1. Effectiveness of drugs acting on adrenergic receptors in the treatment for tobacco or alcohol use disorders: systematic review and meta‐analysis
- Author
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Isabelle Ingrand, Claire Lafay-Chebassier, Marcello Solinas, Nematollah Jaafari, Nicolas Doux, Paul Vanderkam, Soghra Ebrahimighavam, Laboratoire de neurosciences expérimentales et cliniques (LNEC), Université de Poitiers-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Henri Laborit (CHL), CIC - Poitiers, Université de Poitiers-Centre hospitalier universitaire de Poitiers (CHU Poitiers)-Direction Générale de l'Organisation des Soins (DGOS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Pharmacologie clinique et Vigilances [CHU Poitiers], Centre hospitalier universitaire de Poitiers (CHU Poitiers), Université de Poitiers - Faculté de Médecine et de Pharmacie, Université de Poitiers, Allameh Tabataba’i University (ATU), Centre de Recherches sur la Cognition et l'Apprentissage (CeRCA), Centre National de la Recherche Scientifique (CNRS)-Université de Tours-Université de Poitiers, Université de Poitiers-Université de Tours (UT)-Centre National de la Recherche Scientifique (CNRS), Unité de recherche clinique intersectorielle en psychiatrie du Centre Hospitalier Henri Laborit, and SOLINAS, Marcello
- Subjects
Adult ,medicine.medical_specialty ,[SDV]Life Sciences [q-bio] ,medicine.medical_treatment ,media_common.quotation_subject ,adrenergic blockers ,030508 substance abuse ,Medicine (miscellaneous) ,Alcohol use disorder ,alcohol use disorder ,Placebo ,beta-adrenergic receptors ,alpha-adrenergic receptors ,law.invention ,tobacco use disorder ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,Internal medicine ,Tobacco ,Humans ,Medicine ,030212 general & internal medicine ,media_common ,[SDV.MHEP] Life Sciences [q-bio]/Human health and pathology ,Adrenergic agonists ,business.industry ,[SCCO.NEUR]Cognitive science/Neuroscience ,[SCCO.NEUR] Cognitive science/Neuroscience ,Abstinence ,medicine.disease ,Receptors, Adrenergic ,3. Good health ,Clonidine ,Alcoholism ,Psychiatry and Mental health ,Systematic review ,Pharmaceutical Preparations ,Meta-analysis ,Smoking cessation ,Smoking Cessation ,0305 other medical science ,business ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology ,medicine.drug - Abstract
International audience; Aim : To assess the efficacy of drugs directly acting on alpha- and beta-adrenergic receptors in the treatment of patients suffering from tobacco or alcohol use disorder.Methods : Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, studies were identified through PUBMED, EMBASE, the Cochrane Central Register of Controlled Trials and clinicaltrial.gov. We selected only randomized controlled trials with adult patients with tobacco or alcohol use disorders according to DSM-5 criteria. Interventions included any molecule having a direct pharmacological action on alpha- or beta-adrenergic receptors (agonist or antagonist). Comparators were placebo or other validated pharmacotherapies. The duration of the intervention was a minimum of 1 month, with 3 months of follow-up. Measurements included smoking cessation for tobacco; for alcohol, we selected abstinence, alcohol consumption (drinks per day or week) and heavy drinking days (HDD). Ten studies with tobacco and six with alcohol use disorder were included in the qualitative synthesis and fifteen studies in the quantitative analysis.Results: We found that clonidine, an alpha-2 agonist, significantly increased smoking abstinence [relative risk = 1.39 with a 95% confidence interval (CI) = 1.04, 1.84]. Beta-blockers had no significant effect on smoking abstinence. The alpha-1 antagonists prazosin and doxazosin decreased alcohol consumption [SMD = −0.32 (−0.56, −0.07)] but had no effect on abstinence or HDD.Conclusions : The noradrenaline system may represent a promising mechanism to target in tobacco and alcohol use disorders.
- Published
- 2020