22 results on '"Teo Vignoli"'
Search Results
2. Alcohol-Related Liver Disease in the Covid-19 Era: Position Paper of the Italian Society on Alcohol (SIA)
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Pierluigi Allosio, Giovanni Addolorato, Fabio Caputo, Patrizia Balbinot, Davide Mioni, Doda Renzetti, Tiziana Fanucchi, Raffaella Rossin, Gianni Testino, Livia Maccio, Claudia Gandin, S. Arico, Michele Parisi, Maria Francesca Amendola, Aniello Baselice, Vincenzo Palmieri, Vito Campanile, Emanuele Scafato, Valentino Patussi, Mauro Bernardi, Giorgio Zoli, Cristina Meneguzzi, Teo Vignoli, Lisa Lungaro, Giovanni Greco, and Luigi C. Bottaro
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medicine.medical_specialty ,Telemedicine ,Physiology ,medicine.medical_treatment ,Telehealth ,Alcohol use disorder ,Alcohol-related liver cirrhosis ,Alcohol-related liver disease ,ALD and SARS-CoV-2 ,Management of AUD ,SARS-CoV-2 infection ,Liver transplantation ,NO ,03 medical and health sciences ,Liver disease ,0302 clinical medicine ,Internal medicine ,Pandemic ,medicine ,Humans ,Intensive care medicine ,Liver Diseases, Alcoholic ,Pandemics ,business.industry ,Gastroenterology ,COVID-19 ,Hepatology ,medicine.disease ,Alcoholism ,030220 oncology & carcinogenesis ,Communicable Disease Control ,Position paper ,Original Article ,030211 gastroenterology & hepatology ,business - Abstract
Background Coronavirus Disease 2019 (COVID-19), firstly reported in China last November 2019, became a global pandemic. It has been shown that periods of isolation may induce a spike in alcohol use disorder (AUD). In addition, alcohol-related liver disease (ALD) is the most common consequence of excessive alcohol consumption worldwide. Moreover, liver impairment has also been reported as a common manifestation of COVID-19. Aims The aim of our position paper was to consider some critical issues regarding the management of ALD in patients with AUD in the era of COVID-19. Methods A panel of experts of the Italian Society of Alcohology (SIA) met via “conference calls” during the lockdown period to draft the SIA’s criteria for the management of ALD in patients with COVID-19 as follows: (a) liver injury in patients with ALD and COVID-19 infection; (b) toxicity to the liver of the drugs currently tested to treat COVID-19 and the pharmacological interaction between medications used to treat AUD and to treat COVID-19; (c) reorganization of the management of compensated and decompensated ALD and liver transplantation in the COVID-19 era. Results and Conclusions The COVID-19 pandemic has rapidly carried us toward a new governance scenario of AUD and ALD which necessarily requires an in-depth review of the management of these diseases with a new safe approach (management of out-patients and in-patients following new rules of safety, telemedicine, telehealth, call meetings with clinicians, nurses, patients, and caregivers) without losing the therapeutic efficacy of multidisciplinary treatment.
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- 2021
3. Symptoms of protracted alcohol withdrawal in patients with alcohol use disorder: a comprehensive systematic review
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Silvano Gallus, Alessandra Lugo, Elisa Borroni, Teo Vignoli, Lisa Lungaro, Giacomo Caio, Roberto De Giorgio, Giorgio Zoli, and Fabio Caputo
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Pharmacology ,Psychiatry and Mental health ,Neurology ,Pharmacology (medical) ,Neurology (clinical) ,General Medicine - Abstract
Background: Alcohol withdrawal syndrome (AWS) is characterized by different phases (acute, early and protracted). Protracted alcohol withdrawal (PAW) presents some symptoms, which may persist for several weeks, months or even years after drinking cessation. Methods: We conducted a systematic review of the literature in major scientific databases on selected AWS symptoms (craving, sleep disorders, and anhedonia) in patients with alcohol use disorder. Results: Of the 102 eligible publications (70 RCTs and 32 cohort studies), 88 provided data on craving, 21 on sleep disorders, and 1 on anhedonia. Overall, 37 studies assessed craving using the Obsessive Compulsive Drinking Scale (OCDS). Pooled OCDS decreased from 24.2 at baseline to 18.8 at 1 week, 10.3 at 1 month and 9.7 at 3 months. The corresponding estimates for treated individuals were 23.9, 18.8, 8.7, and 8.8, and for non-treated subjects, they were 25.3, 13.9, 13.2, and 11.4, respectively. In 4 studies assessing sleep disorders using the Epworth Sleeping Scale (ESS), the scale remained stable in time, i.e., 7.3 at baseline, 7.3 at 1 week, 7.2 at 1 month, and 7.1 at 3 months. Conclusions: This study confirms the presence of PAW after the resolution of the acute phase of AWS. The pharmacological approach to managing PAW may ensure a more rapid reduction of symptoms in three weeks. We highlight the importance of studying PAW and the ability of pharmacological treatment to reduce its symptoms. This review protocol is registered in Prospero (registration number: CRD42020211265). Summary: This systematic review summarizes literature on major symptoms of protracted alcohol withdrawal in patients with alcohol use disorder. The pharmacological approach to manage protracted alcohol withdrawal ensures a more rapid reduction of symptoms (craving in particular), achieving in three weeks similar results obtained only after almost 6 months without treatment.
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- 2021
4. Alcohol use disorder in the COVID‐19 era: Position paper of the Italian Society on Alcohol (SIA)
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S Arico, Lisa Lungaro, Tiziana Fanucchi, Raffaella Rossin, Cristina Meneguzzi, Gianni Testino, Teo Vignoli, Luigi C. Bottaro, Patrizia Balbinot, Emanuele Scafato, Doda Renzetti, Pierluigi Allosio, Vito Campanile, Valentino Patussi, Fabio Caputo, Giacomo Caio, Livia Maccio, Davide Mioni, Michele Parisi, Giorgio Zoli, Claudia Gandin, Maria Francesca Amendola, and Aniello Baselice
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Liver Cirrhosis ,Medicine (miscellaneous) ,Disease ,Alcohol use disorder ,Telehealth ,Liver Cirrhosis, Alcoholic ,Recurrence ,Ambulatory Care ,Drug Interactions ,infections ,Social isolation ,Societies, Medical ,Alcoholics Anonymous ,media_common ,Alcoholic ,Telemedicine ,Alcoholism ,Psychiatry and Mental health ,COVID‐19 infection ,Italy ,Original Article ,Disease Susceptibility ,medicine.symptom ,medicine.medical_specialty ,COVID-19 Vaccines ,media_common.quotation_subject ,alcohol use disorder ,NO ,Medical ,Intervention (counseling) ,mental disorders ,medicine ,Humans ,Psychiatry ,Immunosuppression Therapy ,Pharmacology ,SARS-CoV-2 ,business.industry ,Addiction ,COVID-19 ,Original Articles ,medicine.disease ,COVID-19 Drug Treatment ,COVID-19 infection ,Liver Transplantation ,Communicable Disease Control ,Position paper ,Societies ,business ,Delivery of Health Care - Abstract
Coronavirus disease 2019 (COVID‐19) first emerged in China in November 2019. Most governments have responded to the COVID‐19 pandemic by imposing a lockdown. Some evidence suggests that a period of isolation might have led to a spike in alcohol misuse, and in the case of patients with alcohol use disorder (AUD), social isolation can favour lapse and relapse. The aim of our position paper is to provide specialists in the alcohol addiction field, in psychopharmacology, gastroenterology and in internal medicine, with appropriate tools to better manage patients with AUD and COVID‐19,considering some important topics: (a) the susceptibility of AUD patients to infection; (b) the pharmacological interaction between medications used to treat AUD and to treat COVID‐19; (c) the reorganization of the Centre for Alcohol Addiction Treatment for the management of AUD patients in the COVID‐19 era (group activities, telemedicine, outpatients treatment, alcohol‐related liver disease and liver transplantation, collecting samples); (d) AUD and SARS‐CoV‐2 vaccination. Telemedicine/telehealth will undoubtedly be useful/practical tools even though it remains at an elementary level; the contribution of the family and of caregivers in the management of AUD patients will play a significant role; the multidisciplinary intervention involving experts in the treatment of AUD with specialists in the treatment of COVID‐19 disease will need implementation. Thus, the COVID‐19 pandemic is rapidly leading addiction specialists towards a new governance scenario of AUD, which necessarily needs an in‐depth reconsideration, focusing attention on a safe approach in combination with the efficacy of treatment., All health care systems need to be reorganized during and after the COVID‐19 pandemic, and also the CAATs in order to combine operator safety with patient safety and care. The multi‐disciplinary intervention involving experts in the treatment of AUD and ALD with specialists in the treatment of COVID‐19 disease will need implementation and the contribution of the family and of care‐givers in the management of AUD and ALD patients will play a significant role.
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- 2021
5. Management of end-stage alcohol-related liver disease and severe acute alcohol-related hepatitis: position paper of the Italian Society on Alcohol (SIA)
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Emanuele Scafato, Valentino Patussi, Sia board, Teo Vignoli, Gianni Testino, and Fabio Caputo
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Pediatrics ,medicine.medical_specialty ,Cirrhosis ,media_common.quotation_subject ,medicine.medical_treatment ,Alcohol use disorder ,Liver transplantation ,NO ,End Stage Liver Disease ,03 medical and health sciences ,Liver disease ,0302 clinical medicine ,Liver Cirrhosis, Alcoholic ,mental disorders ,Medicine ,Humans ,Stage (cooking) ,Hepatic encephalopathy ,Societies, Medical ,media_common ,Hepatitis ,Hepatology ,business.industry ,Alcohol Abstinence ,Hepatitis, Alcoholic ,Addiction ,Gastroenterology ,medicine.disease ,Alcoholism ,Alcohol use disorder, End stage alcohol-related liver disease, Liver transplantation, Severe acute alcohol-related hepatitis ,Italy ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,business ,End stage alcohol-related liver disease ,Severe acute alcohol-related hepatitis - Abstract
Worldwide, the prevalence of alcohol use disorder (AUD) is 20-30% in men and 10-15% in women, and cirrhosis due to alcohol-related liver disease (ALD) is responsible for 0.9% of global deaths and 47.9% of cirrhosis-related deaths. End-stage ALD (ESALD) is the final condition of alcohol-related cirrhosis, and severe acute alcohol-related hepatitis (SAAH) is a distinct clinical syndrome associated with the consumption of large amounts of alcohol. In some cases, ESALD, and SAAH may need liver transplantation (LT). Thus, the management of ESALD and SAAH in patients affected by AUD may be an essential part of the clinical skills for hepatologists. For these reasons, the national board of the Italian Society on Alcohol have reviewed the most recent data on the management of ESALD, SAAH and LT for ALD in patients with AUD, formulating a position paper with related recommendations regarding four issues of specific clinical interest in this field: (a) the management of hepatic encephalopathy in patients with AUD, and LT in patients with ESALD; (b) the management of SAAH; (c) the management of AUD in patients with ESALD and SAAH; (d) special populations: polydrug addicts.
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- 2020
6. Model of Care for Microelimination of Hepatitis C Virus Infection among People Who Inject Drugs
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Francesco Giuseppe Foschi, Alberto Borghi, Alberto Grassi, Arianna Lanzi, Elvira Speranza, Teo Vignoli, Lucia Napoli, Deanna Olivoni, Michele Sanza, Edoardo Polidori, Giovanni Greco, Paolo Bassi, Francesco Cristini, Giorgio Ballardini, Mattia Altini, Fabio Conti, and on behalf of MITH Group
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Drug ,medicine.medical_specialty ,Cirrhosis ,HCV microelimination ,media_common.quotation_subject ,Hepatitis C virus ,Population ,people who inject drugs ,medicine.disease_cause ,DIRECT ACTING ANTIVIRALS ,Article ,reinfection ,Internal medicine ,Health care ,medicine ,direct acting antivirals ,education ,Adverse effect ,media_common ,education.field_of_study ,drug users ,business.industry ,Incidence (epidemiology) ,General Medicine ,medicine.disease ,HCV treatment ,Medicine ,business - Abstract
Background: People who inject drugs (PWID) are the largest group at risk for HCV infection. Despite the direct acting antivirals (DAA) advancements, HCV elimination has been hindered by real-life difficulties in PWID. Aims: This study aimed to assess the impact of a multidisciplinary intervention strategy where HCV screening, treatment and follow-up were performed at the same location on efficacy and safety of DAA-therapy in real-life PWID population. Methods: All HCV-infected PWID referred to five specialized outpatient centers for drug addicts (SerDs) in Northern Italy were prospectively enrolled from May 2015 to December 2019. Hepatologists and SerDs healthcare workers collaborated together in the management of PWID inside the SerDs. Sustained virologic response (SVR), safety of treatment, proportion of patients lost to follow-up and reinfection rate were evaluated. Results: A total of 358 PWID started antiviral treatment. About 50% of patients had advanced fibrosis/cirrhosis, 69% received opioid substitution treatment, and 20.7% self-reported recent injecting use. SVR was achieved in 338 (94.4%) patients. Two patients died during treatment, one prematurely discontinued, resulting in a non-responder, twelve were lost during treatment/follow-up, and five relapsed. No serious adverse events were reported. SVR was lower in recent PWID than in former ones (89.2% vs. 95.8%, p = 0.028). Seven reinfections were detected, equating to an incidence of 1.25/100 person-years. Reinfection was associated with recent drug use (OR 11.07, 95%CI 2.10–58.38, p = 0.005). Conclusion: Our embedded treatment model could be appropriate to increase the linkage to care of HCV-infected PWID. In this setting, DAA regimens are well tolerated and highly effective, achieving a lower rate of reinfection.
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- 2021
7. Alcohol-related chronic exocrine pancreatic insufficiency: diagnosis and therapeutic management. A proposal for treatment by the Italian Association for the Study of the Pancreas (AISP) and the Italian Society of Alcohology (SIA)
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Raffaele, Pezzilli, Fabio, Caputo, Gianni, Testino, Valentino, Patussi, Giovanni, Greco, Livia, Macciò, Maria Raffaella, Rossin, Davide, Mioni, Patrizia, Balbinot, Claudia, Gandin, Francesca, Zanesini, Luca, Frulloni, Sarino, Aricò, Luigi C, Bottaro, Rinaldo, Pellicano, Emanuele, Scafato, and Teo, Vignoli
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Male ,medicine.medical_specialty ,Pancreatitis, Alcoholic ,Antioxidants ,Naltrexone ,NO ,03 medical and health sciences ,Alcohol-induced disorders ,Chronic pancreatitis ,Alcoholic pancreatitis ,Exocrine pancreatic insufficiency ,Alcoholism ,Alcohol Abstinence ,Alcohol Deterrents ,Disease Management ,Disease Progression ,Enzyme Replacement Therapy ,Ethanol ,Exocrine Pancreatic Insufficiency ,Female ,Humans ,Life Style ,Oxidation-Reduction ,Pancreatic Neoplasms ,Psychotherapy ,Risk Factors ,Self-Help Groups ,0302 clinical medicine ,Internal medicine ,medicine ,Risk factor ,Nalmefene ,business.industry ,General Medicine ,Alcoholic ,medicine.disease ,medicine.anatomical_structure ,Acamprosate ,Pancreatitis ,030220 oncology & carcinogenesis ,Disulfiram ,030211 gastroenterology & hepatology ,business ,Pancreas ,medicine.drug - Abstract
Current estimates of the prevalence of chronic pancreatitis, one of the most common causes of exocrine pancreatic insufficiency, are in the range of 3-10 per 100,000 people in many parts of the world. Alcohol consumption is a very important risk factor for exocrine pancreatic insufficiency and is involved in nearly half of all cases. The main hypothesis regarding the role of chronic alcohol consumption in pancreatitis is that there must be additional environmental or genetic risk factors involved for ongoing damage to occur. Treatment of patients with alcohol-related exocrine pancreatic insufficiency is complex, as the patient has two concomitant pathologies, alcohol-use disorder (AUD) and exocrine pancreatic insufficiency/chronic pancreatitis. Alcohol abstinence is the starting point for treatment, although even this along with the most advanced therapies allow only a slowdown in progression rather than restoration of function. This position paper of the Italian Association for the Study of the Pancreas and the Italian Society of Alcohology provides an overview of the pathogenesis of alcohol-related pancreatitis and discuss diagnostic issues. Treatment options for both exocrine pancreatic insufficiency/chronic pancreatitis (with a focus on pancreatic enzyme replacement therapy) and AUD (acamprosate, disulfiram, oral naltrexone, long-acting injectable naltrexone, sodium oxybate, nalmefene, baclofen, and psychosocial interventions) are also reviewed.
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- 2019
8. Diagnosis and treatment of acute alcohol intoxication and alcohol withdrawal syndrome: position paper of the Italian Society on Alcohol
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Gianni Testino, S Arico, Giovanni Greco, Doda Renzetti, Paolo Cimarosti, Michele Parisi, Maria Francesca Amendola, Livia Maccio, Pierluigi Allosio, Cristina Meneguzzi, Teo Vignoli, Fabio Caputo, Patrizia Balbinot, Roberta Agabio, Emanuele Scafato, Valentino Patussi, Vincenzo Palmieri, Tiziana Fanucchi, Raffaella Rossin, Valeria Zavan, and Davide Mioni
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medicine.medical_specialty ,Acute alcohol intoxication ,Acute alcohol intoxication, Alcohol withdrawal syndrome, Pharmacological treatment ,Alcohol use disorder ,030204 cardiovascular system & hematology ,Tiapride ,NO ,law.invention ,Alcohol withdrawal syndrome ,03 medical and health sciences ,chemistry.chemical_compound ,Benzodiazepines ,0302 clinical medicine ,law ,Clomethiazole ,Internal Medicine ,medicine ,Humans ,030212 general & internal medicine ,Propofol ,Delirium tremens ,business.industry ,medicine.disease ,Tiapride Hydrochloride ,Intensive care unit ,Substance Withdrawal Syndrome ,chemistry ,Phenobarbital ,Emergency medicine ,Emergency Medicine ,Anticonvulsants ,business ,Sodium Oxybate ,Pharmacological treatment ,Alcoholic Intoxication ,Chlormethiazole ,medicine.drug - Abstract
The chronic use of alcohol can lead to the onset of an alcohol use disorder (AUD). About 50% of subjects with an AUD may develop alcohol withdrawal syndrome (AWS) when they reduce or discontinue their alcohol consumption and, in 3-5% of them, convulsions and delirium tremens (DTs), representing life-threatening complications, may occur. Unfortunately, few physicians are adequately trained in identifying and treating AWS. The Italian Society on Alcohol has, therefore, implemented a task force of specialists to draw up recommendations for the treatment of AWS with the following main results: (1) while mild AWS may not require treatment, moderate and severe AWS need to be pharmacologically treated; (2) out-patient treatment is appropriate in patients with mild or moderate AWS, while patients with severe AWS need to be treated as in-patients; (3) benzodiazepines, BDZs are the "gold standard" for the treatment of AWS and DTs; (4) alpha-2-agonists, beta-blockers, and neuroleptics may be used in association when BDZs do not completely resolve specific persisting symptoms of AWS; (5) in the case of a refractory form of DTs, the use of anaesthetic drugs (propofol and phenobarbital) in an intensive care unit is appropriate; (6) alternatively to BDZs, sodium oxybate, clomethiazole, and tiapride approved in some European Countries for the treatment of AWS may be employed for the treatment of moderate AWS; (7) anti-convulsants are not sufficient to suppress AWS, and they may be used only in association with BDZs for the treatment of refractory forms of convulsions in the course of AWS.
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- 2018
9. Models of care for the management and treatment of hepatitis C virus infection among people who inject drugs
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Alberto Borghi, D. Olivoni, Teo Vignoli, Fabio Conti, E. Polidori, M. Sanza, P. Bassi, F.G. Foschi, G. Greco, Vittoria Bevilacqua, and Arianna Lanzi
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Hepatology ,business.industry ,Hepatitis C virus ,Gastroenterology ,Medicine ,business ,medicine.disease_cause ,Virology - Published
- 2019
10. Alcohol use disorder and GABA
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Fabio, Caputo, Bianca Maria, Ciminelli, Carla, Jodice, Paola, Blasi, Teo, Vignoli, Mauro, Cibin, Giorgio, Zoli, and Patrizia, Malaspina
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Adult ,Male ,Gene Frequency ,Italy ,Receptors, GABA-B ,Humans ,Female ,Middle Aged ,Alcohol-Related Disorders ,Polymorphism, Single Nucleotide ,Aged - Abstract
Alcohol use disorder (AUD) is a complex trait with genetic and environmental influences. Several gene variants have been associated with the risk for AUD, including genes encoding the sub-units of the γ-aminobutyric acid (GABA) receptors.This study evaluated whether specific single nucleotide polymorphisms (SNPs) in genes encoding GABASeventy-four AUD subjects and 128 Italian controls were genotyped for 10 SNPs in genes encoding GABA-B1 and GABA-B2 sub-units (GABBR1 and GABBR2). Allele, genotype, and haplotype frequencies were tested for the association with the AUD trait.A significant difference between AUD individuals and controls was observed at genotype level for rs2900512 of GABBR2 gene. The homozygous T/T genotype was not found in the controls, whereas it was over-represented in the AUD individuals. Under the recessive model (T/T vs C/T + C/C) this result was statistically significant, as well as the Odds Ratio for the association with the AUD trait.The results provide preliminary data on the association between GABA
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- 2017
11. Alcohol use disorder and GABAB receptor gene polymorphisms in an Italian sample: haplotype frequencies, linkage disequilibrium and association studies
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Giorgio Zoli, Bianca Maria Ciminelli, Teo Vignoli, Patrizia Malaspina, Carla Jodice, Fabio Caputo, Paola Blasi, and Mauro Cibin
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0301 basic medicine ,Adult ,Male ,Linkage disequilibrium ,Aging ,AUD ,Epidemiology ,Physiology ,SNP ,Single-nucleotide polymorphism ,GABBR1 ,GABBR2 ,Single nucleotide polymorphism ,Aged ,Alcohol-Related Disorders ,Female ,Humans ,Italy ,Middle Aged ,Receptors, GABA-B ,Gene Frequency ,Polymorphism, Single Nucleotide ,Genetics ,Public Health, Environmental and Occupational Health ,Single Nucleotide Polymorphism ,Biology ,NO ,03 medical and health sciences ,0302 clinical medicine ,mental disorders ,Genotype ,Receptors ,Allele ,Polymorphism ,Genetic association ,GABA-B ,Haplotype ,Environmental and Occupational Health ,Single Nucleotide ,Settore BIO/18 - Genetica ,030104 developmental biology ,Public Health ,030217 neurology & neurosurgery - Abstract
Background: Alcohol use disorder (AUD) is a complex trait with genetic and environmental influences. Several gene variants have been associated with the risk for AUD, including genes encoding the sub-units of the γ-aminobutyric acid (GABA) receptors.Aim: This study evaluated whether specific single nucleotide polymorphisms (SNPs) in genes encoding GABAB receptor sub-units can be considered as candidates for the risk of AUD.Subjects and methods: Seventy-four AUD subjects and 128 Italian controls were genotyped for 10 SNPs in genes encoding GABA-B1 and GABA-B2 sub-units (GABBR1 and GABBR2). Allele, genotype, and haplotype frequencies were tested for the association with the AUD trait.Results: A significant difference between AUD individuals and controls was observed at genotype level for rs2900512 of GABBR2 gene. The homozygous T/T genotype was not found in the controls, whereas it was over-represented in the AUD individuals. Under the recessive model (T/T vs C/T + C/C) this result was statistically...
- Published
- 2017
12. A Brief Up-Date of the Use of Sodium Oxybate for the Treatment of Alcohol Use Disorder
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Giorgio Zoli, Marco Domenicali, Teo Vignoli, Giovanni Addolorato, Claudia Tarli, Mauro Bernardi, Fabio Caputo, Caputo, F., Vignoli, T, Tarli, C, Domenicali, M, Zoli, G, Bernardi, M, and Addolorato, G
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Male ,Health, Toxicology and Mutagenesis ,lcsh:Medicine ,Hydroxybutyrates ,Craving ,Alcohol use disorder ,Review ,0302 clinical medicine ,Alcohol and health ,Borderline personality disorder ,media_common ,Aged, 80 and over ,Middle Aged ,Substance Withdrawal Syndrome ,Alcoholism ,Italy ,Health ,Alcohol withdrawal syndrome ,Austria ,Female ,Public Health ,medicine.symptom ,Sodium Oxybate ,Alcohol-Related Disorders ,Drug ,Adult ,medicine.medical_specialty ,Pharmacological treatment ,Sodium oxybate ,Public Health, Environmental and Occupational Health ,Alcohol Drinking ,media_common.quotation_subject ,alcohol use disorder ,NO ,03 medical and health sciences ,Young Adult ,pharmacological treatment ,mental disorders ,medicine ,Humans ,Toxicology and Mutagenesis ,Psychiatry ,Aged ,business.industry ,lcsh:R ,Settore MED/09 - MEDICINA INTERNA ,Environmental and Occupational Health ,medicine.disease ,030227 psychiatry ,business ,030217 neurology & neurosurgery ,Alcohol Abstinence - Abstract
The treatment of alcohol use disorder (AUD) with sodium oxybate (SMO) or gamma-hydroxybutyric acid (GHB) was introduced in Italy and Austria more than 20 years and 15 years ago, respectively, and it is now widely employed to treat alcohol withdrawal syndrome (AWS) and to maintain alcohol abstinence. These indications derive from its similar structure to the inhibitory neurotransmitter γ-amino-butyric acid (GABA), exerting an ethanol-mimicking effect, because it binds to GABAB receptors. Craving for, and abuse of, SMO remain a controversial issue; even though these unfavorable effects are evident in poly-drug addicted patients and in those with psychiatric diagnosis of borderline personality disorder. In addition, despite cases of severe intoxication and deaths being widely documented when GHB is used as “street drug”; its clinical use remains safe. Thus, the aim of the present review is to examine the role of SMO in the treatment of AUD, its possible implications in reducing alcohol consumption, and cases of abuse, and severe intoxication due to SMO during its clinical use in the treatment of AUD.
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- 2016
13. Neurobiological Evidence in Alcohol Addiction Can Help Pharmacological Treatment Personalization
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Teo Vignoli, Elisa Martino, and Fabio Caputo
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medicine.medical_specialty ,Alcohol addiction ,business.industry ,Medicine ,business ,Psychiatry ,Omics ,Pharmacological treatment ,Personalization - Published
- 2016
14. Neurobiological Evidence in Alcohol Addiction Can Help Pharmacological Treatment Personalization
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Teo Vignoli and Elisa Martino
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- 2016
15. Pharmacological management of alcohol dependence: From mono-therapy to pharmacogenetics and beyond
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Giovanni Addolorato, Teo Vignoli, Alice Grignaschi, Mauro Cibin, Fabio Caputo, Mauro Bernardi, Caputo F, Vignoli T, Grignaschi A, Cibin M, Addolorato G, and Bernardi M.
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medicine.medical_specialty ,PHARMACOGENOMICS ,Sodium Oxybate ,Population ,Naltrexone ,NO ,medicine ,Animals ,Humans ,Pharmacology (medical) ,Intensive care medicine ,education ,Psychiatry ,Biological Psychiatry ,Nalmefene ,Alcohol dependence, Pharmacological treatment, Typologies of alcoholics, Monotherapy, Combined pharmacological therapy, Pharmacogenomic era ,Pharmacology ,education.field_of_study ,Typologies of alcoholics ,business.industry ,Alcohol dependence ,Settore MED/09 - MEDICINA INTERNA ,Combined pharmacological therapy ,Monotherapy ,Alcoholism ,COMBINED THERAPY ,Psychiatry and Mental health ,Pharmacogenomic era ,Acamprosate ,Neurology ,PHARMACOLOGICAL THERAPY ,Disulfiram ,Neurology (clinical) ,business ,Pharmacological treatment ,Pharmacogenetics ,Alcohol Deterrents ,medicine.drug - Abstract
Almost 10% of the world's population is affected by alcohol use disorders, and the treatment of alcohol dependence (AD) still remains a challenge. Patients with AD can differ in many traits. Three drugs (disulfiram, naltrexone, and acamprosate) have been approved by the FDA for the treatment of AD, and in some European countries sodium oxybate is also approved for this purpose. Combined pharmacological therapy has not provided such convincing results. Considering the fact that the "ideal" and effective drug for all types of alcoholic patients does not exists, the future challenge will be to identify a personalized approach. Recent data has shown that this objective can be achieved by investigating the genetic variability of the patient. Moreover, the use of replacement molecules can probably be considered an advantageous therapeutic opportunity (i.e. sodium oxybate). In addition, reduction of alcohol consumption is increasingly accepted as a viable treatment goal, and the use of nalmefene "as-needed" (a pharmacological approach similar to naltrexone, but, possibly, with lower hepatotoxicity) may help in the treatment of AD. Thus, it is important to stress that a pharmacological approach to treat AD should be preceded by the definition of patient characteristics; this may help in the choice of the most appropriate drug and it can be done more easily when more pharmacological options approved for the treatment of AD are also available.
- Published
- 2014
16. ALCOHOL USE DISORDERS IN THE ELDERLY: A BRIEF OVERVIEW FROM EPIDEMIOLOGY TO TREATMENT OPTIONS
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Mauro Bernardi, Lorenzo Leggio, Giovanni Addolorato, Fabio Caputo, Giorgio Zoli, Teo Vignoli, Caputo F, Vignoli T, Leggio L, Addolorato G, Zoli G, and Bernardi M.
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DIAGNOSIS AND TREATMENT OF ALCOHOL USE DISORDERS ,Aging ,medicine.medical_specialty ,Pediatrics ,ALCOHOL RELATED DISEASE ,Poison control ,Alcohol abuse ,Biochemistry ,ALCOHOL USE DISORDERS ,Article ,NO ,Endocrinology ,Epidemiology ,Injury prevention ,mental disorders ,Alcohol related disease ,Alcohol use disorders ,Diagnosis and treatment of alcohol use disorders ,Elderly ,Pathogenesis of alcohol related damage ,Age Factors ,Aged ,Alcohol-Related Disorders ,Alcoholism ,Biomarkers ,Humans ,Molecular Biology ,Genetics ,Cell Biology ,medicine ,Dementia ,Psychiatry ,PATHOGENESIS OF ALCOHOL RELATED DAMAGE ,Depression (differential diagnoses) ,ELDERLY ,business.industry ,Incidence (epidemiology) ,Settore MED/09 - MEDICINA INTERNA ,social sciences ,medicine.disease ,humanities ,Alcohol withdrawal syndrome ,Biological Markers ,business - Abstract
Alcohol-use-disorders (AUDs) afflict 1–3% of elderly subjects. The CAGE, SMAST-G, and AUDIT are the most common and validated questionnaires used to identify AUDs in the elderly, and some laboratory markers of alcohol abuse (AST, GGT, MCV, and CDT) may also be helpful. In particular, the sensitivity of MCV or GGT in detecting alcohol misuse is higher in older than in younger populations. The incidence of medical and neurological complications during alcohol withdrawal syndrome in elderly alcoholics is higher than in younger alcoholics. Chronic alcohol abuse is associated with tissue damage to several organs. Namely, an increased level of blood pressure is more frequent in the elderly than in younger adults, and a greater vulnerability to the onset of alcoholic liver disease, and an increasing risk of breast cancer in menopausal women have been described. In addition, the prevalence of dementia in elderly alcoholics is almost 5 times higher than in non-alcoholic elderly individuals, approximately 25% of elderly patients with dementia also present AUDs, and almost 20% of individuals aged 65 and over with a diagnosis of depression have a co-occurring AUD. Moreover, prevention of drinking relapse in older alcoholics is, in some cases, better than in younger patients; indeed, more than 20% of treated elderly alcohol-dependent patients remain abstinent after four years. Considering that the incidence of AUDs in the elderly is fairly high, and AUDs in the elderly are still underestimated, more studies in the fields of epidemiology, prevention and pharmacological and psychotherapeutic treatment of AUDs in the elderly are warranted.
- Published
- 2012
17. Incidence of craving for and abuse of gamma-hydroxybutyric acid (GHB) in different populations of treated alcoholics: An open comparative study
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Giovanni Addolorato, A. Del Re, Giorgio Zoli, Mauro Bernardi, Teo Vignoli, Fabio Caputo, L Leggio, Michela Stoppo, F. Lorenzini, C. Comaschi, Sara Francini, Caputo F, Francini S, Stoppo M, Lorenzini F, Vignoli T, Del Re A, Comaschi C, Leggio L, Addolorato G, Zoli G, and Bernardi M.
- Subjects
Adult ,Male ,medicine.medical_specialty ,Methadone maintenance ,Substance-Related Disorders ,Hydroxybutyrates ,Alcohol ,Craving ,GAMMA-HYDROXYBUTIRRIC ACID (GABA) ,Pharmacology ,Gastroenterology ,Group B ,Heroin ,Cocaine dependence ,NO ,chemistry.chemical_compound ,Different population of alcoholics ,Internal medicine ,ABUSE OF GABA ,mental disorders ,medicine ,Humans ,Craving for and abuse of gamma-hydroxybutyric acid ,Treatment of alcohol-dependence ,Pharmacology (medical) ,Alcoholics ,Psychiatry and Mental Health ,Alcohol dependence ,gamma-Hydroxybutyric acid ,CRAVING FOR GABA ,Middle Aged ,medicine.disease ,chemistry ,DRUG DEPENDENCE ,Female ,ALCOHOLISM ,medicine.symptom ,Psychology ,medicine.drug - Abstract
Gamma-hydroxybutyric acid (GHB) is a drug currently used for the treatment of alcohol dependence. The aim of our study was to investigate the incidence of craving for and abuse of GHB in 47 patients enrolled and divided into four groups: group A (pure alcoholics), group B (alcoholics with a sustained full remission from cocaine dependence), group C (alcoholics with a sustained full remission from heroin dependence) and group D (alcoholics in a methadone maintenance treatment [MMT] programme). All patients were treated with an oral dose of GHB (50 mg/kg of body weight t.i.d.) for three months. Craving for GHB was statistically significant higher in group B than in group A (P < 0.001), C (P = 0.01) and D (P < 0.001), and in group C than in group D (P < 0.05). Abuse of GHB proved to be statistically significant higher in group B than in group A (P < 0.001) and D (P < 0.01), and in group C than in group A (P = 0.01) and D (P < 0.05). Thus, the administration of GHB in alcoholics with a sustained full remission from heroin or cocaine dependence is not recommended; however, this should not discourage physicians from using GHB for the treatment of pure alcoholics or alcohol dependents following a MMT.
- Published
- 2009
18. Use of Alcohol During the Treatment of Alcohol Dependence With gamma-Hydroxybutyric Acid: Risk of Severe Events Are Avoided by the Dose Fractioning of the Drug
- Author
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F. Lorenzini, Teo Vignoli, Fabio Caputo, Mauro Bernardi, Michela Stoppo, and Sara Francini
- Subjects
Drug ,business.industry ,Sodium Oxybate ,media_common.quotation_subject ,Alcohol dependence ,Street drugs ,Alcohol ,gamma-Hydroxybutyric acid ,Pharmacology ,NO ,Psychiatry and Mental health ,chemistry.chemical_compound ,chemistry ,Medicine ,Pharmacology (medical) ,Risk factor ,business ,media_common ,medicine.drug - Published
- 2007
19. GABAergic medications for treating alcohol dependence
- Author
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Michela Stoppo, Teo Vignoli, Mauro Bernardi, Fabio Caputo, Sara Francini, Caputo F, Vignoli T, Francini S, Stoppo M, and Bernardi M.
- Subjects
WITHDRAWAL SYNDROME ,Baclofen ,Narcotic Antagonists ,Temperance ,Hydroxybutyrates ,Pharmacology ,NO ,Text mining ,Humans ,Medicine ,Pharmacology (medical) ,GABA Agonists ,gamma-Aminobutyric Acid ,Randomized Controlled Trials as Topic ,ALCOHOL DEPENDENCE ,business.industry ,Alcohol dependence ,TOPIRAMATE ,Naltrexone ,Substance Withdrawal Syndrome ,Alcoholism ,Psychiatry and Mental health ,Receptors, GABA-B ,GABAergic ,GAMMA-HYDROXYBUTYRIC ACID ,Drug Therapy, Combination ,business - Abstract
Gamma-Hydroxybutyric acid is a shortchain fatty acid structurally similar to the inhibitory neurotransmitter +-aminobutyric acid that exerts an ethanol-mimicking effect on the central nervous system by acting on its own receptor and the GABAB receptor. It has been extensively documented that this activation enhances dopamine release, with a consequent behavioral reinforcing effect. This knowledge has stimulated the accomplishment of preclinical and clinical studies, which helped to establish the indications for the use of this drug.
- Published
- 2007
20. P-28RISK OF RE-HOSPITALIZATION IN PATIENTS ATTENDING THE EMERGENCY DEPARTMENT FOR ACUTE ALCOHOL INTOXICATION: AN OBSERVATIONAL RETROSPECTIVE STUDY
- Author
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Teo Vignoli, Fabio Caputo, Marco Domenicali, Maurizio Baldassarre, M. Cavazza, Alice Grignaschi, Mauro Bernardi, S. Guerrini, and Matteo Massimo Bossi
- Subjects
medicine.medical_specialty ,business.industry ,Retrospective cohort study ,General Medicine ,Emergency department ,Acute alcoholic intoxication ,Acute alcohol ,Re hospitalization ,Emergency medicine ,medicine ,In patient ,Observational study ,Intensive care medicine ,business - Abstract
Background. acute alcohol intoxication (AAI) is a frequent cause of admission to the emergency department (ED). Patients with several admission in ED because of AAI may present alcohol use disorders (AUDs) and therefore need specific evaluation and therapy. Aims. to identify factor associated to risk of readmission in ED for AAI patients. …
- Published
- 2015
21. Gamma hydroxybutirric acid (GHB) withdrawal does not occur at therapeutic dosage
- Author
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Giovanni Addolorato, Teo Vignoli, Lorenzo Leggio, Ludovico Abenavoli, Giovanni Gasbarrini, Mauro Bernardi, Fabio Caputo, F. Lorenzini, Addolorato G., Caputo F., Leggio L., Vignoli T., Abenavoli L., Lorenzini F., Bernardi M., and Gasbarrini G.
- Subjects
Pharmacology ,Alcoholism, gamma hydroxybutirric acid, dependence, withdrawal syndrome ,WITHDRAWAL SYNDROME ,business.industry ,MEDLINE ,Toxicology ,NO ,Psychiatry and Mental health ,GAMMA HYDROXYBUTIRRIC ACID ,DEPENDENCE ,Medicine ,Pharmacology (medical) ,ALCOHOLISM ,business - Published
- 2005
22. GAMMA-HYDROXYBUTYRIC ACID PLUS NALTREXONE IN THE TREATMENT OF ALCOHOLICS RESISTANT TO MONO-THERAPY
- Author
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Arfedele Del Re, Mauro Bernardi, F. Lorenzini, Teo Vignoli, Franco Trevisani, Giovanni Gasbarrini, Giovanni Addolorato, Giuseppe Francesco Stefanini, Pietro Andreone, and Fabio Caputo
- Subjects
Psychiatry and Mental health ,business.industry ,Medicine (miscellaneous) ,Medicine ,gamma-Hydroxybutyric acid ,Craving ,Withdrawal syndrome ,Pharmacology ,medicine.symptom ,Toxicology ,business ,Naltrexone ,medicine.drug - Published
- 2004
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