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Kawasaki, Japan

Objective: To undertake a double-blind, randomized, placebo-controlled trial to examine the efficacy of acamprosate in maintaining complete abstinence in Japanese patients with alcohol dependence. Method: We enrolled 327 patients with ICD-10-defined alcohol dependence and randomly assigned them to treatment with either acamprosate (1,998 mg/d orally) or placebo for 24 weeks. The primary endpoint was complete abstinence after 24 weeks of administration. The study was performed at 34 medical institutions between 2009 and 2011. Results: The acamprosate group demonstrated significantly superior efficacy versus the placebo group on the primary endpoint: the proportion maintaining complete abstinence in the acamprosate group was 47.2% (77/163 subjects), compared with 36.0% (59/164 subjects) in the placebo group (P = .039). The difference in complete abstinence rates between the 2 groups was 11.3% (95% CI, 0.6%-21.9%). Conclusions: Acamprosate is superior to placebo in maintaining abstinence in Japanese patients with alcohol dependence. These findings concur with 11 randomized, blinded, placebo-controlled clinical trials conducted in Europe. This study was designed to reflect clinical practice in Japan and is therefore a meaningful addition to the available evidence in this field. © Copyright 2015 Physicians Postgraduate Press, Inc. Source

Min J.-A.,Catholic University of Korea | Lee K.S.,Addiction Center | Kim D.-J.,Catholic University of Korea
Current Drug Abuse Reviews | Year: 2010

Despite the high prevalence and economic burden, biological mechanisms and effective treatments of alcohol hangover are not well understood. We have focused on oxidative stress and inflammatory responses which would substantially contribute to hangover physiology and symptoms based on preexisting research data. And, it is considered that minerals are one of the important components and influencing factors in antioxidant and anti-inflammatory system. Moreover, mineral deficient conditions show similar symptoms that occur in alcohol hangover. Herein we review some possible implications of various minerals, such as selenium, zinc, copper, vanadium, iron, and magnesium, according to suggested mechanisms and symptoms of alcohol hangover. Although, noticeable considerations and controlled trials will be required for general recommendations, we hope that our preliminary speculation would pave the way for further understanding and managing alcohol hangover. © 2010 Bentham Science Publishers Ltd. Source

Skrberg K.,Orebro University | Skrberg K.,Addiction Center | Nyberg F.,Uppsala University | Engstrom I.,Orebro University | Engstrom I.,Psychiatric Research Center
European Addiction Research | Year: 2010

Aims: The aim of this study was to improve our understanding of the proposed association between anabolic-androgenic steroids (AAS) and criminality. Methods: The study was based on interviews and criminality data involving 32 users of AAS who had sought treatment for AAS-related problems at a psychiatric addiction clinic in Sweden. A score derived from the number of crimes, their level of severity and the relevant time periods was computed to allow comparisons between subgroups sorted according to type and timing of drug use. Results: The criminal activity level increased for 69% of the individuals after having started to use drugs. This was particularly obvious in the group who had started its involvement with drugs by using AAS. Crimes of violence and weapon offences showed a great increase in incidence after drug use had been initiated. The study also showed a significant decrease in criminality after treatment, particularly among individuals who had started their drug use with AAS. Conclusion: The results suggest that there is an association between the use of AAS and criminality, especially with regard to crimes of violence and weapon offences, and that this criminality may be enhanced when AAS are combined with other drugs of abuse. Copyright © 2010 S. Karger AG. Source

Yokoyama A.,Addiction Center | Yokoyama T.,Japan National Institute of Public Health | Matsui T.,Addiction Center | Matsui T.,Kyorin University | And 5 more authors.
PLoS ONE | Year: 2015

Background Elevated serum triglyceride (TG) and high-density-lipoprotein cholesterol (HDL-C) levels are common in drinkers. The fast-metabolizing alcohol dehydrogenase-1B encoded by the ADH1B∗2 allele (vs. ADH1B∗1/∗1 genotype) and inactive aldehyde dehydrogenase-2 encoded by the ALDH2∗2 allele (vs. ALDH2∗1/∗1 genotype) modify ethanol metabolism and are prevalent (≈90% and ≈40%, respectively) in East Asians. We attempted to evaluate the associations between the ADH1B and ALDH2 genotypes and lipid levels in alcoholics. Methods The population consisted of 1806 Japanese alcoholic men (≥40 years) who had undergone ADH1B and ALDH2 genotyping and whose serum TG, total cholesterol, and HDL-C levels in the fasting state had been measured within 3 days after admission. Results High serum levels of TG (≥150 mg/dl), HDL-C (>80 mg/dl), and low-density-lipoprotein cholesterol (LDL-C calculated by the Friedewald formula ≥140 mg/dl) were observed in 24.3%, 16.8%, and 15.6%, respectively, of the subjects. Diabetes, cirrhosis, smoking, and body mass index (BMI) affected the serum lipid levels. Multivariate analysis revealed that the presence of the ADH1B∗2 allele and the active ALDH2∗1/∗1 genotype increased the odds ratio (OR; 95% confidence interval) for a high TG level (2.22 [1.67-2.94] and 1.39 [0.99- 1.96], respectively), and decreased the OR for a high HDL-C level (0.37 [0.28-0.49] and 0.51 [0.37-0.69], respectively). The presence of the ADH1B∗2 allele decreased the OR for a high LDL-C level (0.60 [0.45-0.80]). The ADH1B∗2 plus ALDH2∗1/∗1 combination yielded the highest ORs for high TG levels and lowest OR for a high HDL-C level. The genotype effects were more prominent in relation to the higher levels of TG (≥220 mg/dl) and HDL-C (≥100 mg/dl). Conclusions The fast-metabolizing ADH1B and active ALDH2, and especially a combination of the two were strongly associated with higher serum TG levels and lower serum HDL-C levels of alcoholics. The fast-metabolizing ADH1B was associated with lower serum LDL-C levels. Copyright: © 2015 Yokoyama et al. Source

Yokoyama A.,Addiction Center | Yokoyama T.,Japan National Institute of Public Health | Mizukami T.,Addiction Center | Matsui T.,Addiction Center | And 5 more authors.
Alcohol and Alcoholism | Year: 2014

Aims: Genetic polymorphisms of alcohol dehydrogenase-1B (ADH1B, rs1229984) and aldehyde dehydrogenase-2 (ALDH2, rs671) affect ethanol (EtOH) metabolism and susceptibility to alcoholism. Methods: We evaluated associations between ADH1B/ALDH2 genotypes and the blood EtOH levels of 805 Japanese alcoholic men in the morning after they had drunk within the previous 34 h. Results: Age-adjusted usual alcohol consumption did not differ according to ADH1B/ALDH2 genotypes. Higher blood EtOH levels persisted for longer periods in the ADH1B*1/*1 carriers (n = 246) than in the ADH1B*2 carriers (n = 559). Blood EtOH levels did not differ by ALDH2 genotype. The blood EtOH levels >0.3 mg/ml (criterion for drunk driving in Japanese law) were observed (40% vs. 14-17%, P < 0.0001) in a higher proportion of the ADH1B*1/*1 carriers than of the ADH1B*2 carriers after a 12.1-to-18-h interval since the last drink. Multivariate analyses showed that the EtOH levels heightened by 0.500 mg/ml in the presence of ADH1B*1*1 and by 0.248 mg/ml in the presence of cirrhosis, and lowered by 0.120 mg/ml per 10-year age increase, by 0.087 mg/ml per 10-kg body-weight increase and by 0.673 mg/ml per 10-h interval since the last drink. The odds ratio (95% confidence interval) for an EtOH level >0.3 mg/ml was 3.44 (2.34-5.04) in the presence of ADH1B*1/*1, 2.01 (1.28-3.14) in the presence of cirrhosis, 0.59 (0.49-0.71) per 10-year age increase, 0.80 (0.68-0.95) per 10-kg body-weight increase and 0.10 (0.07-0.15) per 10-h interval since the last drink. Conclusion: The longer-than-expected EtOH lingering in the blood of the ADH1B*1/*1 alcoholics may exacerbate alcoholrelated problems, including drunk driving. © The Author 2013. Medical Council on Alcohol and Oxford University Press. All rights reserved. Source

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