Treating Alcohol Use Disorder in U.S. Veterans: The Role of Traumatic Brain Injury
| العنوان: | Treating Alcohol Use Disorder in U.S. Veterans: The Role of Traumatic Brain Injury |
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| المؤلفون: | Daryl I Shorter, Laura Acion, Xiangyu Liu, Ricardo E. Jorge, Ruosha Li, Stephan Arndt, Jill K McGavin |
| المصدر: | CONICET Digital (CONICET) Consejo Nacional de Investigaciones Científicas y Técnicas instacron:CONICET |
| بيانات النشر: | American Psychiatric Association Publishing, 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Adult, Male, medicine.medical_specialty, Traumatic Brain Injury, AUD, GABA Agents, Traumatic brain injury, Comorbidity, Alcohol use disorder, Pharmacological treatment, Stress Disorders, Post-Traumatic, purl.org/becyt/ford/3.3 [https], 03 medical and health sciences, 0302 clinical medicine, Double-Blind Method, Recurrence, Brain Injuries, Traumatic, mental disorders, medicine, Humans, Psychiatry, Veterans, Heavy drinking, business.industry, Valproic Acid, Middle Aged, medicine.disease, Naltrexone, United States, 030227 psychiatry, Alcoholism, Psychiatry and Mental health, Antecedent (behavioral psychology), purl.org/becyt/ford/3 [https], Neurology (clinical), business, 030217 neurology & neurosurgery, Alcohol Deterrents |
| الوصف: | Objective: The authors examined the efficacy of valproate to reduce relapse to heavy drinking among veterans with alcohol use disorder (AUD) and neuropsychiatric comorbidities and whether antecedent traumatic brain injury (TBI) or posttraumatic stress disorder (PTSD) affected treatment response. Methods: Participants were male veterans 18–60 years old with an AUD and no other substance use besides nicotine or cannabis. Sixty-two patients were randomly assigned to receive either valproate or naltrexone. Participants were evaluated at baseline and followed weekly for 24 weeks. All participants received standardized psychosocial interventions as well as treatment for coexistent psychiatric conditions. Results: During the follow-up period, nine study subjects in the naltrexone group and 14 in the valproate group relapsed to heavy drinking, but the difference did not reach statistical significance. Participants with a history of moderate to severe TBI were more likely to relapse to heavy drinking compared with those with no TBI (hazard ratio=4.834, 95% CI=1.103–21.194, p=0.033). PTSD status did not significantly affect outcome. Conclusions: Intensive outpatient programs are efficacious alternatives to treat AUD in veterans, although the role of pharmacological treatment is not completely elucidated. Glutamatergic agents appear to be less effective than opiate antagonists to prevent relapse to heavy drinking and to increase cumulative abstinence. Future studies should examine novel pharmacological and nonpharmacological options. Fil: Jorge, Ricardo E.. Baylor College of Medicine; Fil: Li, Ruosha. Baylor College of Medicine; Fil: Liu, Xiangyu. Baylor College of Medicine; Fil: McGavin, Jill K.. Baylor College of Medicine; Fil: Shorter, Daryl I.. Baylor College of Medicine; Fil: Acion, Laura. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Calculo. - Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Calculo; Argentina Fil: Arndt, Stephan. University of Iowa; Estados Unidos |
| وصف الملف: | application/pdf |
| تدمد: | 1545-7222 0895-0172 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::93040c671179779fdddd2f1968b1893aTest https://doi.org/10.1176/appi.neuropsych.18110250Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....93040c671179779fdddd2f1968b1893a |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15457222 08950172 |
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