Characterizing reward and relief/habit drinking profiles in a study of naltrexone, varenicline, and placebo.

IF 2.1 4区 医学 Q3 SUBSTANCE ABUSE
Annabel Kady, Erica N Grodin, Lara A Ray
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Abstract

Introduction: This study aims to clarify differences in mood, craving, and treatment response between reward and relief/habit individuals in a study of naltrexone, varenicline, and placebo. We hypothesized that relief/habit individuals would have a poorer mood during early abstinence and higher levels of alcohol craving than reward individuals. We hypothesized that reward individuals would demonstrate better drinking outcomes on naltrexone versus placebo.

Methods: Data were culled from a randomized, double-blind, placebo-controlled human trial of 53 individuals (18F/16M) with alcohol use disorder randomized to varenicline (n = 19), naltrexone (n = 15), or matched placebo (n = 19). In this 6-day practice quit trial, participants attempted to abstain from drinking and completed daily diaries. Participants were classified into reward or relief/habit subgroups based on self-reported motivation for drinking. Multilinear models tested differences in mood and alcohol craving between reward and relief/habit individuals. General linear models tested differences between reward and relief/habit individuals' drinking outcomes on each medication versus placebo.

Results: Relief/habit individuals showed decreases in positive mood and increases in negative mood over the quit attempt across medications, compared to reward individuals (P's < .05). Reward individuals' tension decreased on naltrexone, while relief/habit individuals' tension remained stable (F = 3.64, P = .03). Reward individuals in the placebo group had higher percent days abstinent than relief individuals in the placebo group (P < .001).

Discussion: This study suggests relief/habit individuals' mood worsens during early abstinence. Our finding that reward individuals' tension decreased on naltrexone and increased on placebo may suggest a clinical response to the medication.

纳曲酮、伐伦克林和安慰剂研究中的奖励和缓解/习惯性饮酒特征。
研究简介本研究旨在阐明在一项关于纳曲酮、伐伦克林和安慰剂的研究中,奖励型和缓解型/习惯型患者在情绪、渴求和治疗反应方面的差异。我们假设,与奖励型个体相比,解脱型/习惯型个体在早期戒酒期间的情绪较差,对酒精的渴望程度较高。我们假设,与安慰剂相比,服用纳曲酮的奖励患者会表现出更好的饮酒效果:数据来自一项随机、双盲、安慰剂对照人体试验,53 名酒精使用障碍患者(18F/16M)随机接受了伐伦克林(n = 19)、纳曲酮(n = 15)或匹配安慰剂(n = 19)治疗。在为期 6 天的实践戒酒试验中,参与者尝试戒酒并填写每日日记。根据自我报告的饮酒动机,参与者被分为奖励亚组或缓解/习惯亚组。多线性模型检验了奖励型和缓解型/习惯型个体在情绪和酒精渴求方面的差异。一般线性模型检验了奖励型和缓解型/习惯型个体在每种药物与安慰剂之间的饮酒结果差异:结果:与奖励型个体相比,缓解型/习惯型个体在尝试戒酒的过程中,积极情绪下降,消极情绪上升(P's 讨论):这项研究表明,在早期戒酒期间,缓解型/习惯型戒酒者的情绪会恶化。我们发现,服用纳曲酮后,戒毒者的紧张情绪会降低,而服用安慰剂后,紧张情绪会升高,这可能表明戒毒者对药物产生了临床反应。
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来源期刊
Alcohol and alcoholism
Alcohol and alcoholism 医学-药物滥用
CiteScore
4.70
自引率
3.60%
发文量
62
审稿时长
4-8 weeks
期刊介绍: About the Journal Alcohol and Alcoholism publishes papers on the biomedical, psychological, and sociological aspects of alcoholism and alcohol research, provided that they make a new and significant contribution to knowledge in the field. Papers include new results obtained experimentally, descriptions of new experimental (including clinical) methods of importance to the field of alcohol research and treatment, or new interpretations of existing results. Theoretical contributions are considered equally with papers dealing with experimental work provided that such theoretical contributions are not of a largely speculative or philosophical nature.
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