Long-term pharmacotherapy aimed at maintaining abstinence or reducing alcohol intake in alcohol-dependent individuals. Guidelines from the Section of Pharmacotherapy of Polish Society for Research on Addictions (PTBU) and the Section of Psychopharmacology of Polish Psychiatric Association (PTP) – 2019 update

2019 ◽  
Vol 35 (2) ◽  
pp. 95-110
Author(s):  
Przemyslaw Bienkowski ◽  
Marcin Wojnar ◽  
Pawel Mierzejewski ◽  
Jerzy Samochowiec ◽  
Boguslaw Habrat ◽  
...  
Keyword(s):  
Alcohol Dependence ◽  
Alcohol Intake ◽  
Scientific Debate ◽  
Polish Society ◽  
Practical Guidelines ◽  
Alcohol Dependent

The article presents update of the 2013 Guidelines of the Pharmacotherapy Section of the Polish Society for Research on Addictions (PTBU) and the Psychopharmacology Section of the Polish Psychiatric Association (PTP) on long-term pharmacotherapy aimed at maintaining abstinence or reducing alcohol intake in adult alcohol-dependent patients. Apart from practical guidelines for long-term pharmacotherapy of alcohol dependence, the authors present the areas of uncertainty, which still require further studies and scientific debate.

Biochemical and genetic markers in patients with alcohol dependence and affective disorders and their correlation with alcohol intake

2016 ◽  
Vol 33 (S1) ◽  
pp. S19-S20
Author(s):  
U. Preuss ◽  
F. Wurst
Keyword(s):  
Alcohol Use ◽  
Alcohol Dependence ◽  
Affective Disorders ◽  
Alcohol Intake ◽  
Bipolar Disorders ◽  
Cross Sectional Study ◽  
Emergency Rooms ◽  
Higher Alcohol ◽  
Cross Sectional ◽  
Alcohol Dependent

Rates of comorbid affective disorders in alcohol-dependent individuals are significant. Biomarkers of alcohol use may support the diagnosis of high and frequent alcohol use in these individuals. The aim of these analyses of the WHO-ISBRA Study on State and Trait Markers of Alcohol Use and Dependence is to compare biomarkers of alcohol use across individuals with and without comorbid alcohol dependence and affective disorders. Significantly, higher values of these biomarkers are hypothesized in individuals with comorbid disorders compared to alcohol dependence only. Assessment of Alcohol dependence and comorbid depression and bipolar disorders were conducted using an adapted version of the Alcohol Use Disorder and Associated Disabilities Interview Schedule (AUDADIS). Altogether, n = 1863 individuals were included into the analyses, of whom n = 299 had a lifetime history of depression and n = 20 a bipolar disorder. Clinical characteristics like mean alcohol intake last month and biomarkers including ASAT, GGT, CDT, 5-HTOL/5-HIAA ratio and MAO-Activity were included into the analyses. Results indicate that AD only subjects had higher measures of all biomarkers compared to comorbid bipolar and depression subjects, while the latter had a higher alcohol intake during last month.Since this is a cross-sectional study, conducted in emergency rooms of several countries, this allegedly divergent result in alcohol intake in comorbid subjects compared to higher biomarkers in AD only subjects may indicate that drinking is more frequent in alcohol-dependent individuals while bipolar and depressed subjects may have more episodic pattern of alcohol intake. The latter may lead to shorter periods of intake compared to the chronic and frequent use of this substance in alcohol-dependent individuals and higher biomarkers of alcohol use.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Integrated Analyses of the Gut Microbiota, Intestinal Permeability and Serum Metabolome Phenotype in Rats with Alcohol Withdrawal Syndrome

2021 ◽  
Author(s):  
Fan Yang ◽  
Jidong Wei ◽  
Mengke Shen ◽  
Yating Ding ◽  
Yufan Lu ◽  
...  
Keyword(s):  
Alcohol Consumption ◽  
Gut Microbiota ◽  
Alcohol Dependence ◽  
Intestinal Permeability ◽  
Alcohol Intake ◽  
Metabolic Phenotype ◽  
Serum Metabolites ◽  
Colonic Microbiota ◽  
Gut Microbiota Dysbiosis ◽  
Alcohol Dependent

The etiology of alcohol dependence is not completely understood. Increasing evidence reveals that gut microbiota dysbiosis is associated with certain psychiatric disorders, including alcoholism, through the “microbiota-gut-brain” axis. The aims were to evaluate the effect of alcohol abuse on the gut microbiota, intestinal permeability and serum metabolic profile and to determine whether alcohol-induced alterations in gut microbiota are correlated with gut permeability and serum metabolic phenotype changes. 16S rRNA gene high-throughput sequencing and nontarget metabolomics techniques were applied in an alcohol-dependent rat model in the present study. The results showed that alcohol intake altered the composition and structure of the colonic microbiota, especially the relative abundance of the commensal microbes Lachnospiraceae and Prevotellaceae , which was significantly decreased. Alcohol-dependent rats developed gut leakiness and a serum metabolic phenotype disorder. The valine, leucine and isoleucine biosynthesis pathways and arginine and proline metabolism pathways were obviously influenced by alcohol intake. Moreover, alcohol consumption disturbed the brain’s neurotransmitter homeostasis. The regression analysis showed that alcohol-induced colonic microbiota dysbiosis was strongly associated with increased intestinal permeability and serum metabolic phenotype and neurotransmitter disorders. These results revealed that gut microbiota dysbiosis and serum metabolites alteration might be a cofactor for developing of alcohol dependence. IMPORTANCE The gut microbiota dysbiosis is associated with certain psychiatric disorders through the “microbiota-gut-brain” axis. Here we revealed that alcohol consumption induced the colonic microbiota dysbiosis, increased intestinal permeability, altered the serum metabolic phenotype in rats, and there were a strong correlation between gut microbiota dysbiosis and serum metabolites disorders. Thus, gut microbiota dysbiosis and serum metabolites alteration may be a cofactor for development of alcohol dependence.

scholarly journals Prevalence Estimates of ADHD in a Sample of Inpatients With Alcohol Dependence

2018 ◽  
Vol 24 (14) ◽  
pp. 2072-2083 ◽  
Author(s):  
Mathias Luderer ◽  
Christian Sick ◽  
Nurcihan Kaplan-Wickel ◽  
Iris Reinhard ◽  
Agnes Richter ◽  
...  
Keyword(s):  
Alcohol Dependence ◽  
Structured Interview ◽  
Diagnostic Interview ◽  
Diagnostic Assessment ◽  
Illicit Substance Use ◽  
Complex Design ◽  
Diagnostic Interviews ◽  
Prevalence Estimates ◽  
Alcohol Dependent

Objective: ADHD is common in patients with alcohol dependence, but prevalence results are inconsistent. We investigated ADHD prevalence in a complex design to avoid over- or underdiagnosing. Method: Patients with alcohol dependence starting long-term residential treatment were included. A structured interview (Diagnostic Interview for ADHD in Adults [DIVA]) was conducted on all patients. DIVA results indicating childhood or adulthood ADHD were assessed in successive diagnostic interviews by two expert clinicians. Results: 415 of 488 patients had completed the entire diagnostic assessment. ADHD prevalence was 20.5%. DIVA results correlated moderately with experts’ diagnoses. In patients with ADHD, a higher comorbid illicit substance use was prevalent and alcohol dependence started earlier and was more severe. Conclusion: This study provides the largest sample on ADHD prevalence in alcohol dependent inpatients. Despite great efforts to avoid overestimation, we found every fifth patient to have ADHD. ADHD diagnosis should not be based solely on a structured interview but should be clinically confirmed.

scholarly journals Brain-specific inhibition of mTORC1 eliminates side effects resulting from mTORC1 blockade in the periphery and reduces alcohol intake in mice

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Yann Ehinger ◽  
Ziyang Zhang ◽  
Khanhky Phamluong ◽  
Drishti Soneja ◽  
Kevan M. Shokat ◽  
...  
Keyword(s):  
Side Effects ◽  
Inhibitory Action ◽  
Alcohol Use Disorder ◽  
Alcohol Intake ◽  
Therapeutic Agents ◽  
Adverse Side Effects ◽  
Mtorc1 Activation ◽  
Potential Use ◽  
Heavy Alcohol Intake ◽  
Alcohol Dependent

AbstractAlcohol Use Disorder (AUD) affects a large portion of the population. Unfortunately, efficacious medications to treat the disease are limited. Studies in rodents suggest that mTORC1 plays a crucial role in mechanisms underlying phenotypes such as heavy alcohol intake, habit, and relapse. Thus, mTORC1 inhibitors, which are used in the clinic, are promising therapeutic agents to treat AUD. However, chronic inhibition of mTORC1 in the periphery produces undesirable side effects, which limit their potential use for the treatment of AUD. To overcome these limitations, we designed a binary drug strategy in which male mice were treated with the mTORC1 inhibitor RapaLink-1 together with a small molecule (RapaBlock) to protect mTORC1 activity in the periphery. We show that whereas RapaLink-1 administration blocked mTORC1 activation in the liver, RapaBlock abolished the inhibitory action of Rapalink-1. RapaBlock also prevented the adverse side effects produced by chronic inhibition of mTORC1. Importantly, co-administration of RapaLink-1 and RapaBlock inhibited alcohol-dependent mTORC1 activation in the nucleus accumbens and attenuated alcohol seeking and drinking.

Comorbidity among alcohol and tobacco dependent patients

2011 ◽  
Vol 26 (S2) ◽  
pp. 132-132
Author(s):  
A. Zoghlami ◽  
D. Blauensteiner ◽  
O. Scheibenbogen ◽  
S. Zadro-Jäger ◽  
M. Musalek
Keyword(s):  
Alcohol Dependence ◽  
Inpatient Treatment ◽  
Preliminary Analysis ◽  
Psychiatric Comorbidity ◽  
Icd 10 ◽  
Withdrawal Therapy ◽  
Clinically Significant ◽  
Drug Use Disorder ◽  
Group Allocation ◽  
Alcohol Dependent

IntroductionPsychiatric concomitant diseases are common with alcohol and tobacco dependent patients. Few studies have compared comorbidities between alcohol dependent smokers and non-smokers.AimsThe aim of this study is to examine the pattern of psychiatric comorbidity among alcohol dependent smokers in an inpatient alcohol therapy unit.Material and methodAfter successfully completing withdrawal therapy, subjects between the ages of 18–65 years who meet the ICD 10 criteria for alcohol dependence and no criteria for other drug use disorder except smoking, and who were participating in an inpatient treatment program for alcohol dependence at Anton Proksch Institut were included.ResultsThis is a preliminary analysis of the survey. In total 81 patients could be examined. 53.1% of the interviewed subjects were female and 46.9% male. The explored samples age ranged from 21–66 years.74.1% of the questioned subjects were smokers, 60% of these patients smoked more than 20 cigarettes per day.Preliminary analysis shows that smoking alcohol dependent patients present a higher comorbidity rate than non-smokers but above all they show a tendency to increased anxiety disorders. Within the population of smokers 48.3% suffer from an anxiety disorder, 48.3% from depression and dysthymia, 12.1% from manic and hypomanic disorder and 5.2% from psychosis. These differences are not clinically significant. This can be explained by the small number of the sample and by the group allocation.ConclusionAlcohol addicted patients exhibit heightened psychiatric comorbidity. Smoking alcohol dependents are more frequently affected and have a disposition to psychiatric disorders.

“To Maintain the Biological Substance of the Polish Nation” : Reproductive Rights as an Area of Conflict in Poland

2021 ◽  
Vol 10 (2) ◽  
pp. 357-381
Author(s):  
Michael Zok
Keyword(s):  
World War I ◽  
Reproductive Rights ◽  
World War ◽  
Discursive Strategies ◽  
Polish Society ◽  
Constitutional Tribunal ◽  
Biological Substance ◽  
The Law ◽  
Almost All

On October 22, 2020, the long-term dispute about reproductive rights in Polish society had a comeback. The Constitutional Tribunal declared the embryo-pathological indication of abortions guaranteed by the law of 1993 to be unconstitutional. The tribunal’s ruling was met with widespread protests, as it effectively forbade almost all reasons for terminations of pregnancies. While members of the Church’s hierarchy and pro-life activists celebrated, politicians began once again to discuss the law, and different suggestions were made (including a draft law similar to laws in effect in other European countries like Germany, and a law which would allow the termination of a pregnancy if the fetus were likely to die, or a law forbidding them in the case that the fetus had been diagnosed as having down’s syndrome). The debates are hardly new to Polish society and history. On the contrary, they date back to the recreation of the Polish state after World War I. This article concentrates on the developments in the Communist People’s Republic that led to the legislation of 1993, which is commonly referred to as a “compromise.” It focuses on the main actors in this dispute and the policymakers and their arguments. It also contextualizes these discursive strategies in a long-term perspective and highlights continuities and ruptures.

Diet and diabetes - part 2

2007 ◽  
Vol 286 ◽  
pp. 1-3
Keyword(s):  
Type 2 Diabetes ◽  
Glucose Control ◽  
Alcohol Intake ◽  
Dietary Advice ◽  
Lifestyle Interventions ◽  
Long Term Outcomes ◽  
Short Term ◽  
Diet And Diabetes

In a nutshellDietary advice for diabetics has included both reducing and increasing CHO.Some short term trials show improved glucose control from lower CHO, more fibre and lower GI foods. Light alcohol intake may provide some benefit. All these require further trials on their long term outcomes. And we should remember that, of all the lifestyle interventions in type 2 diabetes, the most effective appears to be exercise.

scholarly journals Lipodystrophy syndrome in HIV-infected children on HAART

2009 ◽  
Vol 10 (4) ◽  
pp. 76 ◽  
Author(s):  
Steve Innes ◽  
Leon Levin ◽  
Mark Cotton
Keyword(s):  
Clinical Practice ◽  
Early Detection ◽  
Nucleoside Reverse Transcriptase Inhibitor ◽  
Fat Distribution ◽  
Transcriptase Inhibitor ◽  
Routine Clinical Practice ◽  
Lipodystrophy Syndrome ◽  
Practical Guidelines ◽  
Reverse Transcriptase Inhibitor

Lipodystrophy Syndrome (LD) is common in HIV-infected children, particularly in those taking Didanosine, Stavudine, or Zidovudine. Lipoatrophy in particular causes major stigmatization and interferes with adherence. In addition, LD may have significant long-term health consequences, particularly cardiovascular. Since the stigmatizing fat distribution changes of LD are largely permanent, the focus of management remains on early detection and arresting progression. Practical guidelines for surveillance and avoidance of LD in routine clinical practice are presented. Diagnosis of LD is described and therapeutic options are reviewed. The most important therapeutic intervention is to switch the most likely offending antiretroviral to a non-LD-inducing agent as soon as LD is recognised. Typically, where lipoatrophy or lipohypertrophy is diagnosed, the thymidine nucleoside reverse transcriptase inhibitor (NRTI) is switched to a non-thymidine agent such as Abacavir (or Tenofovir in adults). Where dyslipidaemia is predominant, a dietician review is helpful, and the clinician may consider switching to a protease inhibitor (PI)-sparing regimen or to Atazanavir.

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