Why Anti-Depressant Zoloft Works Best for Later Onset Alcoholism

One of the ways that alcohol can affect the brain is by damaging the functioning ofserotonin，一种影响情绪，睡眠，食欲，温度调节和情绪的化学物质。

因此，含酒精障碍的人通常会报告抑郁和焦虑的问题。他们的医疗保健提供者通常会规定选择性血清素再摄取抑制剂，以帮助他们保持血清素的最佳水平。

“选择性血清素再吸收抑制剂是一类蚂蚁最广泛的规定i-depressants," said William Dundon, senior research investigator in the department of psychiatry at the University of Pennsylvania School of Medicine. "SSRIs work by affecting the level of serotonin in the brain and elsewhere in the body. In the brain, serotonin is thought to influence mood, emotions, sleep, appetite, and temperature regulation."

Research has found, however, thatSSRIs—such as sertraline (Zoloft.)—do not work well for some people with alcohol use disorders.

Zoloft不适用于所有酒精使用障碍

确定为什么ssri类药物帮助一些患者酒精度ohol use disorders and not others, Dundon and his colleagues examined two categories of alcohol dependence defined by researcher Thomas Babor of the University of Connecticut.

Babor划分了个人酒精问题分为两组，型A和B型。型酒精依赖性是基于环境的，并且通常在生命后期发生，而B型酒精依赖性是基于遗传学的遗传和生命早期。

根据Babor的研究，B型酒精中毒倾向于具有比酗酒的更大的不利影响。一般来说，B型酒精中毒比酗酒更严重，风险更高。

在该研究期间，100名含酒精障碍的人进行了三个月的肉类（200毫克/天）或安慰剂胶囊和基于酗酒者匿名框架的个体治疗。55人含有酒精依赖的人和B型酒精依赖的45人受访了他们的饮酒。

Zoloft帮助键入酒精依赖

The researchers compared monthly alcohol consumption for the six months following treatment to alcohol consumption during the last month of treatment. Dundon's study found that people with Type A alcoholism had a better treatment response to Zoloft than people with Type B alcoholism.

During the six months following treatment, the Type A group treated with Zoloft maintained their gains, while the Type B group did not.

保持积极的结果

具体而言，Dundon研究发现：

• Type A people with alcohol use disorder who took Zoloft maintained, for at least six months after treatment ceased, the positive results they obtained during treatment
• Type B people with alcohol use disorder treated with Zoloft continued to show no pharmacotherapeutic benefits during the six-month period following treatment.
• For Type B people with alcohol use disorder, heavy drinking actually increased during the six months following treatment with Zoloft.

SSRIs Are Not Appropriate for Type B Alcohol Dependence

“我们似乎已经确定了酗酒者的亚群，型患者在治疗期间对萨拉尔林作出良好反应，并在结束治疗后的六个月内保持收益，”Dundon说。

"However, there is another subgroup, Type Bs, for whom SSRIs may not be appropriate. This subgroup seemed to maintain their gains from the AA-based individual therapy only if they had not received sertraline," he said.

研究人员审查了Babor两种饮酒依赖性的原因是由于之前的研究表明，两组之间的血清素代谢差异存在差异。在早期的研究中发现B型血酮代谢在血清素代谢中具有更多异常，并且认为该组更有可能应对Zoloft治疗。然而，B型群体对SSRI治疗和六个月后治疗期的造型较差。

对酒精使用障碍治疗计划的影响

The researchers concluded that being able to determine whether people with an alcohol use disorder entering treatment are either Type A or Type B could be helpful in developing a treatment plan.

"I think our study clearly suggests that there may be ways to subtype alcoholics and that these different subgroups of alcoholics may respond differently to the same treatment," Dundon said. "Numerous classification schemes have been proposed to differentiate types of alcoholics. Our study supports the usefulness of the Babor Type A and Type B classification system."

研究证实了Babor的A和B酒精依赖

Later research by the Public Health Institute and the University of California, San Francisco using data from the National Epidemiologic Survey on Alcohol and Related Conditions confirmed that Type A and Type B alcohol dependence exist in real life.

The study found that Type B alcohol dependence in the general population, compared to Type A, led to higher alcohol severity and more co-occurring drug, mental, and physical health problems.

B型组是可能的两倍酒精依赖三年后，更有可能是沉重的饮酒者和药物依赖。