Treatment of Comorbid Alcohol Dependence and Anxiety Disorder : Review of the Scientific Evidence and Recommendations for Treatment
Gimeno, Carmen (Sociedad Española de Patología Dual)
Dorado, Marisa Luisa (Unit for Addictive Behaviors of Guillen de Castro, Conselleria de Sanitat)
Roncero, Carlos (Hospital Universitari Vall d'Hebron)
Szerman, Nestor (Hospital General Universitario Gregorio Marañón)
Vega, Pablo (Instituto de Adicciones)
Balanzá-Martínez, Vicent (Hospital Universitari i Politècnic La Fe (València))
Alvarez, F. Javier (Hospital Clínico Universitario de Valladolid)
Universitat Autònoma de Barcelona

Data:	2017
Resum:	Patients with alcohol-use disorders (AUDs) have a high prevalence of anxiety disorders (AnxDs). "Co-occurring disorders" refers to the coexistence of an AUD and/or drug related disorders with another non-addictive psychiatric disorder. The aim of this study was to assess the effectiveness of psychopharmacological treatments and psychotherapy in patients with AUD and AnxD and to propose recommendations for the treatment of patients with comorbid AnxDs and AUDs. Randomized clinical trials, meta-analyses, and clinical guidelines were retrieved from PubMed, Embase, and Cochrane databases. Paroxetine was found to be effective in social anxiety patients with alcohol dependence. Selective serotonin reuptake inhibitors (SSRIs), especially sertraline, showed effective results in posttraumatic stress disorder and in comorbid AnxD-AUD. However, SSRIs should be used with caution when patients are actively drinking because they may increase alcohol consumption. Buspirone, gabapentin, and pregabalin were found to be effective in comorbid AnxD-AUD. The treatment of dual AnxDs should start as early as possible. Since AUDs and AnxDs can reinforce each other, treatments targeting both pathologies can be effective. Women suffer from higher levels of stress and AnxDs than men, and they are also more vulnerable to maintaining alcohol consumption levels. Further research is needed in this comorbid patient population, including the study of different types of patients and gender perspectives.
Ajuts:	Instituto de Salud Carlos III RD12-0028-0012 Ministerio de Economía y Competitividad RD16-0017-0006
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Alcohol-use disorder ; Anxiety disorders ; Comorbidity ; Co-occurring disorders ; Treatment recommendations
Publicat a:	Frontiers in psychiatry, Vol. 8 (september 2017) , ISSN 1664-0640

DOI: 10.3389/fpsyt.2017.00173
PMID: 29018367

14 p, 317.3 KB

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