Skip to main content
SpringerLink
Log in

Pharmakologische Rückfallprävention bei Alkohol- und Tabakabhängigkeit

Pharmacological relapse prevention in alcohol and tobacco dependence

  • Arzneimitteltherapie
  • Published:
Der Internist Aims and scope Submit manuscript

Zusammenfassung

Mit zunehmendem Verständnis der neurobiologischen Grundlagen von Alkohol- oder Tabakabhängigkeit ist die Bedeutung medikamentöser Möglichkeiten zur Entwöhnung gestiegen. Bei der Alkoholabhängigkeit können Anti-Craving-Substanzen in Kombination mit psychotherapeutischen und psychosozialen Maßnahmen bisherige Behandlungserfolge beträchtlich steigern. Besonders zu nennen sind der in Deutschland in dieser Indikation zugelassene NMDA-Rezeptorantagonist Acamprosat und der Opiatrezeptorantagonist Naltrexon, deren Effekte auf die Rückfallprophylaxe in zahlreichen Studien belegt sind. Werden die zur Abstinenz motivierten Patienten nach Entgiftung ein Jahr lang medikamentös rückfallprophylaktisch behandelt, kommt es zu einer Verdoppelung der Abstinenzrate, die die eigentliche Behandlungszeit überdauert. Bei der Tabakabhängigkeit können Nikotinersatzpräparate in unterschiedlicher Applikationsform (Nikotinpflaster, Kaugummi, Tablette, Inhaler) die Entzugssymptomatik reduzieren und die Abstinenzfähigkeit steigern. In zahlreichen Studien erwies sich eine mit verhaltenstherapeutischen Methoden kombinierte Nikotinersatztherapie als am besten wirksam. Neben Nikotinersatzpräparaten ist das Antidepressivum Bupropion in dieser Indikation in Deutschland zugelassen. Neue individualisierte pharmakologische Ansätze in der Behandlung der Alkohol- und Tabakabhängigkeit sollen zukünftig die Therapieergebnisse weiter verbessern.

Abstract

A better understanding of the neurobiological substrates of alcohol and tobacco dependence has been accompanied by the increasing role of pharmacological relapse prevention. In alcohol dependence, substances which are able to block or ameliorate alcohol craving improve the maintenance of abstinence in combination with psychosocial treatment. In particular, the N-methyl-D-aspartate receptor antagonist acamprosate and the opiate receptor antagonist naltrexone have been shown to be effective in numerous trials. Administration starts immediately after detoxification and should last for 12 months. This treatment, however, is not a replacement for the psychosocial treatment of the alcohol dependence. Compared with placebo treatment, approximately twice as many patients remain abstinent under acamprosate 1 year after the end of treatment. The most widely studied and used pharmacotherapy for the treatment of tobacco dependence is nicotine containing medications. Nicotine replacement therapies (patch, gum, tablet, inhaler) have been shown to reduce tobacco craving and enhance abstinence. The only non-nicotine medication that has been approved in Germany is the antidepressant bupropion. Current studies identify particularly suitable subgroups of patients responding to more individualized pharmacological relapse prevention. A specific application of these substances will optimise the outcome for alcohol and tobacco dependent patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1
Abb. 2

Literatur

  1. Feuerlein W, Kufner H (1989) A prospective multicentre study of in-patient treatment for alcoholics: 18- and 48-month follow-up (Munich Evaluation for Alcoholism Treatment, MEAT). Eur Arch Psychiatry Neurol Sci 239: 144–157

    Article  PubMed  Google Scholar 

  2. Mann K, Schafer DR, Langle G et al. (2005) The long-term course of alcoholism, 5, 10 and 16 years after treatment. Addiction 100: 797–805

    Article  PubMed  Google Scholar 

  3. Project MATCH Research Group (1998) Matching alcoholism treatments to client heterogeneity: Project MATCH three-year drinking outcomes. Alcohol Clin Exp Res 22: 1300–1311

    PubMed  Google Scholar 

  4. Mann K (2004) Pharmacotherapy of alcohol dependence: a review of the clinical data. CNS Drugs 18: 485–504

    PubMed  Google Scholar 

  5. Anton RF, O’Malley SS, Ciraulo DA et al. (2006) Combined pharmacotherapies and behavioral interventions for alcohol dependence: the COMBINE study: a randomized controlled trial. JAMA 295: 2003–2017

    Article  PubMed  Google Scholar 

  6. Abi-Dargham A, Krystal JH, Anjilvel S et al. (1998) Alterations of benzodiazepine receptors in type II alcoholic subjects measured with SPECT and [I-123]iomazenil. American Journal of Psychiatry 155: 1550–1555

    PubMed  Google Scholar 

  7. Tsai G, Gastfriend DR, Coyle JT (1995) The glutamatergic basis of human alcoholism. Am J Psychiatry 152: 332–340

    PubMed  Google Scholar 

  8. Engberg G, Hajos M (1992) Alcohol withdrawal reaction as a result of adaptive changes of excitatory amino acid receptors. Naunyn Schmiedebergs Arch Pharmacol 346: 437–441

    Article  PubMed  Google Scholar 

  9. Siegel S, Hinson RE, Krank MD et al. (1982) Heroin „overdose“ death: contribution of drug-associated environmental cues. Science 216: 436–437

    Article  PubMed  Google Scholar 

  10. Verheul R, van den BW, Geerlings P (1999) A three-pathway psychobiological model of craving for alcohol. Alcohol Alcohol 34: 197–222

    PubMed  Google Scholar 

  11. Fuller RK, Branchey L, Brightwell DR et al. (1986) Disulfiram treatment of alcoholism. A Veterans Administration cooperative study. JAMA 256: 1449–1455

    Article  PubMed  Google Scholar 

  12. Johnsen J, Morland J (1991) Disulfiram implant: a double-blind placebo controlled follow-up on treatment outcome. Alcohol Clin Exp Res 15: 532–536

    Article  PubMed  Google Scholar 

  13. Ehrenreich H, Jahn H, Heutelbeck K et al. (2002) ALITA – Neue Wege in der ambulanten Intensivbehandlung von Alkoholabhängigen. In: Mann KF (Hrsg) Neue Therapieansätze bei Alkoholproblemen. Pabst, Lengerich, pp 145–160

  14. Froehlich JC, Harts J, Lumeng L et al. (1990) Naloxone attenuates voluntary ethanol intake in rats selectively bred for high ethanol preference. Pharmacol Biochem Behav 35: 385–390

    Article  PubMed  Google Scholar 

  15. Anton RF, Moak DH, Waid LR et al. (1999) Naltrexone and cognitive behavioral therapy for the treatment of outpatient alcoholics: results of a placebo-controlled trial. Am J Psychiatry 156: 1758–1764

    PubMed  Google Scholar 

  16. Chick J, Howlett H, Morgan MY et al. (2000) United Kingdom Multicentre Acamprosate Study (UKMAS): a 6-month prospective study of acamprosate versus placebo in preventing relapse after withdrawal from alcohol. Alcohol Alcohol 35: 176–187

    PubMed  Google Scholar 

  17. Cornelius JR, Salloum IM, Ehler JG et al. (1997) Fluoxetine in depressed alcoholics: a double-blind, placebo-controlled trial. Arch Gen Psychiatry 54: 700–705

    PubMed  Google Scholar 

  18. Gastpar M, Bonnet U, Boning J et al. (2002) Lack of efficacy of naltrexone in the prevention of alcohol relapse: results from a German multicenter study. J Clin Psychopharmacol 22: 592–598

    Article  PubMed  Google Scholar 

  19. Johnson BA, Roache JD, Javors MA et al. (2000) Ondansetron for reduction of drinking among biologically predisposed alcoholic patients: a randomized controlled trial. JAMA 284: 963–971

    Article  PubMed  Google Scholar 

  20. Kiefer F, Jahn H, Tarnaske T et al. (2003) Comparing and combining naltrexone and acamprosate in relapse prevention of alcoholism: a double-blind, placebo-controlled study. Arch Gen Psychiatry 60: 92–99

    PubMed  Google Scholar 

  21. Krystal JH, Cramer JA, Krol WF et al. (2001) Naltrexone in the treatment of alcohol dependence. N Engl J Med 345: 1734–1739

    Article  PubMed  Google Scholar 

  22. Namkoong K, Lee BO, Lee PG et al. (2003) Acamprosate in korean alcohol-dependent patients: a multi-centre, randomized, double-blind, placebo-controlled study. Alcohol Alcohol 38: 135–141

    PubMed  Google Scholar 

  23. O’Malley SS, Jaffe AJ, Chang G et al. (1992) Naltrexone and coping skills therapy for alcohol dependence: a controlled study. Arch Gen Psychiatry 49: 881–887

    PubMed  Google Scholar 

  24. Garbutt JC, West SL, Carey TS et al. (1999) Pharmacological treatment of alcohol dependence: a review of the evidence. JAMA 281: 1318–1325

    Article  PubMed  Google Scholar 

  25. Balldin J, Berglund M, Borg S et al. (2003) A 6-month controlled naltrexone study: combined effect with cognitive behavioral therapy in outpatient treatment of alcohol dependence. Alcohol Clin Exp Res 27: 1142–1149

    Article  PubMed  Google Scholar 

  26. Heinala P, Alho H, Kiianmaa K et al. (2001) Targeted use of naltrexone without prior detoxification in the treatment of alcohol dependence: a factorial double-blind, placebo-controlled trial. J Clin Psychopharmacol 21: 287–292

    Article  PubMed  Google Scholar 

  27. Garbutt JC, Kranzler HR, O’Malley SS et al. (2005) Efficacy and tolerability of long-acting injectable naltrexone for alcohol dependence: a randomized controlled trial. JAMA 293: 1617–1625

    Article  PubMed  Google Scholar 

  28. Srisurapanont M, Jarusuraisin N (2005) Naltrexone for the treatment of alcoholism: a meta-analysis of randomized controlled trials. Int J Neuropsychopharmacol 8: 267–280

    Article  PubMed  Google Scholar 

  29. Rammes G, Mahal B, Putzke J et al. (2001) The anti-craving compound acamprosate acts as a weak NMDA-receptor antagonist, but modulates NMDA-receptor subunit expression similar to memantine and MK-801. Neuropharmacology 40: 749–760

    Article  PubMed  Google Scholar 

  30. Littleton J (1995) Acamprosate in alcohol dependence: how does it work? Addiction 90: 1179–1188

    Article  PubMed  Google Scholar 

  31. Besson J, Aeby F, Kasas A et al. (1998) Combined efficacy of acamprosate and disulfiram in the treatment of alcoholism: a controlled study. Alcohol Clin Exp Res 22: 573–579

    Article  PubMed  Google Scholar 

  32. Gual A, Lehert P (2001) Acamprosate during and after acute alcohol withdrawal: a double-blind placebo-controlled study in Spain. Alcohol Alcohol 36: 413–418

    PubMed  Google Scholar 

  33. Sass H, Soyka M, Mann K et al. (1996) Relapse prevention by acamprosate: results from a placebo-controlled study on alcohol dependence. Arch Gen Psychiatry 53: 673–680

    PubMed  Google Scholar 

  34. Roussaux JP, Hers D, Ferauge M (1996) Does acamprosate diminish the appetite for alcohol in weaned alcoholics?. J Pharm Belg 51: 65–68

    PubMed  Google Scholar 

  35. Whitworth AB, Fischer F, Lesch OM et al. (1996) Comparison of acamprosate and placebo in long-term treatment of alcohol dependence. Lancet 347: 1438–1442

    Article  PubMed  Google Scholar 

  36. Ansoms C, Deckers F, Lehert P et al. (2000) An open study with acamprosate in Belgium and Luxemburg: results on sociodemographics, supportive treatment and outcome. Eur Addict Res 6: 132–140

    Article  PubMed  Google Scholar 

  37. Mason BJ, Ritvo EC, Morgan RO et al. (1994) A double-blind, placebo-controlled pilot study to evaluate the efficacy and safety of oral nalmefene HCl for alcohol dependence. Alcohol Clin Exp Res 18: 1162–1167

    Article  PubMed  Google Scholar 

  38. Drobes DJ, Anton RF, Thomas SE et al. (2004) Effects of naltrexone and nalmefene on subjective response to alcohol among non-treatment-seeking alcoholics and social drinkers. Alcohol Clin Exp Res 28: 1362–1370

    PubMed  Google Scholar 

  39. Anton RF, Pettinati H, Zweben A et al. (2004) A multi-site dose ranging study of nalmefene in the treatment of alcohol dependence. J Clin Psychopharmacol 24: 421–428

    Article  PubMed  Google Scholar 

  40. Shaw GK, Waller S, Majumdar SK et al. (1994) Tiapride in the prevention of relapse in recently detoxified alcoholics. Br J Psychiatry 165: 515–523

    PubMed  Google Scholar 

  41. Shaw GK, Majumdar SK, Waller S et al. (1987) Tiapride in the long-term management of alcoholics of anxious or depressive temperament. Br J Psychiatry 150: 164–168

    PubMed  Google Scholar 

  42. Wiesbeck GA, Weijers HG, Lesch OM et al. (2001) Flupenthixol decanoate and relapse prevention in alcoholics: results from a placebo-controlled study. Alcohol Alcohol 36: 329–334

    PubMed  Google Scholar 

  43. Kranzler HR, Burleson JA, Korner P et al. (1995) Placebo-controlled trial of fluoxetine as an adjunct to relapse prevention in alcoholics. Am J Psychiatry 152: 391–397

    PubMed  Google Scholar 

  44. Kabel DI, Petty F (1996) A placebo-controlled, double-blind study of fluoxetine in severe alcohol dependence: adjunctive pharmacotherapy during and after inpatient treatment. Alcohol Clin Exp Res 20: 780–784

    Article  PubMed  Google Scholar 

  45. Janiri L, Gobbi G, Mannelli P et al. (1996) Effects of fluoxetine at antidepressant doses on short-term outcome of detoxified alcoholics. Int Clin Psychopharmacol 11: 109–117

    Google Scholar 

  46. Gorelick DA, Paredes A (1992) Effect of fluoxetine on alcohol consumption in male alcoholics. Alcohol Clin Exp Res 16: 261–265

    Article  PubMed  Google Scholar 

  47. Tiihonen J, Ryynanen OP, Kauhanen J et al. (1996) Citalopram in the treatment of alcoholism: a double-blind placebo-controlled study. Pharmacopsychiatry 29: 27–29

    PubMed  Google Scholar 

  48. Naranjo CA, Bremner KE, Lanctot KL (1995) Effects of citalopram and a brief psycho-social intervention on alcohol intake, dependence and problems. Addiction 90: 87–99

    Article  PubMed  Google Scholar 

  49. Pettinati HM, Volpicelli JR, Luck G et al. (2001) Double-blind clinical trial of sertraline treatment for alcohol dependence. J Clin Psychopharmacol 21: 143–153

    Article  PubMed  Google Scholar 

  50. Johnson BA, Jasinski DR, Galloway GP et al. (1996) Ritanserin in the treatment of alcohol dependence: a multi-center clinical trial. Ritanserin Study Group. Psychopharmacology 128: 206–215

    Article  PubMed  Google Scholar 

  51. Wiesbeck GA, Weijers HG, Chick J et al. (1999) Ritanserin in relapse prevention in abstinent alcoholics: results from a placebo-controlled double-blind international multicenter trial. Ritanserin in Alcoholism Work Group. Alcohol Clin Exp Res 23: 230–235

    Article  PubMed  Google Scholar 

  52. Kranzler HR, Modesto-Lowe V, Van Kirk J (2000) Naltrexone vs. nefazodone for treatment of alcohol dependence: a placebo-controlled trial. Neuropsychopharmacology 22: 493–503

    Article  PubMed  Google Scholar 

  53. Bruno F (1989) Buspirone in the treatment of alcoholic patients. Psychopathology 22 [Suppl 1]: 49–59

    PubMed  Google Scholar 

  54. Malec E, Malec T, Gagne MA et al. (1996) Buspirone in the treatment of alcohol dependence: a placebo-controlled trial. Alcohol Clin Exp Res 20: 307–312

    Article  PubMed  Google Scholar 

  55. Sellers EM, Toneatto T, Romach MK et al. (1994) Clinical efficacy of the 5-HT3 antagonist ondansetron in alcohol abuse and dependence. Alcohol Clin Exp Res 18: 879–885

    Article  PubMed  Google Scholar 

  56. Mueller TI, Stout RL, Rudden S et al. (1997) A double-blind, placebo-controlled pilot study of carbamazepine for the treatment of alcohol dependence. Alcohol Clin Exp Res 21: 86–92

    Article  PubMed  Google Scholar 

  57. Johnson BA, Ait-Daoud N, Akhtar FZ et al. (2004) Oral topiramate reduces the consequences of drinking and improves the quality of life of alcohol-dependent individuals: a randomized controlled trial. Arch Gen Psychiatry 61: 905–912

    Article  PubMed  Google Scholar 

  58. Petrakis IL, Poling J, Levinson C et al. (2005) Naltrexone and disulfiram in patients with alcohol dependence and comorbid psychiatric disorders. Biol Psychiatry 57: 1128–1137

    Article  PubMed  Google Scholar 

  59. Di Chiara G (2000) Role of dopamine in the behavioural actions of nicotine related to addiction. Eur J Pharmacol 393: 295–314

    Article  PubMed  Google Scholar 

  60. Pakkanen JS, Jokitalo E, Tuominen RK (2005) Up-regulation of beta2 and alpha7 subunit containing nicotinic acetylcholine receptors in mouse striatum at cellular level. Eur J Neurosci 21: 2681–2691

    Article  PubMed  Google Scholar 

  61. Picciotto MR, Zoli M, Rimondini R et al. (1998) Acetylcholine receptors containing the beta2 subunit are involved in the reinforcing properties of nicotine. Nature 391: 173–177

    Article  PubMed  Google Scholar 

  62. Brody AL, Olmstead RE, London ED et al. (2004) Smoking-induced ventral striatum dopamine release. Am J Psychiatry 161: 1211–1218

    Article  PubMed  Google Scholar 

  63. Garris PA, Kilpatrick M, Bunin MA et al. (1999) Dissociation of dopamine release in the nucleus accumbens from intracranial self-stimulation. Nature 398: 67–69

    Article  PubMed  Google Scholar 

  64. Dani JA, Radcliffe KA, Pidoplichko VI (2000) Variations in desensitization of nicotinic acetylcholine receptors from hippocampus and midbrain dopamine areas. Eur J Pharmacol 393: 31–38

    Article  PubMed  Google Scholar 

  65. Olausson P, Jentsch JD, Taylor JR (2003) Repeated nicotine exposure enhances reward-related learning in the rat. Neuropsychopharmacology 28: 1264–1271

    Article  PubMed  Google Scholar 

  66. Olausson P, Jentsch JD, Taylor JR (2004) Nicotine enhances responding with conditioned reinforcement. Psychopharmacology 171: 173–178

    Article  PubMed  Google Scholar 

  67. Smolka MN, Buhler M, Klein S et al. (2006) Severity of nicotine dependence modulates cue-induced brain activity in regions involved in motor preparation and imagery. Psychopharmacology 184: 577–588

    Article  PubMed  Google Scholar 

  68. Picciotto MR, Brunzell DH, Caldarone BJ (2002) Effect of nicotine and nicotinic receptors on anxiety and depression. Neuroreport 13: 1097–1106

    Article  PubMed  Google Scholar 

  69. Pomerleau OF (1986) Nicotine as a psychoactive drug: anxiety and pain reduction. Psychopharmacol Bull 22: 865–869

    PubMed  Google Scholar 

  70. Gilbert DG, Robinson JH, Chamberlin CL et al. (1989) Effects of smoking/nicotine on anxiety, heart rate, and lateralization of EEG during a stressful movie. Psychophysiology 26: 311–320

    PubMed  Google Scholar 

  71. Laje RP, Berman JA, Glassman AH (2001) Depression and nicotine: preclinical and clinical evidence for common mechanisms. Curr Psychiatry Rep 3: 470–474

    PubMed  Google Scholar 

  72. Batra A, Fagerstrom K (1997) New aspects of tobacco dependency and smoking cessation. Sucht 43: 277–282

    Google Scholar 

  73. Stead LF, Lancaster T (2005) Group behaviour therapy programmes for smoking cessation. Cochrane Database Syst Rev CD001007

  74. Batra A, Buchkremer G (2004) Tabakentwöhnung. 1. Aufl, Kohlhammer, Stuttgart

  75. Fiore MC, Bailey WC, Cohen SJ et al. (2000) Treating tobacco use and dependence. Clinical practice guideline. U.S. Department of Health and Human Services, Public Health Service

  76. Batra A, Lindinger P, Schütz C et al. (2004) AWMF-Leitlinien zur Behandlung der Tabakabhängigkeit. AWMF Leitlinien der DG Sucht

  77. Silagy C, Lancaster T, Stead L et al. (2004) Nicotine replacement therapy for smoking cessation. Cochrane Database Syst Rev CD000146

  78. Joseph AM, Norman SM, Ferry LH et al. (1996) The safety of transdermal nicotine as an aid to smoking cessation in patients with cardiac disease. N Engl J Med 335: 1792–1798

    Article  PubMed  Google Scholar 

  79. McRobbie H, Hajek P (2001) Nicotine replacement therapy in patients with cardiovascular disease: guidelines for health professionals. Addiction 96: 1547–1551

    Article  PubMed  Google Scholar 

  80. Benowitz NL (1991) Nicotine replacement therapy during pregnancy. JAMA 266: 3174–3177

    Article  PubMed  Google Scholar 

  81. Batra A, Klingler K, Landfeldt B et al. (2005) Smoking reduction treatment with 4-mg nicotine gum: a double-blind, randomized, placebo-controlled study. Clin Pharmacology Ther 78: 689–696

    Article  Google Scholar 

  82. Hughes JR, Stead LF, Lancaster T (2005) Nortriptyline for smoking cessation: a review. Nicotine Tob Res 7: 491–499

    Article  PubMed  Google Scholar 

  83. Jorenby DE, Leischow SJ, Nides MA et al. (1999) A controlled trial of sustained-release bupropion, a nicotine patch, or both for smoking cessation. N Engl J Med 340: 685–691

    Article  PubMed  Google Scholar 

  84. Cohen C, Perrault G, Voltz C et al. (2002) SR141716, a central cannabinoid (CB(1)) receptor antagonist, blocks the motivational and dopamine-releasing effects of nicotine in rats. Behav Pharmacol 13: 451–463

    PubMed  Google Scholar 

  85. Coe JW, Brooks PR, Vetelino MG et al. (2005) Varenicline: an alpha4beta2 nicotinic receptor partial agonist for smoking cessation. J Med Chem 48: 3474–3477

    Article  PubMed  Google Scholar 

  86. Cerny T (2005) Anti-nicotine vaccination: where are we? Recent Results Cancer Res 166: 167–175

    PubMed  Google Scholar 

  87. Granda Orive JI (2005) When will the nicotine vaccine be ready? Arch Bronconeumol 41: 2–4

    Article  PubMed  Google Scholar 

  88. Kandel D, Chen K, Warner LA et al. (1997) Prevalence and demographic correlates of symptoms of last year dependence on alcohol, nicotine, marijuana and cocaine in the U.S. population. Drug Alcohol Depend 44: 11–29

    Article  PubMed  Google Scholar 

  89. Hurt RD, Eberman KM, Croghan IT et al. (1994) Nicotine dependence treatment during inpatient treatment for other addictions: a prospective intervention trial. Alcohol Clin Exp Res 18: 867–872

    Article  PubMed  Google Scholar 

  90. Toneatto A, Sobell LC, Sobell MB et al. (1995) Effect of cigarette smoking on alcohol treatment outcome. J Subst Abuse 7: 245–252

    Article  PubMed  Google Scholar 

  91. Bobo JK, McIlvain HE, Lando HA et al. (1998) Effect of smoking cessation counseling on recovery from alcoholism: findings from a randomized community intervention trial. Addiction 93: 877–887

    Article  PubMed  Google Scholar 

  92. Olbrich R, Troeger S, Nikitopoulos J et al. (2006) Successful smoking reduction during inpatient alcohol detoxification: a controlled clinical trial. European Psychiatry (submitted)

    Google Scholar 

  93. Mann K, Ackermann K, Diehl A et al. (2005) Galantamine: a cholinergic patch in the treatment of alcoholism: a randomized, placebo-controlled trial. Psychopharmacology 184: 115–121

    Article  PubMed  Google Scholar 

  94. Diehl A, Nakovics H, Croissant B et al. (2006) Galantamine reduces smoking in alcohol dependent patients: a randomized, placebo-controlled trial. Int J Clin Pharmacol Ther (in press)

    Google Scholar 

  95. Rohsenow DJ, Monti PM, Colby SM et al. (2003) Naltrexone treatment for alcoholics: effect on cigarette smoking rates. Nicotine Tob Res 5: 231–236

    Article  PubMed  Google Scholar 

  96. Hutchison KE, Monti PM, Rohsenow DJ et al. (1999) Effects of naltrexone with nicotine replacement on smoking cue reactivity: preliminary results. Psychopharmacology 142: 139–143

    Article  PubMed  Google Scholar 

  97. Byars JA, Frost-Pineda K, Jacobs WS et al. (2005) Naltrexone augments the effects of nicotine replacement therapy in female smokers. J Addict Dis 24: 49–60

    Article  Google Scholar 

  98. Johnson BA (2004) Uses of topiramate in the treatment of alcohol dependence. Expert Rev Neurother 4: 751–758

    Article  PubMed  Google Scholar 

  99. Johnson BA, Ait-Daoud N, Akhtar FZ et al. (2005) Use of oral topiramate to promote smoking abstinence among alcohol-dependent smokers: a randomized controlled trial. Arch Intern Med 165: 1600–1605

    Article  PubMed  Google Scholar 

  100. Batra M, Schupp PE, Buchkremer G (1999) Tabakentwöhnung bei schwangeren Frauen oder Raucherinnen mit gesundheitlichen Risikofaktoren. Sucht 45: 339–345

    Google Scholar 

  101. Kiefer F, Mann K (2005) New achievements and pharmacotherapeutic approaches in the treatment of alcohol dependence. Eur J Pharmacol 526: 163–171

    Article  PubMed  Google Scholar 

  102. Henningfield JE, Fant RV, Buchhalter AR (2005) Pharmacotherapy for nicotine dependence. CA Cancer J Clin 55: 281–299

    PubMed  Google Scholar 

  103. West R, McNeill A, Raw M (2000) Smoking cessation guidelines for health professionals: an update. Health Education Authority. Thorax 55: 987–999

    Article  PubMed  Google Scholar 

  104. Hughes JR, Stead LF, Lancaster T (2003) Antidepressants for smoking cessation. Cochrane Database Syst Rev CD000031

  105. Diehl A, Smolka MN, Mann K (2003) Pharmakotherapie: Rückfallprophylaxe bei Alkoholabhängigkeit. Klinikarzt 32: 313–317

    Article  Google Scholar 

Download references

Interessenkonflikt

Keine Angaben

Author information

Authors and Affiliations

  1. Klinik für Abhängiges Verhalten und Suchtmedizin, Zentralinstitut für Seelische Gesundheit, J5, 68159, Mannheim, Deutschland

    A. Diehl & K. Mann

Authors
  1. A. Diehl
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. K. Mann
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to A. Diehl.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Diehl, A., Mann, K. Pharmakologische Rückfallprävention bei Alkohol- und Tabakabhängigkeit. Internist 48, 79–88 (2007). https://doi.org/10.1007/s00108-006-1755-z

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00108-006-1755-z

Schlüsselwörter

Keywords

Search

Navigation