Substance use disorders among older adults: A review of randomized controlled pharmacotherapy trials  

作　　者：Rajesh R Tampi Aarti Chhatlani Hajra Ahmad Kripa Balaram Joel Dey Ricardo Escobar Thejasvi Lingamchetty 

机构地区：[1]Department of Psychiatry and Behavioral Sciences,Cleveland Clinic Akron General,Ohio,NH 44106,United States [2]Cleveland Clinic Lerner College of Medicine of Case Western Reserve University,Cleveland,OH 44109,United States [3]Savant Care Clinic,California,CA 90277,United States [4]Department of Psychiatry,MetroHealth,Cleveland,OH 44109,United States [5]Case Western Reserve University School of Medicine,Cleveland,OH 44109,United States

出　　处：《World Journal of Psychiatry》2019年第5期78-82,共5页世界精神病学杂志

摘　　要：Substance use disorders(SUDs)are a growing problem among older adults.Acamprosate,disulfiram,and naltrexone are United States Food and Drug Administration(referred to as FDA)approved for the treatment of alcohol use disorder,and buprenorphine is approved for the treatment of opiate use disorder among adults.However,the data on the use of these medications for the treatment of SUDs among older adults are unclear from randomized controlled trials(referred to as RCTs).A review of the literature indicates that there are only two RCTs that evaluated the use of pharmacologic agents for SUDs among older adults(≥50 years).One trial evaluated the use of naltrexone when compared to placebo for the treatment of alcohol use disorder among individuals,50-70 years in age.The other trial evaluated the use of naltrexone or placebo as adjuncts with sertraline in the treatment of alcohol use disorder among individuals older than 55 years in age.Both trials indicated that the use of naltrexone reduced the rates of relapse among older adults with alcohol use disorder.However,we did not identify any RCTs that studied the use of buprenorphine,acamprosate,or disulfiram for SUDs among older adults.Based on available evidence,it would be safe to conclude that limited data indicate some efficacy for naltrexone in the treatment of alcohol use disorder among older adults.However,data from controlled trials on the use of other medications that are FDA approved for the treatment of SUDs among younger adults are nonexistent among older adults with SUDs.Substance use disorders(SUDs) are a growing problem among older adults.Acamprosate, disulfiram, and naltrexone are United States Food and Drug Administration(referred to as FDA) approved for the treatment of alcohol use disorder, and buprenorphine is approved for the treatment of opiate use disorder among adults. However, the data on the use of these medications for the treatment of SUDs among older adults are unclear from randomized controlled trials(referred to as RCTs). A review of the literature indicates that there are only two RCTs that evaluated the use of pharmacologic agents for SUDs among older adults(≥ 50 years). One trial evaluated the use of naltrexone when compared to placebo for the treatment of alcohol use disorder among individuals, 50-70 years in age. The other trial evaluated the use of naltrexone or placebo as adjuncts with sertraline in the treatment of alcohol use disorder among individuals older than55 years in age. Both trials indicated that the use of naltrexone reduced the rates of relapse among older adults with alcohol use disorder. However, we did not identify any RCTs that studied the use of buprenorphine, acamprosate, or disulfiram for SUDs among older adults. Based on available evidence, it would be safe to conclude that limited data indicate some efficacy for naltrexone in the treatment of alcohol use disorder among older adults. However, data from controlled trials on the use of other medications that are FDA approved for the treatment of SUDs among younger adults are nonexistent among older adults with SUDs.

关 键 词：OLDER adults Substance use NALTREXONE ACAMPROSATE DISULFIRAM BUPRENORPHINE 

分 类 号：R[医药卫生]