Sestre Milosrdnice University hospital and Institute of Clinical Medical Research
Abstract
Depression is quite common in the early stage of treatment for alcohol addiction. The patient\u27s awareness of his difficult situation may be one of the reasons for depression. Furthermore, depression can develop as the result of depressive disorders that are primarily or secondarily associated with alcohol addiction. Antidepressive therapy is usually initiated after a two-week detoxification procedure. Only exceptionally it may start earlier in case of severe depressive disorder. The administration of sulpiride from the very beginning of treatment yields favorable results because of the wide range of its action, especially antidepressive effects. The effect of sulpiride therapy was investigated in 20 alcoholics suffering from minor to moderate depressive disorders. The patients were administered 50 mg sulpiride capsules three times a day. Control group included 20 patients who received placebo. Both the study and control group patients underwent psychotherapeutic methods usually conducted in a sociotherapeutic community. The severity of depressive disorder was measured by use of Hamilton\u27s and Beck\u27s scale before, and then at 2, 4and 6 weeks from the beginning of treatment. Also, the patients were clinically observed during the psychotherapeutic procedures and other activities performed in the therapeutic community. Study results confirmed the efficacy of sulpiride in the management of depressive alcohol addiction in alcoholics. The sulpiride dose of 150 mg/day showed a rapid antidepressive effect. Accordingly, sulpiride was confirmed to play an important role in the rational use of psychopharmacotherapy in patients with alcohol addiction in a sociotherapeutic community.U početnoj fazi liječenja u alkoholičara se često očituje depresivno raspoloženje. Ono može biti posljedica uvida u problematičnu situaciju u kojoj se alkoholičar nalazi ili se radi o depresivnom poremećaju primarno ili sekundarno vezanom uz alkoholizam. Uvođenje ciljane antidepresivne terapije prakticira se nakon dvotjednog detoksikacijskog postupka, a iznimno kod jasno izraženih slika i ranije. Primjena sulpirida u početku liječenja alkoholizma daje pozitivne rezultate zbog njegovog širokog raspona, između ostalog i antidepresivnog, djelovanja. Ispitivalo se je djelovanje sulpirida u skupini od 20 bolesnika s lakšim i srednje teškim depresivnim poremećajem liječenih u Dnevnoj bolnici za alkoholizam na Klinici za psihijatriju, alkoholizam i druge ovisnosti Kliničke bolnice "Sestre milosrdnice" u Zagrebu. Ispitanici su primali 3x1 kapsulu od 50 miligrama sulpirida, dok je 20 bolesnika u kontrolnoj skupini primalo placebo. Obje su skupine podvrgnute individualnim i grupnim psihoterapijskim metodama u okviru socioterapijske zajednice. Razina depresivnog poremećaja ispitivana je Hamiltonovom i Beckovom ljestvicom koja je primijenjena pri dolasku na liječenje, te nakon dva, četiri i šest tjedana liječenja. Bolesnici su i klinički promatrani tijekom psihoterapijskih postupaka i ostalih aktivnosti koje se provode u terapijskoj zajednici. U radu je potvrđena djelotvornost sulpirida u dozi od 150 mg/dan u liječenju depresivnih poremećaja alkoholičara kroz njegov brz antidepresivni učinak, te je istaknuta njegova uloga u racionalnoj psihofarmakoterapiji alkoholičara u socioterapijskoj zajednici
