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Current and potential pharmacological treatment options for insomnia in patients with alcohol use disorder in recovery

Alcohol use disorder (AUD) is characterized by dysfunction in motivational, mood‐stress regulation, and sleep systems that interact in complex ways to heighten the risk of relapse during abstinence. Emerging data suggest that excessive and chronic alcohol use disrupts sleep homeostasis and, in absti...

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Autores principales: Roehrs, Timothy A., Auciello, Jessica, Tseng, Jack, Whiteside, Garth
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7722668/
https://www.ncbi.nlm.nih.gov/pubmed/32543111
http://dx.doi.org/10.1002/npr2.12117
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author Roehrs, Timothy A.
Auciello, Jessica
Tseng, Jack
Whiteside, Garth
author_facet Roehrs, Timothy A.
Auciello, Jessica
Tseng, Jack
Whiteside, Garth
author_sort Roehrs, Timothy A.
collection PubMed
description Alcohol use disorder (AUD) is characterized by dysfunction in motivational, mood‐stress regulation, and sleep systems that interact in complex ways to heighten the risk of relapse during abstinence. Emerging data suggest that excessive and chronic alcohol use disrupts sleep homeostasis and, in abstinence, subjects with AUD are known to experience insomnia that may persist for weeks to years, which we propose to refer to as insomnia associated with alcohol cessation (IAAC). The purpose of this review is to provide an update of pharmacological approaches to therapy including compounds in development, to raise awareness of the prevalence of and unmet need in IAAC and highlight differences in treatment consideration for IAAC as compared to insomnia disorder. We performed a search of select electronic databases to identify studies of pharmacological agents used to treat sleep disturbances in abstinent or treatment‐seeking patients with alcohol use disorder. The search, conducted in June 2019 and updated in December 2019, yielded 1,188 abstracts after duplicates were removed, of which 36 full‐text articles were assessed for eligibility. Eighteen studies were included, 15 randomized controlled trials and three open‐label studies. Several classes of medications including antidepressants, anticonvulsants, and antipsychotics have been evaluated for their effectiveness in treating sleep disturbances in abstinent or treatment‐seeking patients with AUD. None of these medications are approved by the FDA for the treatment of IAAC, and the currently available evidence for these agents is limited. Randomized, controlled clinical trials are warranted to evaluate the efficacy and safety of medications in the treatment of IAAC.
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spelling pubmed-77226682020-12-08 Current and potential pharmacological treatment options for insomnia in patients with alcohol use disorder in recovery Roehrs, Timothy A. Auciello, Jessica Tseng, Jack Whiteside, Garth Neuropsychopharmacol Rep Review Article Alcohol use disorder (AUD) is characterized by dysfunction in motivational, mood‐stress regulation, and sleep systems that interact in complex ways to heighten the risk of relapse during abstinence. Emerging data suggest that excessive and chronic alcohol use disrupts sleep homeostasis and, in abstinence, subjects with AUD are known to experience insomnia that may persist for weeks to years, which we propose to refer to as insomnia associated with alcohol cessation (IAAC). The purpose of this review is to provide an update of pharmacological approaches to therapy including compounds in development, to raise awareness of the prevalence of and unmet need in IAAC and highlight differences in treatment consideration for IAAC as compared to insomnia disorder. We performed a search of select electronic databases to identify studies of pharmacological agents used to treat sleep disturbances in abstinent or treatment‐seeking patients with alcohol use disorder. The search, conducted in June 2019 and updated in December 2019, yielded 1,188 abstracts after duplicates were removed, of which 36 full‐text articles were assessed for eligibility. Eighteen studies were included, 15 randomized controlled trials and three open‐label studies. Several classes of medications including antidepressants, anticonvulsants, and antipsychotics have been evaluated for their effectiveness in treating sleep disturbances in abstinent or treatment‐seeking patients with AUD. None of these medications are approved by the FDA for the treatment of IAAC, and the currently available evidence for these agents is limited. Randomized, controlled clinical trials are warranted to evaluate the efficacy and safety of medications in the treatment of IAAC. John Wiley and Sons Inc. 2020-06-15 /pmc/articles/PMC7722668/ /pubmed/32543111 http://dx.doi.org/10.1002/npr2.12117 Text en © 2020 Imbrium Therapeutics. Neuropsychopharmacology Reports published by John Wiley & Sons Australia, Ltd on behalf of the Japanese Society of Neuropsychopharmacology. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Review Article
Roehrs, Timothy A.
Auciello, Jessica
Tseng, Jack
Whiteside, Garth
Current and potential pharmacological treatment options for insomnia in patients with alcohol use disorder in recovery
title Current and potential pharmacological treatment options for insomnia in patients with alcohol use disorder in recovery
title_full Current and potential pharmacological treatment options for insomnia in patients with alcohol use disorder in recovery
title_fullStr Current and potential pharmacological treatment options for insomnia in patients with alcohol use disorder in recovery
title_full_unstemmed Current and potential pharmacological treatment options for insomnia in patients with alcohol use disorder in recovery
title_short Current and potential pharmacological treatment options for insomnia in patients with alcohol use disorder in recovery
title_sort current and potential pharmacological treatment options for insomnia in patients with alcohol use disorder in recovery
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7722668/
https://www.ncbi.nlm.nih.gov/pubmed/32543111
http://dx.doi.org/10.1002/npr2.12117
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