RESUMEN
We conducted a controlled, blinded, multicenter study of disulfiram treatment of alcoholism in 605 men randomly assigned to 250 mg of disulfiram (202 men); 1 mg of disulfiram (204 men), a control for the threat of the disulfiram-ethanol reaction; or no disulfiram (199 men), a control for the counseling that all received. Bimonthly treatment assessments were done for one year. Relative/friend interviews and blood and urine ethanol analyses were used to corroborate patients' reports. There were no significant differences among the groups in total abstinence, time to first drink, employment, or social stability. Among the patients who drank and had a complete set of assessment interviews, those in the 250-mg disulfiram group reported significantly fewer drinking days (49.0 +/- 8.4) than those in the 1-mg (75.4 +/- 11.9) or the no-disulfiram (86.5 +/- 13.6) groups. There was a significant relationship between adherence to drug regimen and complete abstinence in all groups. We conclude that disulfiram may help reduce drinking frequency after relapse, but does not enhance counseling in aiding alcoholic patients to sustain continuous abstinence or delay the resumption of drinking.
Asunto(s)
Alcoholismo/tratamiento farmacológico , Disulfiram/uso terapéutico , Análisis Actuarial , Consumo de Bebidas Alcohólicas , Alcoholismo/rehabilitación , Ensayos Clínicos como Asunto , Terapia Combinada , Consejo , Método Doble Ciego , Humanos , Masculino , Persona de Mediana Edad , Cooperación del Paciente , Distribución Aleatoria , Estados Unidos , United States Department of Veterans AffairsRESUMEN
There is evidence that alcohol abuse and withdrawal produces cerebral impairment, some of which may be temporary and some permanent. This impairment has been found to be relatively specific in terms of brain areas affected. Recently our laboratory reported evidence that psychometrically measured impairment was systematically related to the energy in high frequency (beta-2) bands of the EEG. In the present study we attempted to determine the EEG patterns for male alcoholics undergoing withdrawal in comparison to patients who had been stabilized.
Asunto(s)
Alcoholismo/fisiopatología , Electroencefalografía , Síndrome de Abstinencia a Sustancias/fisiopatología , Delirio por Abstinencia Alcohólica/fisiopatología , Delirio por Abstinencia Alcohólica/psicología , Alcoholismo/psicología , Lóbulo Frontal/fisiopatología , Humanos , Inteligencia , Masculino , Lóbulo Temporal/fisiopatologíaRESUMEN
EEGs were recorded for two groups of chronic alcoholics who scored at opposite extremes on the Shipley Institute of Living Scale. The groups were matched in terms of age and drinking history variables and were compared to age-matched control subjects for left and right precentral (F-T) and postcentral (C-O) placements. Significant ANOVA findings were obtained primarily in high-frequency bands in the three group comparison. A significant linear trend was found for power as a function of degree of impairment from controls to moderately impaired alcoholics to severely impaired alcoholics in frequency bands above 14 Hz. The trend was most pronounced in the F-T derivations. Implications of the findings with respect to cortical atrophy in alcoholism are discussed.
Asunto(s)
Alcoholismo/fisiopatología , Encéfalo/fisiopatología , Electroencefalografía , Adulto , Atrofia , Corteza Cerebral/fisiopatología , Humanos , Masculino , Pruebas PsicológicasRESUMEN
Alcohol withdrawal has been characterized in terms of some EEG changes but seldom in terms of the averaged evoked response. Characteristics of the AER, such as amplitude, latency, and the least-squares slope of the AER amplitude as a function of stimulus intensity, have been found to change as a function of arousal and to separate some psychiatric groups. Seventeen alcoholics in withdrawal, 27 stabilized alcoholics, and 30 control volunteer subjects participated in an experiment to determine the changes in AER characteristics in withdrawal. Four stimulus intensities were presented to the subjects from a Grass PS 22 photostimulator with the flash sources 102 cm from the nasion. AER amplitude, the slope of the amplitude as a function of stimulus intensity, and bilateral symmetry scores were calculated for group comparison. Withdrawal and stabilized alcoholics were found to have significantly greater AER amplitudes at all intensity levels. Greater A-I slope from the right hemisphere and higher symmetry were found for withdrawal alcoholics than the other two groups.