Phekolo ea Litlhaselo Tse Ikhethang Tsa Bootsoa Sebelisa Naltrexone: Tlaleho ea Tlhahlobo (2015)

Comments: Mona ho na le thuto e 'ngoe e bonts'ang hore sethethefatsi sa Naltrexone se thusa makhoba a litšoantšo tsa bootsoa ho laola tšebeliso ea bona ea litšoantšo tsa bootsoa (e le khetho ea ho qetela). Bakeng sa puisano e phethahetseng, le e khanyang, ea Naltrexone le bokhoba ba litšoantšo tsa bootsoa bona sena thuto ea pejana.


Khokahano ho Research Gate PDF ea pampiri e felletseng

Journal of American Psychiatry . 01 / 2016; Tobetsa. ETSAHALA: 10.1176 / appi.ajp.2015.15060843

Shane W. Kraus, PhD a, b * Sarah Meshberg-Cohen, PhD a, b Steve Martino, PhD a, b Lantie J. Quinones, MD c Marc N. Potenza, MD, PhD b

VISN 1 Thuto ea Patlisiso ea Boloetse ba Kelello ea Bakuli ba Mafu le Clinical, VA Connecticut Healthcare System, West Haven, CT USA

b Yale University School of Medicine, New Haven, CT USA

c Sepetlele sa McLean, Sekolo sa Bongaka sa Harvard, Lefapha la Psychiatry, Belmont, MA USA

* Sengoli se lumellanang: Shane W. Kraus, Ph.D., VISN 1 MIRECC, VA Connecticut Healthcare System, 950 Campbell Avenue 151D, West Haven, Connecticut 06515, United States. Mohala: 203-932-5711, E fetisitsoeng: 7907; Email: [imeile e sirelelitsoe]

HO TS'ELISO:

Pakeng tsa 30-50% ea banna ba US ba shebelletse litšoantšo tsa bootsoa khafetsa, mme ke karolo e nyane feela ea bashebelli e ntlafatsang tšebeliso e qobelloang. Ts'ebeliso e ts'oanang ea litšoantšo tsa bootsoa e bonts'a ho lakatsa, ho ts'oaroa ka boits'oaro, ho senyeha ha sechaba / mosebetsi, le litheko tse phahameng tsa kelello psychorbidity (1). Ka lebaka la linyeoe tse peli tse phatlalalitsoeng tsa morao-rao (2, 3) tse fanang ka maikutlo a naltrexone, mohanyetsi oa opioid-receptor, a ka fokotsa botebo ba takatso ea thobalano le boits'oaro bo amanang le boitšoaro bo sa qobelloang ba thobalano, re tlaleha ka taba ea naltrexone e le tumello ho psychotherapy ho monna oa monna ea nyetseng, ea sebetsang, ea sa nyalanang le monna oa hae ea neng a batla bongaka ba mofuta o mong oa 30 ea neng a batla kalafo bakeng sa ho shebella litšoantšo tse litšila tse tsosang takatso tsa inthanete. Ts'ebetso ea Naltrexone ea ho fokotsa takatso ea thobalano ea ho ipholla litho tsa botona kapa botšehali e senoloa haholo.

Mong D. o ile a qala ho sebelisa litšoantšo tsa bootsoa khafetsa a le lilemo li 13. Nakong ea lipotso tsa botaki, o tlalehile ho ipholla litho tsa botona kapa botšehali litšoantšo tse tsosang takatso ea ho sheba litšoantšo tsa bootsoa lilemong tse fetileng tsa 10 leha ho bile le liteko tse ngata tse sa atlehang tsa ho tlohela; o ne a shebella litšoantšo tsa bootsoa tsa inthanete hoo e batlang e le letsatsi le leng le le leng ka metsotso e ka bang 30. O tlaleha tlhahlobo ea pejana ea khatello e kholo ea khatello ea maikutlo, mme a se na nalane ea tšebeliso e mpe ea lithethefatsi, boitšoaro bo kotsi ba thobalano, mathata a bohlokoa a bongaka, ebile o ne a sa noe meriana e boletsoeng.

Mong D o ile a qala ho ea bongakeng beke le beke ea bongaka bo sebetsanang le ngaka ea mafu a kelello. Bakeng sa libeke tsa 18, o qetile ho hlahloba litekanyetso tsa ho sheba litšoantšo tsa bootsoa Inthaneteng (1.0 = No Urge, 7.0 = Intense Urge) le hore na o kile a shebella le ho ipholla litho tsa bootsoa. Leha a fokotsa ts'ebeliso ea mantlha ea litšoantšo tsa bootsoa ke 70%, Monghali D o ntse a tsoela pele ho tlaleha takatso ea khafetsa ea thobalano ho ipholla litho tsa botona le botšehali inthanetengglehlasipa. Ka hona, bekeng ea leshome ea kalafo, o ile a fuoa kalafo ea naltrexone (50 mg / d).

Pele ho feta libeke tse peli a qala ho sebelisa bongaka, o tlaleha ho fokotseha ho hoholo hoa takatso ea hae ea ho ipholla litho tsa thobalano. Joalokaha ho bontšitsoe Setšoantšong 1, libekeng tse robong tseo a ileng a li nka naltrexone, botebo ba takatso ea hae ea thobalano bo ile ba fokotseha haholo (MLibeke tsa 1-9 = 3.71, SD= 1.28 vs. MLibeke tsa 10-18 = 2.37, SD= .80), t(124) = 6.93, p<.0001, Cohen's d = 1.25). O ne a boetse a sheba litšoantšo tse manyala tse hlephisang boitšoaro khafetsa (matsatsi a 5 ka libeke tsa 10-18; matsatsi a 17 libekeng tsa 1-9), χ2 (1, N= 125) = 7.04, p<.01 (KAPA = .25, 95% CI = 0.09-0.73). Ntle le moo, o ile a boela a kopanela liphate le mosali oa hae kamehla ka mokhoa o khotsofatsang.

Seo re se fumaneng se fana ka maikutlo a hore naltrexone e ka ba kalafo e thusang ea bakuli ho tlaleha bothata bo bobe ba ho laola boits'oaro bo joalo ka ho shebella litšoantšo tsa bootsoa ka inthanete. Moeli o hlokomelehang oa tlaleho ea linyeoe tsa hona joale ke hore ha rea ​​sebelisa moralo o khutlisetsang (WA) le Mong D. Ho feta moo, tlhahlobo e tsoelang pele tekong e laoloang mahlo e sa sebetseng hantle, e sa sebetseng, e laoloang sebaka le ho hlahloba matla le mamello ea naltrexone le ( kapa ntle le) psychotherapy bakeng sa kalafo ea ho sheba litšoantšo tse litšila tse tsosang takatso ea boitšoaro bo bobe le mekhoa e meng e tlamang ea thobalano e ea hlokahala.

LITLHAHISO

1. Kraus SW, Potenza MN, Martino S, Grant JE. Ho hlahloba likarolo tsa psychometric tsa Yale-Brown Obsessive-Compulsive Scale ka har'a mohlala oa basebelisi ba litšoantšo tsa bootsoa tse qobelloang. Compr Psychiatry. 2015.

2. Bostwick JM, Bucci JA: Bokhoba ba thobalano ba marang-rang bo tšoaroang ka naltrexone. in Provenings ea Mayo Clinic, Elsevier; 2008. maq. 226-230.

3. Raymond NC, Grant JE, Coleman E. Augmentation le naltrexone ho tšoara boitšoaro bo qobelloang ba thobalano: Letoto la linyeoe. Ann Clin Psychiatry. 2010; 22: 55-62. 5

 

Palo ea Libeke Setšoantšo sa 1. Ho Bolela Bongata ba Takatso ea Litšoantšo Tsa Bootsoa le Palo ea Matsatsi a Bontšitsoeng Litšoantšo Tsa Bootsoa Beke e 'ngoe le e' ngoe Pele / Post Naltrexone (50mg / d) Ho lakatsa Lintlha (1.0 - Ha ho Khothaletso, 7.0 - Khatello e Matla) Palo ea matsatsi a sebelisitsoeng litšoantšo tsa bootsoa ka beke

Naltrexone 50mg / d

dithuso tsa ditjhelete

Nyeoe ena e tlalehiloe e tšehelitsoe ke Tsamaiso ea Litaba tsa Veterans, VISN 1 Mental Illness Research Education le Litsi tsa Tleliniki, CASAColumbia le Setsi sa Naha sa Lipapali tse Ikarabellang. Litaba tsa sengoloang li bontša maikutlo a bangoli eseng hakaalo mekhatlo ea lichelete. Mekhatlo ea lithuso ea lichelete e ne e se na mokhoa oa ho ngola litaba tse ngotsoeng ka letsoho.

Litlhaloso

Bangoli ba tlaleha hore ha ba na likhohlano tsa lichelete mabapi le litaba tsa buka ena e ngotsoeng ka letsoho. Ngaka Potenza o fumane tšehetso ea lichelete kapa matšeliso bakeng sa tse latelang: Dr. Potenza o buisane le ho eletsa Lundbeck, Ironwood, Shire, INSYS le RiverMend Health; o amohetse tšehetso ea lipatlisiso (ho Yale) ho tsoa ho Setsi sa Naha sa Bophelo, Mohegan Sun Casino, Setsi sa Naha sa Lipapatso tse Ikarabellang, le meriana ea Pfizer; o nkile karolo lipatlisisong, liposong tsa mangolo kapa lipuisanong tsa mehala tse amanang le tšebeliso ea lithethefatsi, mathata a taolo ea tšusumetso kapa lihlooho tse ling tsa bophelo; e buisane le mekhatlo ea papali ea chelete le litaba tsa molao litabeng tse amanang le taolo ea tšusumetso; e fana ka tlhokomelo ea bongaka Lefapheng la Connecticut la Bophelo bo Botle ba kelello le lits'ebeletso tsa tlhekefetso ea mathata a boloi; e entse tlhahlobo ea lithuso bakeng sa Setsi sa Naha sa Bophelo le mekhatlo e meng; e hlophisitse kapa e hlophisitse baeti likoranteng kapa likarolo tsa koranta; e fane ka lipuo tsa thuto lithutong tse ntle, liketsahalong tsa CME le libakeng tse ling tsa bongaka kapa tsa saense; mme e hlahisitse libuka kapa likhaolo tsa buka bakeng sa baphatlalatsi ba mangolo a bophelo bo botle ba kelello.