Rethinking trazodone for insomnia in alcohol use disorder.

IF 3.2 2区医学 Q1 SUBSTANCE ABUSE Addiction Science & Clinical Practice Pub Date : 2025-03-25 DOI:10.1186/s13722-025-00552-3

Jeffrey Pan, Jürgen Rehm, Evan Wood

引用次数: 0

Abstract

Background: Insomnia is a common condition experienced by many individuals with excessive alcohol use and alcohol use disorder, and the serotonin antagonist and reuptake inhibitor trazodone has emerged as a mainstay of treatment for insomnia in this population.

Main body: However, an underappreciated literature has demonstrated potential for an increase in alcohol use while persons with alcohol use disorder are taking trazodone for sleep challenges. Additionally, multiple trials have identified trazodone's metabolite meta-Chlorophenylpiperazine as a pharmaceutical inducer of increased alcohol craving and use.

Conclusion: Increased awareness in the potential of worsening drinking behaviour with trazodone accompanied by the preferential use of safer alternative treatment strategies can likely improve outcomes for patients with heavy drinking and alcohol use disorder.

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再思考曲唑酮对酒精使用障碍患者失眠的作用。

背景：失眠是许多过度饮酒和酒精使用障碍患者的常见症状，血清素拮抗剂和再摄取抑制剂曲唑酮已成为这类人群治疗失眠的主要药物。正文：然而，一篇未得到充分重视的文献表明，当酒精使用障碍患者服用曲唑酮治疗睡眠障碍时，酒精使用可能会增加。此外，多项试验已经确定曲唑酮的代谢物间氯苯哌嗪是增加酒精渴望和使用的药物诱导剂。结论：提高对曲唑酮可能加重饮酒行为的认识，同时优先使用更安全的替代治疗策略，可能改善重度饮酒和酒精使用障碍患者的预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Addiction Science & Clinical Practice Psychology-Clinical Psychology

CiteScore

3.90

自引率

10.80%

发文量

审稿时长

28 weeks

期刊介绍： Addiction Science & Clinical Practice provides a forum for clinically relevant research and perspectives that contribute to improving the quality of care for people with unhealthy alcohol, tobacco, or other drug use and addictive behaviours across a spectrum of clinical settings. Addiction Science & Clinical Practice accepts articles of clinical relevance related to the prevention and treatment of unhealthy alcohol, tobacco, and other drug use across the spectrum of clinical settings. Topics of interest address issues related to the following: the spectrum of unhealthy use of alcohol, tobacco, and other drugs among the range of affected persons (e.g., not limited by age, race/ethnicity, gender, or sexual orientation); the array of clinical prevention and treatment practices (from health messages, to identification and early intervention, to more extensive interventions including counseling and pharmacotherapy and other management strategies); and identification and management of medical, psychiatric, social, and other health consequences of substance use. Addiction Science & Clinical Practice is particularly interested in articles that address how to improve the quality of care for people with unhealthy substance use and related conditions as described in the (US) Institute of Medicine report, Improving the Quality of Healthcare for Mental Health and Substance Use Conditions (Washington, DC: National Academies Press, 2006). Such articles address the quality of care and of health services. Although the journal also welcomes submissions that address these conditions in addiction speciality-treatment settings, the journal is particularly interested in including articles that address unhealthy use outside these settings, including experience with novel models of care and outcomes, and outcomes of research-practice collaborations. Although Addiction Science & Clinical Practice is generally not an outlet for basic science research, we will accept basic science research manuscripts that have clearly described potential clinical relevance and are accessible to audiences outside a narrow laboratory research field.