Nā Hana Hana Hana Hana Hanaʻia me Naltrexone Monotherapy (2018)

Kākoʻo nui o CNS Disorder. 2018 Feb 15; 20 (1). pii: 17l02109. doi: 10.4088 / PCC.17l02109.

Kamaumau M1, Moura AR1,2, Oliveira-Maia AJ3,1,2,4,5.

PMID: 29469239

DOI: 10.4088 / PCC.17l02109

I ka mea hoʻoponopono: Hoʻopilikia nui ʻole nā ​​hana kūpono ʻole a i ʻole nā ​​hewa kolohe o nā hanana kūpono e alakaʻi ai i nā pilikia koʻikoʻi ma nā hopena lapaʻau, pāpō, hana, kānāwai, a i ʻole nā ​​hopena kālā.1 ʻO ka maʻamau, ka hana i hoʻohālikelike ʻia i ke ʻano o ka hiki ʻole ke pale aku i ka manaʻo no ke ʻano moeʻuhane i hāʻawi ʻia, ka mea e hele pinepine ʻia e ka manaʻo o ka hewa, ke kala ʻana, a me ka hōʻino ʻana iā ʻoe iho, ke alakaʻi nei iā lākou e komo i loko o ke kikoʻī o ka hōʻeuʻeu o ka hoʻokaumaha.2 He paʻakikī i ka mālama ʻia ʻana o nā ʻano hana hoʻohālikelike, me nā hōʻike3 o nā kūlike ʻokoʻa no ka nui o nā psychotherapeutic a me nā hōʻiliʻili pharmacologic, e komo pū ana me nā serotonin reuptake inhibitors, nā paʻa stabilizer, a me nā antipsychotics. Hōʻike4,5 ʻōlelo aku ua naltrexone, he antagonist opioid i hoʻohana ʻia i loko o ka hoʻohana ʻana i ke hilinaʻi opioid, hiki ke lilo i koho no ka mālama ʻana i kēia mau kūlana. Ua hōʻike ʻia nā hopena o ka naltrexone no ka hoʻopiʻi ʻana i nā ʻonekele opioid ma ka interneurons acid γ-aminobutyric ma ka wahi o ka ventral tegmental (VTA), no laila ke kāohi ʻia nei nā VTA dopaminergic neuron i manaʻo ʻia e hoʻomau i nā waiwai paʻa6 Hōʻike mākou i ka hihia o ka mea maʻi me nā mea hana hoʻomāiuki maikaʻi i mālama ʻia me ka monotherapy naltrexone.

Hōʻike hōʻike. Ua hōʻike mua kekahi kanaka 27 i ke keʻena psychiatry outpatient no ka manaʻo "pilikino." Ua hōʻike ka mea maʻi i ka hoʻolimalima nui o ka manawa a me ka hoʻolimalima ʻana i nā lawelawe moekolohe, e wehewehe ana i kahi hoʻoponopono pilikino me "kanaka transvestite. "Ua noʻonoʻo ʻo ia iā ia heterosexual a ua wehewehe i kēia mau ʻano moe kolohe" he mea ʻino ʻē aʻe, "i hoʻoilo ʻia ai ka hilahila a me nāʻino ʻole. Ua haʻi ʻia ka mea maʻi no ka loiloi ʻikepili a hoʻopau i ke kālā kūʻē o Yale-Brown Obsitive Compulsive Scale-II7 e loiloi i ke ʻano a me ka paʻakikī o kāna mau hana pilikino.1 Pūnaewele). ʻOiai ʻo ka pīpī nui loa ka hana i hoʻopili ʻia me nā kāne transvestite, e hōʻea ana ma kēlā me kēia manawa i kēlā me kēia mahina 2, hōʻike nō hoʻi ʻo ia i ka nānā ʻana i nā kiʻi ma mua o nā hola 3 a hiki i nā hola 10 i kēlā me kēia lā. ʻOiai he hana hoʻonaninani maʻamau, ʻaʻole ia i hōʻike i ka masturbation compulsive. Ua manaʻo ka mea maʻi ʻaʻole i hiki ke kāohi i kēia mau hana a hōʻike i kahi maʻi kaumaha a me nā hopohopo koʻikoʻi. Lawe ʻo ia i ka fluoxetine 20 mg / d a hele i kahi papahana psychotherapy kākoʻo, akā ua hōʻike ʻo ia ʻaʻole pono ke pōmaikaʻi ʻo ia mau mea a me ka hoʻomaʻamaʻa mua, me nā ʻano antidepressants, stabil stabil mood, neuroleptics, a me nā papa o ka psychotherapy. ʻO ka nānā ʻole o ka hoʻomohala ʻana i ka mālama ʻana (fluoxetine 40 mg / d a me ka aripiprazole 10 mg / d), ʻaʻole loli, ke ʻano o ka hoʻāʻo ʻana i ka naltrexone (50 mg / d).

Ma hope o nā mahina 2, hōʻike ka mea maʻi i ka hoʻonui nui ʻana i ka hōʻemi ʻana i nā moekolohe wahine a me ka kāohi o nā kolohe moe hewa. ʻAʻole ʻo ia i hoʻopili me nā wahine hoʻokamakama wahine, a ua māʻona maikaʻi loa i ka mālama ʻana iā ia. Ma muli o kona kīnā ʻole i loaʻa he mea pono i ka hoʻohana ʻana o nā lāʻau lapaʻau ʻē aʻe, ua pau ʻo ka lawe ʻana iā lākou ma kāna ʻano ponoʻī a i hoʻokahi wale nō pule i ka naltrexone i kekahi mau pule. Ua hoʻomau ʻo ia i ka hele ʻana i ka psychotherapy. Ua hoʻonui ʻia ka dosis naltrexone i 100 mg / d. Ma hope o nā mahina ʻo 10 no ka monotherapy naltrexone, ua ʻike ʻia ka hoʻomaikaʻi hou ʻana, a hōʻike ʻia ka mea maʻi i ka hana hou ʻana o ka hoʻohana ʻana i nā lawelawe moekolohe. Ua wehewehe ʻo ia i kahi ho'āʻo kuikawa e hooki i ka naltrexone, akā ua hoʻomaka hou ʻo ia i ka lāʻau lapaʻau ma hope o nā lā 2 wale nō ma muli o nā manaʻo i hoʻonui ʻia a me ke koi ʻana i nā hana moekolohe. Ka hoʻāʻo ʻikepili holomua (1 Pūnaewele) hōʻike i ka holomua o kāna mau kaumaha kaumaha akā ke hoʻonui nei i ka hopohopo. ʻOiai e hoʻomau ka mea maʻi me ka hoʻohana ʻana i nā kiʻi i nā kiʻi huki ma mua o nā hola 3 i kēlā me kēia lā, ʻaʻole nui ʻo ia i manaʻo i ka pilikia.

Aia kekahi mau puke ʻē aʻe4,6,10-12 hōʻike ana i ka hana kūpono no ka naltrexone i nā hihia o nā hana moekolohe. Raymond et al4 ua hōʻike i nā hihia 2 o ka holomua i nā hana pilikino a me nā hana psychosocial e hana ana me ka hoʻohana ʻana i ka naltrexone e hoʻonui i ka maʻi me ka fluoxetine. ʻO Bostwick a me Bucci6 Loaʻa nā hopena like i kahi hihia o ka pūnaewele pili me ka hana hoʻomāneʻane i ka hana i kahi manawa i hoʻoneʻe ʻia ai nā hana kolohe o ka mea maʻi ma hope o ka naltrexone i hoʻohui ʻia i ka mālama ʻana me sertraline. Aloha ʻOihana11 i wehewehe i ka noiʻi puka ʻōmole o ka naltrexone ma 21 kāne ʻōpio kāne lawehala i mālama ʻia me ka hoʻoulu ʻana, antidepressants, stabilizer mood, antipsychotics, a i ʻole nā ​​lāʻau lapaʻau. I kēlā mau mea maʻi, ua hōʻike ʻo 71% i kahi hōʻemi nui loa i ka moʻo wahine, ka masturbation frequency, a me nā moekolohe me ka naltrexone. Ma 9 o nā maʻi 10, hoʻihoʻi ʻia ka ʻano hana hewa i ka pae baseline i ka manawa a naltrexone a lawelawe ʻia.11 Grant a me Kim10 ua hōʻike ʻia ke kala a ka ʻaihue a me ka lawehala ma kahi hihia o kleptomania me ka comorbid compulsive ka hana hoʻonaninani ma hope o ka mālama ʻana me ka naltrexone nui (150 mg / d), akā ʻaʻole maopopo inā pili ka antagonist opioid i ka fluoxetine kiʻekiʻe a hoʻohana ʻia paha i ka monotherapy . ^ E Ha yM. Hoʻopili ka hihia i hōʻike ʻia ma kēia ʻatikala mai ka hana ʻana i ka moekolohe i hana ʻia me ka monotherapy naltrexone, i kū like pū me ka wehewehe a Kraus et al.12 o ka hōʻemi ʻana ma ka nui porno e nānā ʻana ma hope o ka mālama ʻana me monotherapy naltrexone.

Aia nō kekahi hōʻike pū me ke kākoʻo i ka hoʻohana ʻana i ka naltrexone ma ka pōmaikaʻi o nā pilikia ʻē aʻe o ka hoʻopili puhipuhi i hoʻokūʻē ʻia, ʻo ia hoʻi ka mea e koi ʻia.13 kleptomania,10 palaka pūnaewele5 inu waiu,14 Naikahiki,15 nā kīnā ʻai, nā maʻi16 a me ka ʻeha hōʻeha i ka hoʻoliʻiliʻi ʻana i ka maʻi pilikino.17 ʻO ka hapa nui, hoʻohana ka naltrexone e hoʻonui i nā mea lapaʻau ʻē aʻe, e like me ka antidepressants, akā aia kahi hōʻike, no ka hoʻohālike ʻana i ka maʻi ʻoluʻolu, ʻo ka naltrexone monotherapy e kūleʻa like ka hopena hui, ʻoiai e hōʻemi ana i ka hopena o ka hopena o nā hopena lāʻau a i ʻole ka hopena o ka lāʻau lapaʻau.14 Eia kekahi, ʻaʻole ʻike ka naltrexone e hoʻopilikia i ka hana moekolohe a ua hoʻoholo ʻia no ke ʻano maʻi no ka erectile dysfunction.18 Eia nō naʻe, hiki ke loaʻa kekahi mau pono no ka hoʻomaʻemaʻe hui. Eia, ʻike mākou i ka hoʻonui o nā hōʻailona hopohopo, hiki ke hoʻopili ʻia i ka hopena o ka hoʻōmi ʻana me ka fluoxetine a i ʻole he hopena kumu o ka naltrexone, e like me ka mea i hōʻike ʻia ma nā haʻawina ʻē aʻe.19 I ka hopena, ʻoiai naltrexone monotherapy hiki ke ea a maikaʻi loa, palekana, a me ka hopena maikaʻi no ka hana hoʻonaninani, hoʻokolohua a hoʻokuʻi ʻia e pono ai ke hōʻoia i ka hana a me ka palekana.

E hoʻomaopopo '

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Marta Camacho, MSa

Ana Rita Moura, MDa, b

Albino J. Oliveira-Maia, MD, MPH, PhDa, b, c, d

[pale ʻia ka leka uila]

kahi kikowaena maʻi ʻoChampalimaud, Champalimaud Center no ka maopopo ʻole, Lisbon, Pokukala

bDepart of Psychiatry and Mental Health, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal

cChampalimaud Research Center, Champalimaud Center no ka ʻIa ʻike ʻole, Lisbon, Pokukala

dNOVA Kula Kauka, Faculdade de Ciências Médicas, Na kula ʻo Nova de Lisboa, Lisbon, Portugal

Nā hoʻopaʻapaʻa o nā hoihoi: ʻAʻohe.

Hoʻopuka kālā / kākoʻo: ʻAʻohe.

ʻO ka hōʻike mua: Ua hōʻike ʻia ma ka XII National Congress of Psychiatry; Nowemapa 10 – 12, 2016; Vilamoura, Pokukala.

ʻAe i ka ahonui: Ua hāʻawi ka mea maʻi i ka mana i kākau ʻia e hoʻopuka i ka hihia, a ua hōʻike ʻia ka ʻike e pale ai i kahi ʻimi ʻole.

Kūpono ʻia ma ka pūnaewele: Pepeluali 15, 2018.

ʻO ka mālama mua mua CNS Disord 2018; 20 (1): 17l02109

To cite: Camacho M, Moura AR, Oliveira-Maia AJ. ʻO ka hana hoʻohālikelike hana hoʻohālikelike ʻia me ka maʻi naltrexone. ʻO ka mālama mua mua CNS Disord. 2018; 20 (1): 17l02109.

E kaʻana: https://doi.org/10.4088/PCC.17l02109