Advances in the health area and the implementation of preventive measures for HIV infection have reduced the detection of new cases of seropositive patients

Can Physical Exercise Cure Alcoholism?

Physical activity has shown benefits for both physical and mental health in individuals with alcohol use problems. A study points to an increase in substances associated with pleasure and well-being, reducing the harmful effects of alcohol use.

A recent study, published in the scientific journal PLoS ONE, sought to compile the results of highly reliable clinical research that involved physical exercise interventions for patients with Alcohol Use Disorder (AUD). The authors aimed to provide stronger evidence on ways to treat alcohol dependence and the physical and mental health of this patient group.

The survey included only randomized clinical trials with patients diagnosed with AUD or post-traumatic stress disorder (PTSD) with symptoms of AUD. To be included in the survey, studies needed to compare "experimental groups" that underwent exercise interventions, with variations in type, intensity, and duration, against "control groups" that did not perform exercises.

The outcomes analyzed in the studies included the number of daily and weekly alcohol doses, questionnaires for alcohol consumption identification, aerobic capacity (VO2max), resting heart rate, symptoms of anxiety, depression, and stress, with interventions varying between aerobic exercises, resistance training, yoga, and combinations of these approaches, lasting from 3 to 24 weeks.

The survey obtained interesting results, with evidence highlighting that physical exercise had positive effects on daily alcohol consumption, with a significant reduction in the number of daily doses, but no impact on weekly consumption. There was also a significant reduction in the scores of the Alcohol Use Disorders Identification Test (AUDIT), indicating an improvement in alcohol use patterns.

Regarding physical and psychological effects, exercise increased VO2max and improved resting heart rate, as well as significantly reducing anxiety, depression, and stress levels. The subgroup analysis indicated that mixed exercises and an intervention duration of up to 12 weeks were effective in reducing anxiety.

Despite the interesting and promising results, one limitation identified was the assessment of risk of bias, as this raised concerns in 53% of the studies, particularly regarding the lack of blinding in the interventions, meaning participants and researchers knew which group they were in, which may have influenced the results.

References:

Li J, Zhou Z, Gao G, Zang L (2024) Effectiveness of exercise intervention in improving physical and mental status of patients with alcohol use disorders: A systematic review and metaanalysis. PLoS ONE 19(10): e0311166. https://doi.org/10.1371/journal.pone.0311166

Study reveals that alcohol consumption during a sexual encounter does not affect women's memory.

Are alcoholism medications safe for people with cirrhosis?

A recent study analyzed the use of medications for alcohol use disorder in patients with cirrhosis, as the safety and effectiveness of these medications in this population is scarce.

A recent study analyzed the use of medications to promote alcohol abstinence in patients with alcohol dependence and cirrhosis [1]. Through research encompassing several studies, it was possible to assess whether the medications reduced consumption or promoted abstinence and whether there was safety in terms of side effects for people with liver problems.

The liver, the main organ responsible for alcohol metabolism, suffers damage due to excessive consumption, characterizing alcoholic liver disease. This can range from asymptomatic changes, such as fatty liver (hepatic steatosis), to alcoholic hepatitis and alcoholic cirrhosis. Early diagnosis and abstinence are fundamental in the treatment strategy for alcoholic liver disease, especially in the early stages, where there is still no irreversible damage and liver decompensation [2].

The presence of alcoholic cirrhosis and its complications can alter the action of medications, impacting the safety of use and increasing side effects. Therefore, the characteristics of the medication and the way it is administered must always be considered in cirrhotic patients.

Since clinical treatment options are limited to improve liver function in patients with cirrhosis, alcohol abstinence is the most important and proven therapeutic intervention [3]. However, many patients have difficulty achieving abstinence. Medications approved for alcohol use disorder include: naltrexone, which helps reduce excessive alcohol consumption; acamprosate, which facilitates the maintenance of abstinence; and disulfiram, which blocks the body's metabolism of alcohol, causing unpleasant symptoms such as nausea and redness of the skin. Other medications, such as baclofen, gabapentin, sertraline and topiramate, are also studied [4]. Among them, only baclofen has been shown to be safe and effective in maintaining abstinence in individuals with liver disease [5].

Seeking to analyze the side effects and effectiveness of medications in patients with cirrhosis or liver disease, even with limitations due to the low level of studies found, the study indicated that the use of medications can increase the probability of alcohol abstinence by 32% compared to placebo or standard treatment. Furthermore, the safety profile of these medications was considered adequate in most studies, suggesting that they may be an alternative for the treatment of patients with alcoholic cirrhosis. However, it is important to highlight the need for more research, especially in patients with advanced liver disease, to confirm these findings and evaluate the safety of these medications in this vulnerable population [1].

Therefore, if you or someone you know is dealing with alcohol use disorder and cirrhosis, it is essential to follow medical recommendations. Appropriate treatment can significantly increase quality of life and survival.

References:

1. Gratacós-Ginès, J., Bruguera, P., Pérez-Guasch, M., López-Lazcano, A., Borràs, R., Hernández-Évole, H., Pons-Cabrera, M. T., Lligoña, A., Bataller, R., Ginès, P., López-Pelayo, H., & Pose, E. (2024). Medications for alcohol use disorder promote abstinence in alcohol-associated cirrhosis: Results from a systematic review and meta-analysis. Hepatology (Baltimore, Md.), 79(2), 368–379. https://doi.org/10.1097/HEP.0000000000000570
2. Addolorato G., Mirijello A., Barrio P., Gual A. Treatment of alcohol use disorders in patients with alcoholic liver disease. J. Hepatol. 2016;65:618–630. doi: 10.1016/j.jhep.2016.04.029.
3. O'Shea, R. S., Dasarathy, S., McCullough, A. J., Practice Guideline Committee of the American Association for the Study of Liver Diseases, & Practice Parameters Committee of the American College of Gastroenterology (2010). Alcoholic liver disease. Hepatology (Baltimore, Md.), 51(1), 307–328. https://doi.org/10.1002/hep.23258
4. Jonas, D. E., Amick, H. R., Feltner, C., Bobashev, G., Thomas, K., Wines, R., Kim, M. M., Shanahan, E., Gass, C. E., Rowe, C. J., & Garbutt, J. C. (2014). Pharmacotherapy for adults with alcohol use disorders in outpatient settings: a systematic review and meta-analysis. JAMA, 311(18), 1889–1900. https://doi.org/10.1001/jama.2014.3628
5. Addolorato, G., Leggio, L., Ferrulli, A., Cardone, S., Vonghia, L., Mirijello, A., Abenavoli, L., D'Angelo, C., Caputo, F., Zambon, A., Haber, P. S., & Gasbarrini, G. (2007). Effectiveness and safety of baclofen for maintenance of alcohol abstinence in alcohol-dependent patients with liver cirrhosis: randomised, double-blind controlled study. Lancet (London, England), 370(9603), 1915–1922. https://doi.org/10.1016/S0140-6736(07)61814-5

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