CravingT.  Hillemacher1 , J.  Kornhuber1 , S.  Bleich1
  • 1Psychiatrische und Psychotherapeutische Klinik, Universitätsklinikum Erlangen
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Publication History

Publication Date:
10 October 2006 (online)

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Zusammenfassung

In den letzten Jahren wurden zahlreiche Untersuchungen zu neurobiologischen Grundlagen des Alkoholcraving durchgeführt. Von besonderem Interesse sind dabei Veränderungen des hypothalamischen Cortison-Stoffwechsels sowie des Leptin-Stoffwechsels, welcher nach neuen Untersuchungen auch mit der Pharmakotherapie in Verbindung steht. Pharmakotherapeutisch stehen mit den Substanzen Acamprosat und Naltrexon 2 Substanzen zur Rückfallprophylaxe bei Alkoholabhängigkeit zur Verfügung, wobei die Studienlage insbesondere aufgrund neuester Ergebnisse nicht unumstritten ist. Vorteilhaft scheint zumindest für einen Teil der Patienten auch eine Alkohol-aversive Behandlung mit Disulfiram zu sein. Daneben existieren eine ganze Reihe erfolgversprechender Kandidatensubstanzen. Aktuelle Forschungsbemühungen beschäftigen sich insbesondere mit einer differenziellen Indikationsstellung der Pharmakotherapie bei Alkoholabhängigkeit, unter Einbezug psychologischer und genetischer Faktoren.

Abstract

In the last years, numerous studies have been performed on neurobiological mechanisms in alcohol craving. Changes in the hypothalamic cortisol pathway and the leptin metabolism, which is also associated with pharmacological interventions, have been of special interest. With acamprosate and naltrexone two substances exist for pharmacotherapy, but recent results about the efficacy are controversial. The clinical profit of disulfiram has been shown, at least in a subgroup of patients. Besides, there are several promising candidate substances. Current investigations focus on a diffentiated pharmacotherapy of alcohol dependence, including psychological and genetic factors.

Schlüsselwörter

Craving - Alkoholabhängigkeit - HPA-Achse - Naltrexon - Acamprosat

Key words

craving - alcohol dependency - HPA-axis - naltrexone - acamprosate

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Dr. med. Thomas Hillemacher

Psychiatrische und Psychotherapeutische Klinik Universitätsklinikum Erlangen

Schwabachanlage 6

91054 Erlangen

Email: thomas.hillemacher@psych.imed.uni-erlangen.de