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Kasson E, Filiatreau LM, Davet K, Kaiser N, Sirko G, Bekele M, Cavazos-Rehg P. Examining Symptoms of Stimulant Misuse and Community Support Among Members of a Recovery-Oriented Online Community. J Psychoactive Drugs 2024; 56:422-432. [PMID: 37381990 PMCID: PMC10755072 DOI: 10.1080/02791072.2023.2228781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 04/28/2023] [Accepted: 06/09/2023] [Indexed: 06/30/2023]
Abstract
Misuse of prescription and non-prescription stimulants and related overdose deaths represent a growing public health crisis that warrants immediate intervention. We examined 100 posts and their respective comments from a public, recovery-oriented Reddit community in January 2021 to explore content related to DSM-V stimulant use disorder symptoms, access and barriers to recovery, and peer support. Using inductive and deductive methods, a codebook was developed with the following primary themes: 1) DSM-V Symptoms and Risk Factors, 2) Stigma/Shame, 3) Seeking Advice or Information, 4) Supportive or Unsupportive Comments. In 37% of posts community members reported taking high doses and engaging in prolonged misuse of stimulants. Nearly half of posts in the sample (46%) were seeking advice for recovery, but 42% noted fear of withdrawal symptoms or a loss of productivity (18%) as barriers to abstinence or a reduction in use. Concerns related to stigma, shame, hiding use from others (30%), and comorbid mental health conditions (34%) were also noted. Social media content analysis allows for insight into information about lived experiences of individuals struggling with substance use disorders. Future online interventions should address recovery barriers related to stigma and shame as well as fears associated with the physical and psychological impact of quitting stimulant misuse.
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Affiliation(s)
- Erin Kasson
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110
| | - Lindsey M. Filiatreau
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110
| | - Kevin Davet
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110
| | - Nina Kaiser
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110
| | - Georgi Sirko
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110
| | - Mehaly Bekele
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110
- University of Southern California, Los Angeles, CA 90007
| | - Patricia Cavazos-Rehg
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110
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Ribeiro FJ, Poínhos R. Nootropic supplements for esports. INT J VITAM NUTR RES 2024; 94:275-295. [PMID: 37563907 DOI: 10.1024/0300-9831/a000790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/12/2023]
Abstract
Background: esports, or organized video game competitions, have been expanding quickly. The use of dietary supplements by esports players appears vulgarized but lacks supporting evidence. Objectives: To outline studies that tested the effects of dietary supplements on video gaming, summarize their findings, highlight knowledge gaps, and recommend future research. Eligibility criteria: Clinical trials published in English between 1990 and 2023 that assessed the effects of dietary supplements on the cognitive performance of video gamers. Sources of evidence: The Web of Science, PubMed, Scopus, and Google Scholar databases. Charting methods: PRISMA's (2020) flow diagram was used to create the data chart. Results: Sixteen studies were outlined. Thirteen were randomized, thirteen applied acute interventions, ten applied a crossover design and only three weren't placebo-controlled. Of the 10 studies that included caffeine (40-200 mg), four reported significant positive effects on cognition (attention, processing speed, working memory), two on first-person shooter video gaming performance (reaction time, hit accuracy, time to hit 60 targets), and one on Tetris game score. All 3 studies that included arginine silicate (1500 mg) reported significant improvements in one or more aspects of cognition (reaction time, attention, visual representation, and spatial planning). Two studies that tested sucrose (21 and 26.8 g) didn't report significant improvements, while one study that tested 26.1 g of glucose registered significant positive effects on processing speed and sustained attention. Conclusions: The published literature has focused on the effects of caffeine, which may exert both positive and negative effects on esports players. Additional, high-quality research is needed.
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Affiliation(s)
- Fernando J Ribeiro
- Faculty of Nutrition and Food Sciences, University of Porto (FCNAUP), Porto, Portugal
- Faculty of Sciences, University of Porto (FCUP), Porto, Portugal
| | - Rui Poínhos
- Faculty of Nutrition and Food Sciences, University of Porto (FCNAUP), Porto, Portugal
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Cid-Jofré V, Bahamondes T, Zúñiga Correa A, Ahumada Arias I, Reyes-Parada M, Renard GM. Psychostimulants and social behaviors. Front Pharmacol 2024; 15:1364630. [PMID: 38725665 PMCID: PMC11079219 DOI: 10.3389/fphar.2024.1364630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 04/01/2024] [Indexed: 05/12/2024] Open
Abstract
Mounting evidence from animal models and human studies indicates that psychostimulants can significantly affect social behaviors. This is not surprising considering that the neural circuits underlying the regulation and expression of social behaviors are highly overlapped with those targeted by psychostimulants, which in most cases have strong rewarding and, consequently, addictive properties. In the present work, we provide an overview regarding the effects of illicit and prescription psychostimulants, such as cocaine, amphetamine-type stimulants, methylphenidate or modafinil, upon social behaviors such as social play, maternal behavior, aggression, pair bonding and social cognition and how psychostimulants in both animals and humans alter them. Finally, we discuss why these effects can vary depending on numerous variables such as the type of drug considered, acute versus long-term use, clinical versus recreational consumption, or the presence or absence of concomitant risk factors.
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Affiliation(s)
- Valeska Cid-Jofré
- Centro de Investigación Biomédica y Aplicada (CIBAP), Escuela de Medicina, Facultad de Ciencias Médicas, Universidad de Santiago de Chile (USACH), Santiago, Chile
| | - Tamara Bahamondes
- Centro de Investigación Biomédica y Aplicada (CIBAP), Escuela de Medicina, Facultad de Ciencias Médicas, Universidad de Santiago de Chile (USACH), Santiago, Chile
| | - Agustina Zúñiga Correa
- Centro de Investigación Biomédica y Aplicada (CIBAP), Escuela de Medicina, Facultad de Ciencias Médicas, Universidad de Santiago de Chile (USACH), Santiago, Chile
| | - Ivalú Ahumada Arias
- Centro de Investigación Biomédica y Aplicada (CIBAP), Escuela de Medicina, Facultad de Ciencias Médicas, Universidad de Santiago de Chile (USACH), Santiago, Chile
| | - Miguel Reyes-Parada
- Centro de Investigación Biomédica y Aplicada (CIBAP), Escuela de Medicina, Facultad de Ciencias Médicas, Universidad de Santiago de Chile (USACH), Santiago, Chile
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile
| | - Georgina M. Renard
- Centro de Investigación Biomédica y Aplicada (CIBAP), Escuela de Medicina, Facultad de Ciencias Médicas, Universidad de Santiago de Chile (USACH), Santiago, Chile
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Beatty A, Shepard E, Bickford E, Weyandt L. Adverse Childhood Experiences and Prescription Stimulant Use in Adults: A Systematic Review. PHARMACY 2024; 12:52. [PMID: 38525732 PMCID: PMC10961765 DOI: 10.3390/pharmacy12020052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 02/16/2024] [Accepted: 02/28/2024] [Indexed: 03/26/2024] Open
Abstract
Nonmedical prescription stimulant use (NPSU) is an ongoing public health crisis in the United States. There exists, however, a dearth of research investigating specific childhood risk factors that may contribute to this illicit use. Adverse childhood experiences (ACEs) may be a significant risk factor to address in the prevention and treatment of NPSU, as research has provided evidence for increased substance use, potentially including prescription stimulant misuse, among individuals who have experienced trauma. A systematic review of the literature was conducted to gather and synthesize research articles specifically examining the relationship between nonmedical prescription stimulant use in adults and the experience of adverse childhood experiences (ACEs). Four studies met all inclusion criteria and were included in the review. The results demonstrated that the nonmedical use of prescription stimulants in adults is significantly associated with ACEs, with a higher numerical count of ACEs associated with a greater likelihood of nonmedical prescription stimulant use. Gaps in the literature were identified, specifically noting a lack of information available regarding the relationship between ACEs and NPSU within gender- and racially diverse populations. The findings have implications for informing interventions related to ACEs and the misuse of prescription stimulant medication in adults.
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Affiliation(s)
- Avery Beatty
- Department of Psychology, University of Rhode Island, Kingston, RI 02881, USA
| | - Emily Shepard
- Department of Psychology, University of Rhode Island, Kingston, RI 02881, USA
| | - Erek Bickford
- Interdisciplinary Neuroscience Program, University of Rhode Island, Kingston, RI 02881, USA
| | - Lisa Weyandt
- Department of Psychology and Interdisciplinary Neuroscience Program, University of Rhode Island, Kingston, RI 02881, USA
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Friehs MA, Klarkowski M, Frommel J, Phillips C, Mandryk RL. Fighting fair: community perspectives on the fairness of performance enhancement in esports. Front Sports Act Living 2024; 6:1330755. [PMID: 38532852 PMCID: PMC10963441 DOI: 10.3389/fspor.2024.1330755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 03/04/2024] [Indexed: 03/28/2024] Open
Abstract
Aims This study aims to explore community perspectives on enhancer usage in competitive gaming and esports, focusing on the perception of fairness and concerns about various potential performance enhancers. Methods We conducted both qualitative and quantitative surveys to understand the competitive gaming community's opinions on different types of performance enhancers and their potential impact on esports. A thematic analysis was performed to identify key themes in how players rationalize their opinions. Conclusions The gaming community differentiates between potential performance enhancers based on how problematic they are for the esports scene, with the most concern surrounding hard drugs, pharmaceuticals, and brain stimulation interventions. Participants who are more invested in competitive gaming tend to be more sceptical of enhancers and express greater concerns. Four themes were identified in the thematic analysis: (1) risk, (2) morality, (3) enhancer effects, and (4) regulation. To increase acceptance and perceived legitimacy in decision-making, it is recommended that regulators engage a variety of stakeholders in transparent decision-making processes when forming tournament rules and regulations. This will help address the fragmented regulatory landscape and prevent potential differences in the perception of tournament winners based on the governing body supervising the competition.
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Affiliation(s)
- Maximilian A. Friehs
- Psychology of Conflict Risk and Safety, University of Twente, Enschede, Netherlands
- School of Psychology, University College Dublin, Dublin, Ireland
- Max-Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Madison Klarkowski
- Human-Computer Interaction Lab, Department of Computer Science, University of Saskatchewan, Leipzig, Germany
| | - Julian Frommel
- Interaction Media Group, Information and Computing Sciences, Utrecht University, Utrecht, Netherlands
| | - Cody Phillips
- Human-Computer Interaction Lab, Department of Computer Science, University of Saskatchewan, Leipzig, Germany
| | - Regan L. Mandryk
- Faculty of Computer Science, University of Victoria, Victoria, BC, Canada
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Finley JCA, Cerny BM, Brooks JM, Obolsky MA, Haneda A, Ovsiew GP, Ulrich DM, Resch ZJ, Soble JR. Cross-validating the Clinical Assessment of Attention Deficit-Adult symptom validity scales for assessment of attention deficit/hyperactivity disorder in adults. J Clin Exp Neuropsychol 2024; 46:111-123. [PMID: 37994688 DOI: 10.1080/13803395.2023.2283940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 11/09/2023] [Indexed: 11/24/2023]
Abstract
INTRODUCTION The Clinical Assessment of Attention Deficit-Adult is among the few questionnaires that offer validity indicators (i.e., Negative Impression [NI], Infrequency [IF], and Positive Impression [PI]) for classifying underreporting and overreporting of attention-deficit/hyperactivity disorder (ADHD) symptoms. This is the first study to cross-validate the NI, IF, and PI scales in a sample of adults with suspected or known ADHD. METHOD Univariate and multivariate analyses were conducted to examine the independent and combined value of the NI, IF, and PI scores in predicting invalid symptom reporting and neurocognitive performance in a sample of 543 adults undergoing ADHD evaluation. RESULTS The NI scale demonstrated better classification accuracy than the IF scale in discriminating patients with and without valid scores on measures of overreporting. Only NI scores significantly predicted validity status when used in combination with IF scores. Optimal cut-scores for the NI (≤51; 30% sensitivity / 90% specificity) and IF (≥4; 18% sensitivity / 90% specificity) scales were consistent with those reported in the original manual; however, these indicators poorly discriminated patients with invalid and valid neurocognitive performance. The PI scale demonstrated acceptable classification accuracy in discriminating patients with invalid and valid scores on measures of underreporting, albeit with an optimal cut-score (≥27; 36% sensitivity / 90% specificity) lower than that described in the manual. CONCLUSION Findings provide preliminary evidence of construct validity for these scales as embedded validity indicators of symptom overreporting and underreporting. However, these scales should not be used to guide clinical judgment regarding the validity of neurocognitive test performance.
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Affiliation(s)
- John-Christopher A Finley
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School, Chicago, IL, USA
| | - Brian M Cerny
- Department of Psychology, Illinois Institute of Technology Chicago, Chicago, IL, USA
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
| | - Julia M Brooks
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
- Department of Psychology, University of Illinois College of Medicine, Chicago, IL, USA
| | - Maximillian A Obolsky
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
- Department of Psychology, Roosevelt University, Chicago, IL, USA
| | - Aya Haneda
- Department of Psychology, Roosevelt University, Chicago, IL, USA
| | - Gabriel P Ovsiew
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
| | - Devin M Ulrich
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
| | - Zachary J Resch
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
| | - Jason R Soble
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
- Department of Neurology, University of Illinois College of Medicine, Chicago, IL, USA
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Klein SR, Blum K, Gold MS, Thanos PK. Chronic Methylphenidate Effects on Brain Gene Expression: An Exploratory Review. Psychol Res Behav Manag 2024; 17:577-592. [PMID: 38379637 PMCID: PMC10876479 DOI: 10.2147/prbm.s445719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 02/05/2024] [Indexed: 02/22/2024] Open
Abstract
Methylphenidate (MP) is a psychostimulant commonly prescribed for individuals with attention deficit hyperactivity disorder (ADHD) but it is also taken with and without a prescription for performance enhancement. Prior research has characterized the effects of MP on behavior, cognition, and neurochemistry. This exploratory review covers the uses of MP and examined the effects of MP on gene expression in the brain following exposure. Overall, MP causes a wide-spread potentiation of genes, in a region-specific manner; consequently, inducing neuronal alterations, such as synaptic plasticity and transmission, resulting in observed behaviors and affects. Monoamine neurotransmitters and post-synaptic density protein genes generally had a potentiating effect in gene expression after exposure to MP.
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Affiliation(s)
- Shannon Rae Klein
- Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions (BNNLA), Clinical Research Institute on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Kenneth Blum
- Center for Sports, Exercise, & Mental Health, Western University Health Sciences, Pomona, CA, 91766, USA
| | - Mark S Gold
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, 63130, USA
| | - Panayotis K Thanos
- Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions (BNNLA), Clinical Research Institute on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
- Department of Psychology, University at Buffalo, Buffalo, NY, 14203, USA
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Zhang YQ, Min HK, Hong E, Yu E, Gu SM, Yoon SS, Lee D, Lee J, Hong JT, Yun J. Abused drug-induced intracranial self-stimulation is correlated with the alteration of dopamine transporter availability in the medial prefrontal cortex and nucleus accumbens of mice. Biomed Pharmacother 2023; 169:115860. [PMID: 37948992 DOI: 10.1016/j.biopha.2023.115860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 11/02/2023] [Accepted: 11/05/2023] [Indexed: 11/12/2023] Open
Abstract
Intracranial self-stimulation (ICSS) of the medial forebrain bundle in mice is an experimental model use to assess the relative potential of reward-seeking behaviors. Here, we used the ICSS model to evaluate the abuse potential of 18 abused drugs: 3-Fluoroethamphetamine (3-FEA); methylphenidate; cocaine; dextroamphetamine; alpha-Pyrrolidinobutyrophenone (α-PBT); 4'-Fluoro-4-methylaminorex (4-FPO); methamphetamine; larocaine; phentermine; paramethoxymethamphetamine (PMMA); phendimetrazine; N-(1-adamantyl)-1-pentyl-1H-indazole-3-carboxamide (AKB-48); Naphthalen-1-yl-(4-pentyloxynaphthalen-1-yl)methanone (CB-13); 4-Ethylnaphthalen-1-yl-(1-pentylindol-3-yl)methanone (JWH-210); Naphthalen-1-yl-(1-pentylindol-3-yl)methanone (JWH-018); N-(ortho-methoxybenzyl)-4-ethylamphetamine (4-EA-NBOMe); N-[(2-Methoxyphenyl)methyl]-N-methyl-1-(4-methylphenyl)propan-2-amine (4-MMA-NBOMe); and 1-[1-(4-methoxyphenyl)cyclohexyl]piperidine (4-MeO-PCP). We determined dopamine transporter (DAT) availability in the medial prefrontal cortex (mPFC), striatum, and nucleus accumbens (NAc) after drug treatment. DAT availability in the mPFC and NAc significantly correlated with the ICSS threshold after drug treatment. Extracellular dopamine and calcium levels in PC-12 cells were measured following drug treatment. After drug treatment, Spearman rank and Pearson correlation analyses showed a significant difference between the extracellular dopamine level and the ICSS threshold. After drug treatment, Spearman rank correlation analysis showed a significant correlation between Ca2+ signaling and the ICSS threshold. A positive correlation exists between the ICSS threshold and DAT availability in the mPFC and NAc provoked by abused drugs. The relative potential of drug-induced reward-seeking behavior may be related to DAT availability-mediated extracellular dopamine levels in the mPFC and NAc.
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Affiliation(s)
- Yong-Qing Zhang
- College of Pharmacy, Chungbuk National University, 194-31 Osongsaengmyeong 1-ro, Osong-eup, Heungdeok-gu, Cheongju-si, Chungcheongbuk-do 28160, Republic of Korea
| | - Hyun Kyu Min
- College of Pharmacy, Chungbuk National University, 194-31 Osongsaengmyeong 1-ro, Osong-eup, Heungdeok-gu, Cheongju-si, Chungcheongbuk-do 28160, Republic of Korea
| | - Eunchong Hong
- College of Pharmacy, Chungbuk National University, 194-31 Osongsaengmyeong 1-ro, Osong-eup, Heungdeok-gu, Cheongju-si, Chungcheongbuk-do 28160, Republic of Korea
| | - Eunhye Yu
- College of Pharmacy, Chungbuk National University, 194-31 Osongsaengmyeong 1-ro, Osong-eup, Heungdeok-gu, Cheongju-si, Chungcheongbuk-do 28160, Republic of Korea
| | - Sun Mi Gu
- College of Pharmacy, Chungbuk National University, 194-31 Osongsaengmyeong 1-ro, Osong-eup, Heungdeok-gu, Cheongju-si, Chungcheongbuk-do 28160, Republic of Korea
| | - Seong Shoon Yoon
- College of Korean Medicine, Daegu Haany University, 136 Sincheondong-ro, Suseong-gu, Daegu 42158, Republic of Korea
| | - Dohyun Lee
- Laboratory Animal Center, Osong Medical Innovation Foundation, 123 Osongsaengmyeong-ro, Osong-eup, Heungdeok-gu, Cheongju-si, Chungcheongbuk-do 28160, Republic of Korea
| | - Jaejun Lee
- Laboratory Animal Center, Osong Medical Innovation Foundation, 123 Osongsaengmyeong-ro, Osong-eup, Heungdeok-gu, Cheongju-si, Chungcheongbuk-do 28160, Republic of Korea
| | - Jin Tae Hong
- College of Pharmacy, Chungbuk National University, 194-31 Osongsaengmyeong 1-ro, Osong-eup, Heungdeok-gu, Cheongju-si, Chungcheongbuk-do 28160, Republic of Korea
| | - Jaesuk Yun
- College of Pharmacy, Chungbuk National University, 194-31 Osongsaengmyeong 1-ro, Osong-eup, Heungdeok-gu, Cheongju-si, Chungcheongbuk-do 28160, Republic of Korea.
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Tomasi D, Manza P, Yan W, Shokri-Kojori E, Demiral ŞB, Yonga MV, McPherson K, Biesecker C, Dennis E, Johnson A, Zhang R, Wang GJ, Volkow ND. Examining the role of dopamine in methylphenidate's effects on resting brain function. Proc Natl Acad Sci U S A 2023; 120:e2314596120. [PMID: 38109535 PMCID: PMC10756194 DOI: 10.1073/pnas.2314596120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 11/14/2023] [Indexed: 12/20/2023] Open
Abstract
The amplitude of low-frequency fluctuations (ALFF) and global functional connectivity density (gFCD) are fMRI (Functional MRI) metrics widely used to assess resting brain function. However, their differential sensitivity to stimulant-induced dopamine (DA) increases, including the rate of DA rise and the relationship between them, have not been investigated. Here we used, simultaneous PET-fMRI to examine the association between dynamic changes in striatal DA and brain activity as assessed by ALFF and gFCD, following placebo, intravenous (IV), or oral methylphenidate (MP) administration, using a within-subject double-blind placebo-controlled design. In putamen, MP significantly reduced D2/3 receptor availability and strongly reduced ALFF and increased gFCD in the brain for IV-MP (Cohen's d > 1.6) but less so for oral-MP (Cohen's d < 0.6). Enhanced gFCD was associated with both the level and the rate of striatal DA increases, whereas decreased ALFF was only associated with the level of DA increases. These findings suggest distinct representations of neurovascular activation with ALFF and gFCD by stimulant-induced DA increases with differential sensitivity to the rate and the level of DA increases. We also observed an inverse association between gFCD and ALFF that was markedly enhanced during IV-MP, which could reflect an increased contribution from MP's vasoactive properties.
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Affiliation(s)
- Dardo Tomasi
- Laboratory of Neuroimaging (LNI), National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, MD20892
| | - Peter Manza
- Laboratory of Neuroimaging (LNI), National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, MD20892
| | - Weizheng Yan
- Laboratory of Neuroimaging (LNI), National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, MD20892
| | - Ehsan Shokri-Kojori
- Laboratory of Neuroimaging (LNI), National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, MD20892
| | - Şükrü Barış Demiral
- Laboratory of Neuroimaging (LNI), National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, MD20892
| | - Michele-Vera Yonga
- Laboratory of Neuroimaging (LNI), National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, MD20892
| | - Katherine McPherson
- Laboratory of Neuroimaging (LNI), National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, MD20892
| | - Catherine Biesecker
- Laboratory of Neuroimaging (LNI), National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, MD20892
| | - Evan Dennis
- Laboratory of Neuroimaging (LNI), National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, MD20892
| | - Allison Johnson
- Laboratory of Neuroimaging (LNI), National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, MD20892
| | - Rui Zhang
- Laboratory of Neuroimaging (LNI), National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, MD20892
| | - Gene-Jack Wang
- Laboratory of Neuroimaging (LNI), National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, MD20892
| | - Nora D. Volkow
- Laboratory of Neuroimaging (LNI), National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, MD20892
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Harton MR, Seo DC, Evans-Polce RJ, Nguyen I, Parker MA. Cigarette and e-cigarette use trajectories and prospective prescription psychotherapeutic drug misuse among adolescents and young adults. Addict Behav 2023; 147:107818. [PMID: 37540966 PMCID: PMC10528320 DOI: 10.1016/j.addbeh.2023.107818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 07/19/2023] [Accepted: 07/27/2023] [Indexed: 08/06/2023]
Abstract
OBJECTIVE This study aimed to determine the potential longitudinal impact of different cigarette and e-cigarette use trajectories among people aged 10-24 on prescription drug misuse of psychotherapeutic drugs. METHODS Data came from waves 1-5 of the Population Assessment of Tobacco and Health (PATH) Study (2013-2019; n = 14,454). Group-based trajectory modeling identified groups of adolescents and young adults based on cigarette and e-cigarette use across the five waves. Weighted logistic regression models were fit to examine the association of group membership with two outcomes at all waves: 1) misuse of opioids, sedatives, and/or tranquilizers, and 2) misuse of Ritalin and/or Adderall, adjusting for background characteristics. RESULTS Five trajectory groups emerged: (1) non-use (77.7 %); (2) early-onset cigarette use with reducing use (4.6 %); (3) ever-increasing e-cigarette use (6.1 %); (4) stable dual use of cigarettes and e-cigarettes (3.2 %); and (5) accelerating dual use of cigarettes and e-cigarettes (8.4 %). In comparison to the non-use group, all other groups had significantly higher odds of misuse of opioids, tranquilizers, and/or sedatives and all but the early-onset cigarette use with reducing use group had significantly higher odds of misuse of Ritalin and/or Adderall by the end of wave 5. DISCUSSION Patterns of cigarette and e-cigarette use in adolescent and young adult populations may serve as important indicators for concurrent and prospective prescription psychotherapeutic drug misuse. Findings highlight the need for cigarette and e-cigarette use prevention, harm reduction, and/or cessation efforts among adolescents and young adults.
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Affiliation(s)
- Moriah R Harton
- Indiana University Bloomington, School of Public Health, Department of Epidemiology and Biostatistics, 809 E 9th St, Bloomington, IN 47405, USA
| | - Dong-Chul Seo
- Indiana University Bloomington, School of Public Health, Department of Applied Health Science, 1025 E 7th St, Bloomington, IN 47405, USA
| | - Rebecca J Evans-Polce
- University of Michigan, School of Nursing, Department of Health Behavior and Biological Sciences, 400 North Ingalls Building, Ann Arbor, MI 48109, USA
| | - Ivana Nguyen
- Indiana University Bloomington, School of Public Health, Department of Epidemiology and Biostatistics, 809 E 9th St, Bloomington, IN 47405, USA
| | - Maria A Parker
- Indiana University Bloomington, School of Public Health, Department of Epidemiology and Biostatistics, 809 E 9th St, Bloomington, IN 47405, USA.
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Finley JCA, Brooks JM, Nili AN, Oh A, VanLandingham HB, Ovsiew GP, Ulrich DM, Resch ZJ, Soble JR. Multivariate examination of embedded indicators of performance validity for ADHD evaluations: A targeted approach. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-14. [PMID: 37703401 DOI: 10.1080/23279095.2023.2256440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
This study investigated the individual and combined utility of 10 embedded validity indicators (EVIs) within executive functioning, attention/working memory, and processing speed measures in 585 adults referred for an attention-deficit/hyperactivity disorder (ADHD) evaluation. Participants were categorized into invalid and valid performance groups as determined by scores from empirical performance validity indicators. Analyses revealed that all of the EVIs could meaningfully discriminate invalid from valid performers (AUCs = .69-.78), with high specificity (≥90%) but low sensitivity (19%-51%). However, none of them explained more than 20% of the variance in validity status. Combining any of these 10 EVIs into a multivariate model significantly improved classification accuracy, explaining up to 36% of the variance in validity status. Integrating six EVIs from the Stroop Color and Word Test, Trail Making Test, Verbal Fluency Test, and Wechsler Adult Intelligence Scale-Fourth Edition was as efficacious (AUC = .86) as using all 10 EVIs together. Failing any two of these six EVIs or any three of the 10 EVIs yielded clinically acceptable specificity (≥90%) with moderate sensitivity (60%). Findings support the use of multivariate models to improve the identification of performance invalidity in ADHD evaluations, but chaining multiple EVIs may only be helpful to an extent.
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Affiliation(s)
- John-Christopher A Finley
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School, Chicago, IL, USA
| | - Julia M Brooks
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA
| | - Amanda N Nili
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
- Department of Medical Social Sciences, Northwestern University Feinberg School, Chicago, IL, USA
| | - Alison Oh
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
- Department of Psychology, Illinois Institute of Technology Chicago, IL, USA
| | - Hannah B VanLandingham
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
- Department of Psychology, Illinois Institute of Technology Chicago, IL, USA
| | - Gabriel P Ovsiew
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
| | - Devin M Ulrich
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
| | - Zachary J Resch
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
| | - Jason R Soble
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
- Department of Neurology, University of Illinois College of Medicine, Chicago, IL, USA
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12
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Emerick TD, Martin TJ, Ririe DG. Perioperative Considerations for Patients Exposed to Psychostimulants. Anesth Analg 2023; 137:474-487. [PMID: 37590793 PMCID: PMC10437106 DOI: 10.1213/ane.0000000000006303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Abstract
Concerns regarding the perioperative management of acute psychostimulant intoxication have been recognized for decades, but novel and diverse substances in this class continue to be developed. Despite the similarities in mechanisms of action among psychostimulants, each subclass within this broad category has unique receptor specificity and different mechanisms that play a role in patient clinical presentation. These issues present challenges to anesthesia providers when caring for patients with either acute or chronic exposure to psychostimulants during the perioperative period. Challenges result from both physiological and psychological effects that influence the action of the primary anesthetic agent, adjuvant anesthetics, and analgesics used for perioperative management of pain. The epidemiology, pharmacology, and perioperative implications of psychostimulant use are presented for amphetamines and similar acting nonamphetamines, cocaine, and, finally, the mixed-action drugs known as entactogens that share stimulant and psychedelic properties. This information is then used as the foundation for safe and effective perioperative management of patients exposed to psychostimulants.
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Affiliation(s)
- Trent D Emerick
- From the Department of Anesthesiology and Perioperative Medicine, Division of Chronic Pain, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Thomas J Martin
- Pain Mechanisms Lab, Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Douglas G Ririe
- Pain Mechanisms Lab, Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina
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Suri D, Zanni G, Mahadevia D, Chuhma N, Saha R, Spivack S, Pini N, Stevens GS, Ziolkowski-Blake A, Simpson EH, Balsam P, Rayport S, Ansorge MS. Dopamine transporter blockade during adolescence increases adult dopamine function, impulsivity, and aggression. Mol Psychiatry 2023; 28:3512-3523. [PMID: 37532798 PMCID: PMC10618097 DOI: 10.1038/s41380-023-02194-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 07/11/2023] [Accepted: 07/17/2023] [Indexed: 08/04/2023]
Abstract
Sensitive developmental periods shape neural circuits and enable adaptation. However, they also engender vulnerability to factors that can perturb developmental trajectories. An understanding of sensitive period phenomena and mechanisms separate from sensory system development is still lacking, yet critical to understanding disease etiology and risk. The dopamine system is pivotal in controlling and shaping adolescent behaviors, and it undergoes heightened plasticity during that time, such that interference with dopamine signaling can have long-lasting behavioral consequences. Here we sought to gain mechanistic insight into this dopamine-sensitive period and its impact on behavior. In mice, dopamine transporter (DAT) blockade from postnatal (P) day 22 to 41 increases aggression and sensitivity to amphetamine (AMPH) behavioral stimulation in adulthood. Here, we refined this sensitive window to P32-41 and identified increased firing of dopaminergic neurons in vitro and in vivo as a neural correlate to altered adult behavior. Aggression can result from enhanced impulsivity and cognitive dysfunction, and dopamine regulates working memory and motivated behavior. Hence, we assessed these behavioral domains and found that P32-41 DAT blockade increases impulsivity but has no effect on cognition, working memory, or motivation in adulthood. Lastly, using optogenetics to drive dopamine neurons, we find that increased VTA but not SNc dopaminergic activity mimics the increase in impulsive behavior in the Go/NoGo task observed after adolescent DAT blockade. Together our data provide insight into the developmental origins of aggression and impulsivity that may ultimately improve diagnosis, prevention, and treatment strategies for related neuropsychiatric disorders.
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Affiliation(s)
- Deepika Suri
- Department of Psychiatry, Columbia University, New York, NY, 10032, USA
- Department of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY, 10032, USA
| | - Giulia Zanni
- Department of Psychiatry, Columbia University, New York, NY, 10032, USA
- Department of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY, 10032, USA
| | - Darshini Mahadevia
- Department of Psychiatry, Columbia University, New York, NY, 10032, USA
- Department of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY, 10032, USA
| | - Nao Chuhma
- Department of Psychiatry, Columbia University, New York, NY, 10032, USA
- Department of Molecular Therapeutics, New York State Psychiatric Institute, New York, NY, 10032, USA
| | - Rinki Saha
- Department of Psychiatry, Columbia University, New York, NY, 10032, USA
- Department of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY, 10032, USA
| | - Stephen Spivack
- Department of Psychiatry, Columbia University, New York, NY, 10032, USA
- Department of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY, 10032, USA
| | - Nicolò Pini
- Department of Psychiatry, Columbia University, New York, NY, 10032, USA
- Department of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY, 10032, USA
| | - Gregory S Stevens
- Department of Psychiatry, Columbia University, New York, NY, 10032, USA
- Department of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY, 10032, USA
| | - Annette Ziolkowski-Blake
- Department of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY, 10032, USA
| | - Eleanor H Simpson
- Department of Psychiatry, Columbia University, New York, NY, 10032, USA
- Department of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY, 10032, USA
| | - Peter Balsam
- Department of Psychiatry, Columbia University, New York, NY, 10032, USA
- Department of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY, 10032, USA
- Department of Neuroscience and Behavior, Barnard College, Columbia University, New York, NY, 10032, USA
| | - Stephen Rayport
- Department of Psychiatry, Columbia University, New York, NY, 10032, USA
- Department of Molecular Therapeutics, New York State Psychiatric Institute, New York, NY, 10032, USA
| | - Mark S Ansorge
- Department of Psychiatry, Columbia University, New York, NY, 10032, USA.
- Department of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY, 10032, USA.
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Habib DRS, Giorgi S, Curtis B. Role of the media in promoting the dehumanization of people who use drugs. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2023; 49:371-380. [PMID: 36995266 PMCID: PMC10759778 DOI: 10.1080/00952990.2023.2180383] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 02/01/2023] [Accepted: 02/05/2023] [Indexed: 03/31/2023]
Abstract
Dehumanization, the perception or treatment of people as subhuman, has been recognized as "endemic" in medicine and contributes to the stigmatization of people who use illegal drugs, in particular. As a result of dehumanization, people who use drugs are subject to systematically biased policies, long-lasting stigma, and suboptimal healthcare. One major contributor to the public opinion of drugs and people who use them is the media, whose coverage of these topics consistently uses negative imagery and language. This narrative review of the literature and American media on the dehumanization of illegal drugs and the people who use them provides a perspective on the components of dehumanization in each case and explores the consequences of dehumanization on health, law, and society. Drawing from language and images from American news outlets, anti-drug campaigns, and academic research, we recommend a shift away from the disingenuous trope of people who use drugs as poor, uneducated, and most likely of color. To this end, positive media portrayals and the humanization of people who use drugs can help form a common identity, engender empathy, and ultimately improve health outcomes.
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Affiliation(s)
- Daniel Roy Sadek Habib
- Technology and Translational Research Unit, National Institute on Drug Abuse Intramural Research Program, Baltimore, MD, USA
- School of Medicine, Vanderbilt University, Nashville, TN, USA
| | - Salvatore Giorgi
- Technology and Translational Research Unit, National Institute on Drug Abuse Intramural Research Program, Baltimore, MD, USA
| | - Brenda Curtis
- Technology and Translational Research Unit, National Institute on Drug Abuse Intramural Research Program, Baltimore, MD, USA
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15
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McNealy KR, Weyrich L, Bevins RA. The co-use of nicotine and prescription psychostimulants: A review of their behavioral and neuropharmacological interactions. Drug Alcohol Depend 2023; 248:109906. [PMID: 37216808 PMCID: PMC10361216 DOI: 10.1016/j.drugalcdep.2023.109906] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 04/05/2023] [Accepted: 04/27/2023] [Indexed: 05/24/2023]
Abstract
BACKGROUND Nicotine is commonly co-used with other psychostimulants. These high co-use rates have prompted much research on interactions between nicotine and psychostimulant drugs. These studies range from examination of illicitly used psychostimulants such as cocaine and methamphetamine to prescription psychostimulants used to treat attention deficit hyperactivity disorder (ADHD) such as methylphenidate (Ritalin™) and d-amphetamine (active ingredient of Adderall™). However, previous reviews largely focus on nicotine interactions with illicitly used psychostimulants with sparse mention of prescription psychostimulants. The currently available epidemiological and laboratory research, however, suggests high co-use between nicotine and prescription psychostimulants, and that these drugs interact to modulate use liability of either drug. The present review synthesizes epidemiological and experimental human and pre-clinical research assessing the behavioral and neuropharmacological interactions between nicotine and prescription psychostimulants that may contribute to high nicotine-prescription psychostimulant co-use. METHODS We searched databases for literature investigating acute and chronic nicotine and prescription psychostimulant interactions. Inclusion criteria were that participants/subjects had to experience nicotine and a prescription psychostimulant compound at least once in the study, in addition to assessment of their interaction. RESULTS AND CONCLUSIONS Nicotine clearly interacts with d-amphetamine and methylphenidate in a variety of behavioral tasks and neurochemical assays assessing co-use liability across preclinical, clinical, and epidemiological research. The currently available research suggests research gaps examining these interactions in women/female rodents, in consideration of ADHD symptoms, and how prescription psychostimulant exposure influences later nicotine-related outcomes. Nicotine has been less widely studied with alternative ADHD pharmacotherapy bupropion, but we also discuss this research.
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Affiliation(s)
- Kathleen R McNealy
- Department of Psychology, University of Nebraska-Lincoln, 238 Burnett Hall, Lincoln, NE68588-0308, USA.
| | - Lucas Weyrich
- Institute for Human Neuroscience, Boys Town National Research Hospital, 14090 Mother Teresa Ln, Boys Town, NE68010, USA; Department of Pharmacology and Neuroscience, Creighton University, 2500 California Plaza, Omaha, NE687178, USA
| | - Rick A Bevins
- Department of Psychology, University of Nebraska-Lincoln, 238 Burnett Hall, Lincoln, NE68588-0308, USA
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16
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Macmadu A, Banks AJ, Hallowell BD, Scagos RP, Hadland SE, Chambers LC, Marshall BD. Receipt of Prescription Psychostimulants and Stimulant-Involved Fatal Overdose: A Population-Based Case-Control Study. Subst Use Misuse 2023; 58:1163-1167. [PMID: 37170622 PMCID: PMC10247490 DOI: 10.1080/10826084.2023.2212037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Background: Rates of psychostimulant use, misuse, and hospitalization have increased markedly over the past decade. The objective of this study was to estimate the association between receipt of a psychostimulant prescription in the past year and fatal, unintentional psychostimulant-involved overdose. Methods: We conducted a population-based case-control study using linked, state-level databases from the Rhode Island Department of Health. Cases were defined as Rhode Island residents who experienced a fatal, unintentional drug overdose involving a psychostimulant, and controls included non-psychostimulant involved fatal overdoses occurring between May 1, 2017 and May 31, 2020 The primary exposure of interest was receipt of a psychostimulant prescription within 12 months prior to death, ascertained through linkage to the state's prescription drug monitoring program. Conditional logistic regression was used to estimate unadjusted and adjusted odds ratios. Results: Of 894 eligible overdose fatalities, the majority were white/non-Hispanic (72%), mean age was 43 years, and most resided in Providence County (69%). A total of 39 (4%) involved a psychostimulant. After adjusting for year of death and matching by sex, age, and county of residence, cases had 4.1 (95% confidence interval: 1.6, 10.6) times the odds of receiving a prescription stimulant in the past year compared to controls. Conclusions: Our findings suggest that there is a strong, positive association between prescription psychostimulant receipt and psychostimulant-involved fatal overdose. In response to an evolving polysubstance use landscape, current harm reductions measures, including naloxone training, fentanyl test strip distribution, and overdose education, should be expanded to include patients who receive psychostimulant prescriptions.
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Affiliation(s)
- Alexandria Macmadu
- Brown University School of Public Health, 121 South Main Street, Providence, Rhode Island 02906, USA
| | - Alexandra J. Banks
- Brown University School of Public Health, 121 South Main Street, Providence, Rhode Island 02906, USA
| | - Benjamin D. Hallowell
- Rhode Island Department of Health, 3 Capitol Hill, Providence, Rhode Island 02908, USA
| | - Rachel P. Scagos
- Rhode Island Department of Health, 3 Capitol Hill, Providence, Rhode Island 02908, USA
| | - Scott E. Hadland
- Grayken Center for Addiction, Boston Medical Center, One Boston Medical Center Place, Boston, Massachusetts 02118, USA
- Department of Pediatrics, Boston Medical Center, 850 Harrison Ave 6th floor, Boston, Massachusetts 02118, USA
- Division of General Pediatrics, Department of Pediatrics, Boston University School of Medicine, 72 E Concord St, Boston, Massachusetts 02118, USA
| | - Laura C. Chambers
- Rhode Island Department of Health, 3 Capitol Hill, Providence, Rhode Island 02908, USA
| | - Brandon D.L. Marshall
- Brown University School of Public Health, 121 South Main Street, Providence, Rhode Island 02906, USA
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17
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Pujalte GGA, Narducci DM, Smith MS, King R, Logan K, Callender SS, Liebman CA, Kane SF, Israel MP, Wolf SF, Nuti R, Khodaee M. Athletes With Attention-Deficit/Hyperactivity Disorder: Position Statement of the American Medical Society for Sports Medicine. Clin J Sport Med 2023; 33:195-208. [PMID: 37185161 DOI: 10.1097/jsm.0000000000001152] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 03/28/2023] [Indexed: 05/17/2023]
Abstract
ABSTRACT Athletes of all ages may be affected by medical and mental health issues. Sports medicine physicians should be familiar with common conditions that may affect the well-being of athletes, such as attention-deficit/hyperactivity disorder (ADHD). ADHD behaviors have the potential to affect a person's ability to concentrate. It is likely that social and cognitive therapies combined with pharmacotherapy will be the most effective way to treat ADHD in athletes. Medications used for ADHD, especially stimulant types, are known to improve alertness, reaction time, anaerobic performance, and endurance, which would potentially improve athletic performance. Furthermore, stimulant medications may enable student athletes with ADHD to focus on academic studies for longer periods of time, beyond usual levels of fatigue, important for those who may be exhausted after practices and games. The purported performance enhancement effects and potential adverse effects of stimulant medications have prompted many sports governing bodies to ban prescription stimulants or establish strict rules for their use. Athletes taking physician-prescribed stimulants to treat ADHD need to provide the appropriate documentation for approval before competition or risk punitive measures. Physicians should strive to provide a high quality of care to athletes with ADHD through early diagnosis, appropriate and careful multidisciplinary treatment, and complete and timely documentation to facilitate continued sports participation.
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Affiliation(s)
- George G A Pujalte
- Department of Family Medicine and Department of Orthopedic Surgery, Mayo Clinic, Jacksonville, Florida
| | - Dusty Marie Narducci
- Department of Family Medicine, University of South Florida College of Medicine, Tampa, Florida
| | - Michael Seth Smith
- Sports Medicine Institute, Department of Orthopaedics, Florida Health, Gainesville, Florida
| | - Rebecca King
- Primary Care National Landing, Virginia Hospital Center, Arlington, Virginia
| | - Kelsey Logan
- Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Shelley Street Callender
- Departments of Pediatrics and Family Medicine, Mercer University School of Medicine, Macon, Georgia
| | - Catherine A Liebman
- Department Family Medicine and Community Health, Penn Health, Philadelphia, Pennsylvania
| | - Shawn F Kane
- Department of Family Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Michael P Israel
- Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Sigrid F Wolf
- Division of Orthopaedic Surgery and Sports Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | | | - Morteza Khodaee
- AF Williams Family Medicine Clinic, UCHealth, Denver, Colorado
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18
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Ramdin C, Bikkina R, Nelson L, Mazer-Amirshahi M. Trends in amphetamine prescriptions given at discharge in emergency departments: A national analysis (2012-2019). Am J Emerg Med 2023; 66:91-97. [PMID: 36738570 DOI: 10.1016/j.ajem.2023.01.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 01/09/2023] [Accepted: 01/24/2023] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVES In parallel with the opioid epidemic, there has been a resurgence in abuse, medical complications, and deaths related to amphetamines. The opioid epidemic began with increasing rates of prescription products that evolved overtime to include heroin and more recently, fentanyl analogues. Current trends in amphetamine prescriptions are less well described. We sought to determine if there has been a change in amphetamine prescriptions given at discharge in U.S. emergency departments (EDs) in recent years. METHODS We conducted a retrospective review of data provided by the National Hospital Ambulatory Medical Care Survey (NHAMCS) from 2012 to 2019. We computed total number of visits that were given amphetamine prescriptions (amphetamine salts, methylphenidate derivatives, and dexmethylphenidate) at discharge for each year. We computed the total number and rate of visits (of all ED visits) that had both amphetamines and opioids prescribed at discharge over the years. We computed data normality using Shapiro Wilke's test and used descriptive statistics such as mean to describe the data distribution as applicable. We used spearman's rho (SR) or pearson's correlation (PC) as applicable to describe trends in data. All p-values were one-tailed and were reported at a 0.05 significance level. All analyses were conducted in IBM SPSS version 28. RESULTS/FINDINGS From 2012 to 2019, there were an estimated 817,895 ED visits where an amphetamine prescription was given at discharge, with an overall strong increase in rate over time (SR = 0.71, p = 0.02). At the beginning of the study period (2012) there were 83,503 (0.06%) visits and in 2019 there were 186,539 (0.12%) visits (123% absolute increase). On average, there were 102,237 (SD: 52,725) visits with discharge amphetamine prescriptions per year. There was a strong, linear increase in number of visits that involved a discharge amphetamine salt prescription (PC = 0.92, p = 0.001). In 2012, there were a total of 23,676 visits and in 2019, a total of 124,773 visits (427% increase). There was no trend in visits where both an amphetamine and opioid were prescribed (PC: 0.61, p = 0.06). CONCLUSION There have been increases in discharge prescriptions for amphetamines in the ED over time. This was largely driven by prescriptions for amphetamine salts. Future research initiatives should continue to monitor this trend and in prescriptions and associated abuse in the setting of rising amphetamine abuse.
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Affiliation(s)
- Christine Ramdin
- Rutgers New Jersey Medical School, Department of Emergency Medicine, United States of America.
| | - Rama Bikkina
- Georgetown University, School of Medicine, United States of America
| | - Lewis Nelson
- Rutgers New Jersey Medical School, Department of Emergency Medicine, United States of America
| | - Maryann Mazer-Amirshahi
- Georgetown University, School of Medicine, United States of America; Department of Emergency Medicine, MedStar Washington Hospital Center, United States of America
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Sifeddine W, Ba-M'hamed S, Landry M, Bennis M. Effect of atomoxetine on ADHD-pain hypersensitization comorbidity in 6-OHDA lesioned mice. Pharmacol Rep 2023; 75:342-357. [PMID: 36787018 DOI: 10.1007/s43440-023-00459-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 01/26/2023] [Accepted: 01/31/2023] [Indexed: 02/15/2023]
Abstract
BACKGROUND Methylphenidate and atomoxetine are used for the treatment of attention-deficit/hyperactivity disorder (ADHD). Our previous studies established the validity of the 6-hydroxydopamine (6-OHDA) mouse model of ADHD and demonstrated hypersensitivity to pain, in line with clinical reports in ADHD patients. Acute methylphenidate treatment reduces hyperactivity and increases attention, but does not affect pain behaviors in this mouse model. Whereas atomoxetine has been shown to be effective against some symptoms of ADHD, nothing is known about its possible action on comorbid pain hypersensitivity. The objectives of the present research are (1) to investigate the effects of acute and chronic treatment with atomoxetine on ADHD-like symptoms and nociceptive thresholds, and (2) to explore the catecholaminergic systems underlying these effects. METHODS Sham and 6-OHDA cohorts of male mice were tested for hyperactivity (open field), attention and impulsivity (5-choice serial reaction time task test), and thermal (hot plate test) and mechanical (von Frey test) thresholds after acute or repeated treatment with vehicle or atomoxetine (1, 3 or 10 mg/kg). RESULTS Acute administration of atomoxetine (10 mg/kg) reduced the hyperactivity and impulsivity displayed by 6-OHDA mice, without affecting attention or nociception. However, atomoxetine administered at 3 mg/kg/day for 7 days alleviated the ADHD-like core symptoms and attenuated the hyperalgesic responses. Furthermore, hyperlocomotion and anti-hyperalgesic activity were antagonized with phentolamine, propranolol, and sulpiride pre-treatments. CONCLUSION These findings demonstrated that when administered chronically, atomoxetine has a significant effect on ADHD-associated pain hypersensitization, likely mediated by both α- and β-adrenergic and D2/D3 dopaminergic receptors, and suggest new indications for atomoxetine that will need to be confirmed by well-designed clinical trials.
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Affiliation(s)
- Wahiba Sifeddine
- Laboratory of Pharmacology, Neurobiology, Anthropobiology, and Environment, Faculty of Sciences, Cadi Ayyad University, Avenue Prince My Abdellah, B.P. 2390, 40000, Marrakesh, Morocco
| | - Saadia Ba-M'hamed
- Laboratory of Pharmacology, Neurobiology, Anthropobiology, and Environment, Faculty of Sciences, Cadi Ayyad University, Avenue Prince My Abdellah, B.P. 2390, 40000, Marrakesh, Morocco
| | - Marc Landry
- University of Bordeaux, CNRS, Institute of Neurodegenerative Diseases, UMR 5293, Bordeaux, France.,University of Bordeaux, CNRS, INSERM, Bordeaux Imaging Center, UMS 3420, US 4, Bordeaux, France
| | - Mohamed Bennis
- Laboratory of Pharmacology, Neurobiology, Anthropobiology, and Environment, Faculty of Sciences, Cadi Ayyad University, Avenue Prince My Abdellah, B.P. 2390, 40000, Marrakesh, Morocco.
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20
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Abdulghani A, Poghosyan M, Mehren A, Philipsen A, Anderzhanova E. Neuroplasticity to autophagy cross-talk in a therapeutic effect of physical exercises and irisin in ADHD. Front Mol Neurosci 2023; 15:997054. [PMID: 36776770 PMCID: PMC9909442 DOI: 10.3389/fnmol.2022.997054] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 12/30/2022] [Indexed: 01/28/2023] Open
Abstract
Adaptive neuroplasticity is a pivotal mechanism for healthy brain development and maintenance, as well as its restoration in disease- and age-associated decline. Management of mental disorders such as attention deficit hyperactivity disorder (ADHD) needs interventions stimulating adaptive neuroplasticity, beyond conventional psychopharmacological treatments. Physical exercises are proposed for the management of ADHD, and also depression and aging because of evoked brain neuroplasticity. Recent progress in understanding the mechanisms of muscle-brain cross-talk pinpoints the role of the myokine irisin in the mediation of pro-cognitive and antidepressant activity of physical exercises. In this review, we discuss how irisin, which is released in the periphery as well as derived from brain cells, may interact with the mechanisms of cellular autophagy to provide protein recycling and regulation of brain-derived neurotrophic factor (BDNF) signaling via glia-mediated control of BDNF maturation, and, therefore, support neuroplasticity. We propose that the neuroplasticity associated with physical exercises is mediated in part by irisin-triggered autophagy. Since the recent findings give objectives to consider autophagy-stimulating intervention as a prerequisite for successful therapy of psychiatric disorders, irisin appears as a prototypic molecule that can activate autophagy with therapeutic goals.
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Affiliation(s)
- Alhasan Abdulghani
- C. and O. Vogt Institute for Brain Research, Medical Faculty and University Hospital Düsseldorf, Henrich Heine University, Düsseldorf, Düsseldorf, Germany,*Correspondence: Alhasan Abdulghani,
| | - Mikayel Poghosyan
- Institute for Biology-Neurobiology, Freie University of Berlin, Berlin, Germany
| | - Aylin Mehren
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Alexandra Philipsen
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Elmira Anderzhanova
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
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Prakash S, Gu Y, Previti M. Quantitative Survey on Prevalence of Prescription Pain Medications and Stimulants Use in Young Adults. Subst Abuse 2023; 17:11782218231162827. [PMID: 37101598 PMCID: PMC10123905 DOI: 10.1177/11782218231162827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 02/22/2023] [Indexed: 04/28/2023]
Abstract
Background Prescription drug use including pain relievers and stimulants has been a growing problem in young adults and the issue has been a public health concern for years. Methods This Quantitative Cross-sectional study aimed to collect preliminary data regarding prescription opioid use, prescription stimulant drug use and overdose treatment knowledge in young adults between 18 and 24 years old in a southern New Jersey university through administering an online survey. Results Of the 1663 students who completed the survey, 33% reported using prescription pain relievers and 15% reported using prescription stimulant drugs. Stimulant drug users were found to be more likely to use prescription pain relievers (49%) as compared to non-stimulant users (30%). Furthermore, students with overdose treatment knowledge of opioids were more likely to report misuse of prescription drugs (15%) than students with less knowledge (8%). Conclusions This study reiterates the increasing usage of prescription drugs and stimulant use among college students. There is a need for effective education strategies to inform students about the prescription medication uses and misuse to reduce nonmedical use of prescription medications.
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Affiliation(s)
- Sreelekha Prakash
- Dr. Sreelekha Prakash, School of Health Sciences, Stockton University, 101 Vera King Farris Drive, Galloway, NJ 08205, USA.
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Muacevic A, Adler JR, Abbas MS, Nassar ST, Tasha T, Desai A, Bajgain A, Ali A, Dutta C, Elshaikh AO. Psychosis Induced by Methylphenidate in Children and Young Patients With Attention-Deficit Hyperactivity Disorder. Cureus 2023; 15:e34299. [PMID: 36860219 PMCID: PMC9970721 DOI: 10.7759/cureus.34299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 01/28/2023] [Indexed: 01/30/2023] Open
Abstract
Attention-deficit hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders diagnosed in children of this era. ADHD in children and adults is challenging but highly manageable. Children with ADHD cannot focus, are hyperactive, and appear withdrawn. These symptoms make them endure difficulties in learning and create academic challenges. Methylphenidate (MPH) is one of the psychostimulants used as a first-line therapy for ADHD. In this literature review, we have gathered information that describes the evidence of psychotic symptoms in children and young patients with ADHD as a side effect of MPH. We used articles from the National Library of Medicine (PubMed) and Google Scholar to gather the relevant information. Our findings concluded that MPH can increase the risk of psychosis, particularly when taken in high doses. It is still unclear whether the psychotic range of symptoms occurred due to an increased dopamine (DA) level caused by MPH or as a predominant feature of ADHD or if there was another comorbid feature in the history of the patient that led to psychosis. However, a necessary step for every medical practitioner prescribing psychostimulants is that they enlighten the patient and caregiver that this rare but threatening side effect is a possibility.
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Perspectives on Deterrents from Students Who Have Discontinued Prescription Stimulant Misuse and Diversion Behaviors. JOURNAL OF PREVENTION 2022; 44:193-206. [PMID: 36357645 DOI: 10.1007/s10935-022-00714-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/19/2022] [Indexed: 11/12/2022]
Abstract
Although a growing number of studies have sought to understand what motivates the initiation of prescription stimulant misuse and diversion among college students, there has been a lack of studies focused on what motivates behavior cessation. We aimed to explore what motivates prescription stimulant misuse and diversion cessation, from the perspective of college students with a history of having initiated and then discontinued these behaviors. We conducted face-to-face interviews with students who had a history of misuse, diversion, or both, and who had intentionally, either for the short-term or long-term, ceased these behaviors. We audio-recorded, transcribed, and analyzed interviews inductively using a thematic analysis approach. Of the six themes we identified, four applied to both misuse and diversion, while two applied to diversion only. Engaging in related behavior change, seasonality of the behaviors, changes in personal needs, and negative and/or null experiences with the behaviors were themes for both misuse and diversion cessation. Themes that emerged solely for diversion cessation included: moral and legal concerns and not wanting to be perceived as a drug dealer. The information shared by students with first-hand misuse and diversion cessation experience has the potential to guide interventions designed to address prescription stimulant misuse on college campuses.
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Demir B, Ozsoy F, Buyuk A, Altindag A. The effects of methamphetamine on electrocardiographic parameters in male patients. Int J Psychiatry Clin Pract 2022; 26:381-386. [PMID: 35225724 DOI: 10.1080/13651501.2022.2041671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE We aimed to compare the electrocardiographic parameters in patients with methamphetamine use to healthy controls. METHODS The study is a cross-sectional case-control study. Sixty-eight patients diagnosed with methamphetamine use disorder (MUD) according to DSM-5 criteria and 65 subjects in healthy control group who can match the patient group with demographic data were included in the study. Heart rate, P wave dispersion, QT dispersion, QTc and Tp-e/QTc ratios were calculated in the ECGs of all participants. RESULTS The mean age of the patients was 25.60 ± 5.70 and of the control group was 27.43 ± 6.10 (p = 0.076). There was no statistically significant difference between the blood pressure, body mass index, HDL-LDL-total cholesterol and triglyceride values of the participants (p > 0.05). Although QT dispersion was 13.68 ± 9.12 in patients with methamphetamine use disorder, it was calculated as 9.08 ± 7.85 in the control group (p = 0.002). Finally, the Tp-e/QTc ratio of the patients was higher than the healthy controls (p = 0.014). CONCLUSION In our study, we found a significant deterioration in QT dispersion and Tp-e/QTc ratio in the MUD group. Therefore, it should be kept in mind that there is a risk of malignant arrhythmia in this patient group and care should be taken in terms of arrhythmic events during follow-up in this patient group.Key pointsPatients with methamphetamine use showed significant deterioration in QTd and Tp-e/QTcMethamphetamine users have prolonged Tp-e/QTc ratio and QTdCaution should be exercised in terms of arrhythmic events in methamphetamine users.
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Affiliation(s)
- Bahadir Demir
- Faculty of Medicine, Department of Psychiatry, Gaziantep University, Gaziantep, Turkey
| | - Filiz Ozsoy
- Faculty of Medicine, Department of Psychiatry, Gaziosmanpasa University, Tokat, Turkey
| | - Ahmet Buyuk
- M.D. - 25 December State Hospital, Clinic of Cardiology, Gaziantep, Turkey
| | - Abdurrahman Altindag
- Faculty of Medicine, Department of Psychiatry, Gaziantep University, Gaziantep, Turkey
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25
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Johnson Holm AK, Tuthill SD, Klein ND, Wedelll E, Looby A, Bravo AJ, Prince MA. Compounding Privilege, Resilience, and Nonmedical Prescription Stimulant Use among College Students. Subst Use Misuse 2022; 57:1751-1760. [PMID: 36096474 PMCID: PMC10851314 DOI: 10.1080/10826084.2022.2102182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Background: In this study, we examined why non-Hispanic White cisgender men are more likely than other subgroups to misuse prescription stimulants in college. The objective of the current study was to use a strength-based framework to examine intersectional demographic predictors. Methods: We examined gender and race/ethnicity as predictors of nonmedical prescription stimulant use (NPS) among college students. We also investigated resilience as a moderator. This report uses data from an online multisite study conducted at seven universities with 4,764 undergraduate students (70.1% women and 52.0% People of Color). Results: We found that college students who were cisgender men and non-Hispanic White used NPS significantly more than students who identified as another gender and as People of Color. There was also a buffering effect of resilience between race/ethnicity and NPS, such that resilience predicted lower NPS for People of Color, but not non-Hispanic White people 28% of the time. Conclusions: It may be that Students of Color are more resilient than non-Hispanic White students, and this resilience is protective of NPS use in college. Importantly, a compounding-privilege and/or intersectional approach to identity is crucial to fully understanding behavior (in this case NPS) in a diversity of college students; future studies should continue to use and develop such approaches.
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Affiliation(s)
| | | | | | - Emma Wedelll
- Department of Psychological Sciences, William & Mary
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Yuan A, King N, Kharas N, Yang P, Dafny N. The effect of environment on cross-sensitization between methylphenidate and amphetamine in female rats. Physiol Behav 2022; 252:113845. [PMID: 35594929 DOI: 10.1016/j.physbeh.2022.113845] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 04/22/2022] [Accepted: 05/15/2022] [Indexed: 11/17/2022]
Abstract
Methylphenidate (MPD) and amphetamine (AMP) are both psychostimulants that are often used to treat behavioral disorders. More recently, it has also been increasingly used illicitly for recreation as well as to improve intellectual performance. Many factors such as age, gender, genetic background, and environment govern the development of behavioral sensitization to MPD and cross-sensitization with other drugs, which are experimental behavioral markers indicating potential of substance dependence and abuse. This study examines the effects of the environment and age when MPD was exposed in adulthood alone as well as in adolescence into adulthood on cross-sensitization with AMP in female SD rats by randomizing animals to either receive the drug in a home cage or a test cage during adolescence, adulthood, or both. In a 34 day experiment, 16 groups of animals starting in adolescence were treated with saline on experimental day one (ED1), followed by a 6 day (ED2-ED7) treatment with either saline, 0.6 mg/kg AMP, 0.6, 2.5, or 10.0 mg/kg MPD. Experimental groups were then subject to a 3-day washout period (ED8-ED10) and then a retreatment with the respective drug on ED11 in adolescence (P-38 to P-49). Experiments continued in the same animal groups now in adulthood (P-60) with a saline treatment (ED1), followed by the same sequence of treatments in adolescence (ED2-ED11;P-61 to P-69). A rechallenge with the same AMP or MPD dose was performed on ED11 (P-70) followed by a single exposure to 0.6 mg/kg AMP on ED12 (P-71) to assess for cross sensitization between MPD and AMP. Animals treated with MPD in both adolescence and adulthood and in the last experimental day of AMP (ED12) showed higher intensity of cross-sensitivity between MPD and AMP as compared to animals treated with MPD only in adulthood. AMP and MPD treatment in adolescence and into adulthood in the home or test cage resulted in significantly higher responses to the drug as compared to those treated only in adulthood. Overall, we conclude that environmental alteration and adolescent exposure to MPD appeared to increase the risk of cross-sensitization to AMP in female SD rats i.e, using MPD in adolescence may increase the probability of becoming dependent on drugs of abuse. This further indicates that age, sex, and environment all influence the response to MPD and AMP, and further work is needed to elucidate the risks associated with MPD and AMP use.
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Affiliation(s)
- Anthony Yuan
- Department of Neurobiology and Anatomy, University of Texas Health at the McGovern Medical School, 6431 Fannin Street, MSB 7.208, Houston, TX 77030, United States
| | - Nicholas King
- Department of Neurobiology and Anatomy, University of Texas Health at the McGovern Medical School, 6431 Fannin Street, MSB 7.208, Houston, TX 77030, United States
| | - Natasha Kharas
- Department of Neurobiology and Anatomy, University of Texas Health at the McGovern Medical School, 6431 Fannin Street, MSB 7.208, Houston, TX 77030, United States
| | - Pamela Yang
- Department of Neurobiology and Anatomy, University of Texas Health at the McGovern Medical School, 6431 Fannin Street, MSB 7.208, Houston, TX 77030, United States
| | - Nachum Dafny
- Department of Neurobiology and Anatomy, University of Texas Health at the McGovern Medical School, 6431 Fannin Street, MSB 7.208, Houston, TX 77030, United States.
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Arnavut E, Hamilton J, Yao R, Sajjad M, Hadjiargyrou M, Komatsu D, Thanos PK. Abstinence following intermittent methylphenidate exposure dose-dependently modifies brain glucose metabolism in the rat brain. Synapse 2022; 76:17-30. [PMID: 35730134 DOI: 10.1002/syn.22243] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 06/01/2022] [Accepted: 06/12/2022] [Indexed: 11/10/2022]
Abstract
Methylphenidate (MP) is a psychostimulant chronically prescribed for the treatment of attention deficit hyperactivity disorder (ADHD). Additionally, MP users may take breaks from using the medication during "drug holidays," which may include short-term or long-term breaks from medication. The present study utilized fluorodeoxyglucose (FDG) positron emission tomography (PET) to analyze the effects of chronic oral MP use and abstinence on brain glucose metabolism (BGluM) in rats at two different doses: high dose (HD) and low dose (LD). The schedule of treatment was 3 weeks on-treatment and 1 week off-treatment for a period of 13 weeks, followed by an abstinence period of 4 total weeks. Results showed that chronic MP treatment using this schedule did not lead to significant changes in BGluM when comparing the control to HD MP groups. However, significant activation in BGluM was observed after periods of abstinence between control and HD MP rats in the following brain regions: the trigeminal nucleus, reticular nucleus, inferior olive, lemniscus, mesencephalic reticular formation, inferior colliculus, and several areas of the cerebellum. These brain regions and functional brain circuit play a role in facial sensory function, the auditory pathway, organizing connections between the thalamus and cortex, motor learning, auditory function, control over eye movement, auditory information integration, and both motor and cognitive functions. These results, when considered with previous studies, indicate that MP schedule of use may have differing effects on BGluM. BGluM following long-term MP use was dependent on MP dose and schedule of use in rats. This study was conducted in non-ADHD model rats with the aim to establish an understanding of the effects of MP itself, especially given the growing chronic off-label and prescribed use of MP. Further studies are needed for analysis of the drug's effects on an ADHD model.
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Affiliation(s)
- Eliz Arnavut
- Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions (BNNLA), Department of Pharmacology and Toxicology, Clinical Research Institute on Addictions, Jacobs School of Medicine and Biomedical Sciences, State University at Buffalo, Buffalo, New York
| | - John Hamilton
- Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions (BNNLA), Department of Pharmacology and Toxicology, Clinical Research Institute on Addictions, Jacobs School of Medicine and Biomedical Sciences, State University at Buffalo, Buffalo, New York
| | - Rutao Yao
- Department of Nuclear Medicine, State University of New York at Buffalo, Buffalo, New York, USA
| | - Munawwar Sajjad
- Department of Nuclear Medicine, State University of New York at Buffalo, Buffalo, New York, USA
| | - Michael Hadjiargyrou
- Department of Biological and Chemical Sciences, New York Institute of Technology, Old Westbury, New York, USA
| | - David Komatsu
- Department of Orthopedics, Stony Brook University, Stony Brook, New York, USA
| | - Panayotis K Thanos
- Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions (BNNLA), Department of Pharmacology and Toxicology, Clinical Research Institute on Addictions, Jacobs School of Medicine and Biomedical Sciences, State University at Buffalo, Buffalo, New York.,Department of Psychology, State University at Buffalo, Buffalo, New York, USA
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Holm AJ, Hausman H, Rhodes MG. Study strategies and "study drugs": investigating the relationship between college students' study behaviors and prescription stimulant misuse. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022; 70:1094-1103. [PMID: 32672517 DOI: 10.1080/07448481.2020.1785472] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 04/14/2020] [Accepted: 06/12/2020] [Indexed: 06/11/2023]
Abstract
ObjectiveThe current study examined the regular use of study strategies between college students who misused prescription stimulants (N = 36) and college students who did not misuse prescription stimulants (N = 298) in an undergraduate sample. Participants: 334 college students at a large, Midwestern university. Methods: Using logistic regression, we examined whether students who misused prescription stimulants did so to compensate for poor study strategies and/or a lack of study strategies overall. We hypothesized that regularly spacing studying, using more study strategies, and using more effective study strategies would predict lower odds of prescription stimulant misuse among students. In contrast, we hypothesized that using more ineffective study strategies would predict higher odds of prescription stimulant misuse. Results: Results indicated that a greater number of total study strategies and effective study strategies, and higher importance of school predicted higher odds of prescription stimulant misuse. Conclusions: Thus, students may not be misusing prescription stimulants as a substitute for effective studying but, rather, to augment effective study habits.
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Affiliation(s)
- Abby Johnson Holm
- Department of Psychology, Colorado State University, Fort Collins, CO, USA
| | - Hannah Hausman
- Department of Psychology, Colorado State University, Fort Collins, CO, USA
| | - Matthew G Rhodes
- Department of Psychology, Colorado State University, Fort Collins, CO, USA
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29
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Ni AM, Bowes BS, Ruff DA, Cohen MR. Methylphenidate as a causal test of translational and basic neural coding hypotheses. Proc Natl Acad Sci U S A 2022; 119:e2120529119. [PMID: 35467980 PMCID: PMC9169912 DOI: 10.1073/pnas.2120529119] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 03/17/2022] [Indexed: 11/18/2022] Open
Abstract
Most systems neuroscience studies fall into one of two categories: basic science work aimed at understanding the relationship between neurons and behavior, or translational work aimed at developing treatments for neuropsychiatric disorders. Here we use these two approaches to inform and enhance each other. Our study both tests hypotheses about basic science neural coding principles and elucidates the neuronal mechanisms underlying clinically relevant behavioral effects of systemically administered methylphenidate (Ritalin). We discovered that orally administered methylphenidate, used clinically to treat attention deficit hyperactivity disorder (ADHD) and generally to enhance cognition, increases spatially selective visual attention, enhancing visual performance at only the attended location. Further, we found that this causal manipulation enhances vision in rhesus macaques specifically when it decreases the mean correlated variability of neurons in visual area V4. Our findings demonstrate that the visual system is a platform for understanding the neural underpinnings of both complex cognitive processes (basic science) and neuropsychiatric disorders (translation). Addressing basic science hypotheses, our results are consistent with a scenario in which methylphenidate has cognitively specific effects by working through naturally selective cognitive mechanisms. Clinically, our findings suggest that the often staggeringly specific symptoms of neuropsychiatric disorders may be caused and treated by leveraging general mechanisms.
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Affiliation(s)
- Amy M. Ni
- Department of Neuroscience, University of Pittsburgh, Pittsburgh, PA 15260
- Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA 15260
| | - Brittany S. Bowes
- Department of Neuroscience, University of Pittsburgh, Pittsburgh, PA 15260
- Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA 15260
| | - Douglas A. Ruff
- Department of Neuroscience, University of Pittsburgh, Pittsburgh, PA 15260
- Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA 15260
| | - Marlene R. Cohen
- Department of Neuroscience, University of Pittsburgh, Pittsburgh, PA 15260
- Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA 15260
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Schifano F, Catalani V, Sharif S, Napoletano F, Corkery JM, Arillotta D, Fergus S, Vento A, Guirguis A. Benefits and Harms of 'Smart Drugs' (Nootropics) in Healthy Individuals. Drugs 2022; 82:633-647. [PMID: 35366192 DOI: 10.1007/s40265-022-01701-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2022] [Indexed: 12/14/2022]
Abstract
'Smart drugs' (also known as 'nootropics' and 'cognitive enhancers' [CEs]) are being used by healthy subjects (i.e. students and workers) typically to improve memory, attention, learning, executive functions and vigilance, hence the reference to a 'pharmaceutical cognitive doping behaviour'. While the efficacy of known CEs in individuals with memory or learning deficits is well known, their effect on non-impaired brains is still to be fully assessed. This paper aims to provide an overview on the prevalence of use; putative neuroenhancement benefits and possible harms relating to the intake of the most popular CEs (e.g. amphetamine-type stimulants, methylphenidate, donepezil, selegiline, modafinil, piracetam, benzodiazepine inverse agonists, and unifiram analogues) in healthy individuals. CEs are generally perceived by the users as effective, with related enthusiastic anecdotal reports; however, their efficacy in healthy individuals is uncertain and any reported improvement temporary. Conversely, since most CEs are stimulants, the related modulation of central noradrenaline, glutamate, and dopamine levels may lead to cardiovascular, neurological and psychopathological complications. Furthermore, use of CEs can be associated with paradoxical short- and long-term cognitive decline; decreased potential for plastic learning; and addictive behaviour. Finally, the non-medical use of any potent psychotropic raises serious ethical and legal issues, with nootropics having the potential to become a major public health concern. Further studies investigating CE-associated social, psychological, and biological outcomes are urgently needed to allow firm conclusions to be drawn on the appropriateness of CE use in healthy individuals.
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Affiliation(s)
- Fabrizio Schifano
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, College Lane Campus, Hatfield, UK.
| | - Valeria Catalani
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, College Lane Campus, Hatfield, UK
| | - Safia Sharif
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, College Lane Campus, Hatfield, UK
| | - Flavia Napoletano
- East London Foundation Trust (ELFT), Newham Early Intervention Service, London, UK
| | - John Martin Corkery
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, College Lane Campus, Hatfield, UK
| | - Davide Arillotta
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, College Lane Campus, Hatfield, UK
| | - Suzanne Fergus
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, College Lane Campus, Hatfield, UK
| | - Alessandro Vento
- Department of Mental Health, ASL Roma 2, Rome, Italy
- Addictions' Observatory (ODDPSS), Rome, Italy
- Department of Psychology, Guglielmo Marconi University, Rome, Italy
| | - Amira Guirguis
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, College Lane Campus, Hatfield, UK
- Swansea University Medical School, Institute of Life Sciences 2, Swansea University, Singleton Park, Swansea, UK
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31
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Hacker CM, Rust NC. Ritalin as a causal perturbation. Trends Cogn Sci 2022; 26:542-543. [DOI: 10.1016/j.tics.2022.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 04/15/2022] [Indexed: 10/18/2022]
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Stueber A, Cuttler C. Self-Reported Effects of Cannabis on ADHD Symptoms, ADHD Medication Side Effects, and ADHD-Related Executive Dysfunction. J Atten Disord 2022; 26:942-955. [PMID: 34632827 DOI: 10.1177/10870547211050949] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE People with ADHD are more likely to use cannabis but little is known about the effects of cannabis on ADHD symptoms, ADHD medication side effects, or ADHD-related executive dysfunction. METHOD Students (n = 1,738) completed an online survey containing measures of ADHD symptoms, cannabis use, perceived effects of cannabis on ADHD symptoms and medication side effects, as well as executive dysfunction. RESULTS Participants with ADHD who have used cannabis reported that cannabis has acute beneficial effects on many symptoms of ADHD (e.g., hyperactivity, impulsivity). Further, they perceived cannabis to improve most of their medication side effects (e.g., irritability, anxiety). Finally, cannabis use frequency was a significant moderator of the associations between symptom severity and executive dysfunction. CONCLUSION Results suggest people with ADHD may be using cannabis to self-medicate for many of their symptoms and medication side effects and that more frequent use may mitigate ADHD-related executive dysfunction.
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Arkell TR, Bradshaw K, Downey LA, Hayley AC. Acute effects of amphetamine and related psychostimulants on impulsivity: a systematic review of clinical trials. Addict Biol 2022; 27:e13128. [PMID: 35229937 DOI: 10.1111/adb.13128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 10/04/2021] [Accepted: 12/03/2021] [Indexed: 11/29/2022]
Abstract
Evidence for acute amphetamine effects on behavioural impulsivity in healthy populations remains elusive and, at times, mixed. This review collates and reviews the clinical literature on the acute effects of amphetamines on measures of behavioural impulsivity in healthy adults. Randomised and placebo-controlled clinical trials that assessed behavioural impulsivity following the administration of an acute dose of amphetamine or a related psychostimulant (including amphetamine analogues and methylphenidate) were eligible for inclusion. The EBSCOHost, SCOPUS, PsychNet, Web of Science and ProQuest databases were searched from inception to 26 April 2021. Study selection, data extraction and the Cochrane risk of bias assessments were conducted by two independent reviewers. Reporting follows PRISMA guidelines, and the review was registered a priori on the PROSPERO database (Registration No: CRD42021249861). A total of 20 studies were included, comprising a total of 737 participants. Overall, results indicate that low-moderate doses of amphetamine and related psychostimulants may improve (i.e., reduce) impulsive responding without compromising performance, reflecting enhanced inhibitory control of behaviour. These effects are mild and appear most pronounced in individuals with high baseline impulsivity. This review highlights the need for greater consistency in behavioural task selection and future high-quality and well-designed studies to address current concerns around growing prescription psychostimulant use and misuse.
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Affiliation(s)
- Thomas R. Arkell
- Centre for Human Psychopharmacology Swinburne University of Technology Melbourne Victoria Australia
| | - Kristina Bradshaw
- Centre for Human Psychopharmacology Swinburne University of Technology Melbourne Victoria Australia
| | - Luke A. Downey
- Centre for Human Psychopharmacology Swinburne University of Technology Melbourne Victoria Australia
- Institute for Breathing and Sleep Austin Hospital Melbourne Victoria Australia
| | - Amie C. Hayley
- Centre for Human Psychopharmacology Swinburne University of Technology Melbourne Victoria Australia
- Institute for Breathing and Sleep Austin Hospital Melbourne Victoria Australia
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Chronic Treatment and Abstinence from Methylphenidate Exposure Dose-dependently Changes Glucose Metabolism in the Rat Brain. Brain Res 2022; 1780:147799. [DOI: 10.1016/j.brainres.2022.147799] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 01/14/2022] [Accepted: 01/17/2022] [Indexed: 02/03/2023]
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Ekström L, Broström S, Dahl ML, Börjesson A. A Summary of Online Enquiries Submitted to Anti-doping Hotline 2005–2018. FRONTIERS IN REPRODUCTIVE HEALTH 2021; 3:787954. [PMID: 36304044 PMCID: PMC9580816 DOI: 10.3389/frph.2021.787954] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 11/08/2021] [Indexed: 11/13/2022] Open
Abstract
Anabolic Androgenic Steroid (AAS) abuse in the society is considered a health problem and has been associated with cardiovascular toxicity, endocrine disruption, as well as psychiatric symptoms such as aggression and cognitive dysfunction. Men and women abusing AAS, as well as persons in close relationship to AAS abusers, may encounter concerns. Subsequently, the Anti-Doping Hotline was formed 1993 to answers questions about doping in the society. Here we have reviewed 7,123 enquiries posted on the Anti-Doping Hotline website between 2005 and 2018 to see what type of questions were raised. Most questions (n = 2,924) involved AAS, 60% from abusers themselves, and 17% from a person close to an AAS abusers. Only 2.3% of the questions concerned AAS abusing women. Of the AAS specific questions most were from persons who sought personal advice regarding risks and side effects. Notably, the AAS abusers themselves were concerned about somatic side effects (e.g., gynecomastia) and problems related to the AAS injection. The persons in close relationship to an AAS abusers on the other hand, expressed concerns about psychiatric changes including mood swings and aggressivity. In addition to AAS, 26 and 13% of the questions involved dietary supplements and other doping substances, respectively. A gradual decrease of questions regarding ephedrine was noted, whereas the numbers of SARMs related questions increased during this time. Our results show that there is a continuous need to provide medical, nursing, and social support and counseling to AAS abusers and their next of kin.
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Affiliation(s)
- Lena Ekström
- Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden
- Department of Clinical Pharmacology, Karolinska University Hospital, Stockholm, Sweden
| | - Susanne Broström
- Department of Clinical Pharmacology, Karolinska University Hospital, Stockholm, Sweden
| | - Marja-Liisa Dahl
- Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden
- Department of Clinical Pharmacology, Karolinska University Hospital, Stockholm, Sweden
| | - Annica Börjesson
- Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden
- Department of Clinical Pharmacology, Karolinska University Hospital, Stockholm, Sweden
- *Correspondence: Annica Börjesson
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Prescription Stimulant Misuse and Diversion Events Among College Students: A Qualitative Study. J Prim Prev 2021; 43:49-66. [PMID: 34729661 DOI: 10.1007/s10935-021-00654-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2021] [Indexed: 10/19/2022]
Abstract
Prescription stimulant misuse and diversion are interrelated behaviors: diversion increases the availability of stimulants for misuse, and persons who misuse are also more likely to divert. To date, research has examined these behaviors using a primarily quantitative lens. We led a qualitative investigation to better understand misuse and diversion events. Data are from a diverse southern California campus where we interviewed students who misuse and/or divert prescription stimulants (32 total interviews: 16 interviews with students who had a history of misuse, and 16 different interviews with students who had a history of diversion). We analyzed interview data inductively. We identified the following themes about misuse and diversion events, several of which intersected during interviews: medication surplus, diversion and misuse hubs, ease of behavior performance, academic stress, and other drugs commonly involved. For diversion, altruism and monetary gain were juxtaposed themes. Across themes, friends and family were influential figures. Implications for prevention, intervention, and future research directions are discussed.
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Hameed U, Khan A, Gomaa H, Garman JC, Hameed A. A Case of Constipation and Gastrointestinal Retention of Lisdexamfetamine Dimesylate Capsules in an 11-Year-Old. JOURNAL OF THE CANADIAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY = JOURNAL DE L'ACADEMIE CANADIENNE DE PSYCHIATRIE DE L'ENFANT ET DE L'ADOLESCENT 2021; 30:292-296. [PMID: 34777513 PMCID: PMC8561853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 06/16/2021] [Indexed: 06/13/2023]
Abstract
Attention deficit hyperactivity disorder (ADHD) has a worldwide prevalence of 5.29% and stimulant medications are considered first-line treatment. Common adverse events with these medications include decreased appetite, increased sleep latency, tics, abdominal pain, and weight loss. Lisdexamfetamine dimesylate (LDX) is a stimulant used for treating ADHD and may lead to gastrointestinal, among other adverse effects. In this report, we present a case of constipation and retention of LDX capsules in the gastrointestinal tract. An 11-year-old male with a diagnosis of ADHD was being treated with once daily LDX 30 mg in our clinic. After about ten weeks of treatment, he was brought to an emergency department due to epigastric pain and constipation. An abdominal X-ray was significant for the presence of approximately 20 capsules in the large intestine. He was admitted to the pediatric gastroenterology service. Following management with two saline enemas, fewer capsules were seen on repeat X-ray. The patient was observed overnight, advised to discontinue LDX and discharged home in a stable condition. LDX may be associated with constipation and retention of intact capsules in the gastrointestinal tract. Further research is warranted to exclude the risk of sympathomimetic toxidrome if intact LDX capsules simultaneously disintegrate in the gastrointestinal tract.
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Affiliation(s)
- Usman Hameed
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, Pennsylvania, US
| | - Asfand Khan
- Psychiatry Department, Kaiser Permanente Santa Rosa Medical Center, Santa Rosa, California, USA
| | - Hassaan Gomaa
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, Pennsylvania, US
| | - John C Garman
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, Pennsylvania, US
| | - Ahmad Hameed
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, Pennsylvania, US
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38
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The video gamer 500: Performance-enhancing drug use and Internet Gaming Disorder among adult video gamers. COMPUTERS IN HUMAN BEHAVIOR 2021. [DOI: 10.1016/j.chb.2021.106890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Hoots JK, Webber HE, Nunez C, Cooper JA, Lopez-Gamundi P, Lawlor VM, Lane SD, Treadway MT, Wardle MC. Acute drug effects differentially predict desire to take dextroamphetamine again for work and recreation. Psychopharmacology (Berl) 2021; 238:2815-2826. [PMID: 34137904 DOI: 10.1007/s00213-021-05897-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 06/07/2021] [Indexed: 11/24/2022]
Abstract
RATIONALE Misuse of dextroamphetamine occurs in work and recreational contexts. While acute drug effects broadly predict abuse liability, few studies have considered the relationship between acute effects and context. OBJECTIVES This study examined how individual differences in acute effects of dextroamphetamine relate to desire to take dextroamphetamine again in different contexts. METHODS This secondary analysis used data from healthy adults with no history of moderate-to-severe substance use disorder, who received oral doses of placebo and dextroamphetamine (10 and 20 mg) over 3 sessions under double-blind, randomized conditions. Subjects rated subjective effects and completed reward-related behavioral tasks. Subjects rated their desire to take dextroamphetamine again in hypothetical work and recreational contexts. Multilevel models examined within-subjects change scores (10 mg-placebo; 20 mg-placebo) to determine how subjective effects and behavioral outcomes predicted desire to take dextroamphetamine again for work versus recreation. RESULTS Subjects reported more desire to take 20 mg dextroamphetamine again for work than for recreation. At 20 mg, there was an interaction between context and liking/wanting, such that liking/wanting predicted desire to use dextroamphetamine for work only. There was also an interaction at 20 mg between context and psychomotor speed, such that psychomotor speed predicted interest in using dextroamphetamine for recreation only. CONCLUSIONS We found that positive subjective effects predicted desire to use dextroamphetamine again for work, while increased motor effects predicted desire to use dextroamphetamine recreationally. Hedonic effects may be perceived as advantageous when working, while increased physical energy may be preferred during recreation, suggesting that context of intended use is important when examining abuse liability.
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Affiliation(s)
- Jennifer K Hoots
- Department of Psychology, University of Illinois At Chicago, 1007 W. Harrison St, MC 285, Chicago, IL, 60607, USA
| | - Heather E Webber
- Faillace Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center At Houston, Houston, TX, USA
| | - Cecilia Nunez
- Department of Psychology, University of Illinois At Chicago, 1007 W. Harrison St, MC 285, Chicago, IL, 60607, USA
| | | | - Paula Lopez-Gamundi
- Faillace Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center At Houston, Houston, TX, USA.,Department of Cognition, Development and Educational Psychology, Institute of Neurosciences, University of Barcelona, Barcelona, Spain.,Cognition and Brain Plasticity Unit, Bellvitge Biomedical Research Institute, Barcelona, Spain
| | | | - Scott D Lane
- Faillace Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center At Houston, Houston, TX, USA
| | - Michael T Treadway
- Department of Psychology, Emory University, Atlanta, GA, USA.,Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA
| | - Margaret C Wardle
- Department of Psychology, University of Illinois At Chicago, 1007 W. Harrison St, MC 285, Chicago, IL, 60607, USA.
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Rezaei Kalat A, Taghavi A, Askari E, Parizadeh SM, Jafarzadeh Esfehani A, Rajaei Z, Jafarzadeh Esfehani R, Talaei A. Medical students and stimulants; they have enough knowledge but they still use non prescribed stimulants. JOURNAL OF SUBSTANCE USE 2021. [DOI: 10.1080/14659891.2021.1961888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Afsaneh Rezaei Kalat
- Department of Psychiatry, Faculty of Medicine, Mashhad University of Medical Sciences,Mashhad, Iran
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Atiyeh Taghavi
- Department of Neuroscience, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Emran Askari
- Nuclear Medicine Research Center, Mashhad University or Medical Sciences, Mashhad, Iran
| | | | | | - Zahra Rajaei
- Department of Psychiatry, Faculty of Medicine, Mashhad University of Medical Sciences,Mashhad, Iran
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Reza Jafarzadeh Esfehani
- Department of Medical Genetics, Faculty of Medicine, Mashhad University of MedicalSciences, Mashhad, Iran
| | - Ali Talaei
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Consumo de psicoestimulantes por estudantes de medicina de uma universidade do extremo sul do Brasil. SCIENTIA MEDICA 2021. [DOI: 10.15448/1980-6108.2021.1.38886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Objetivo: analisar a evolução do consumo de psicoestimulantes pelos acadêmicos de Medicina da Universidade Federal do Rio Grande (FURG) durante quatro anos.Métodos: foi realizado um estudo de painel com amostra de estudantes do primeiro ao quarto ano do curso de medicina, matriculados na instituição no período de 2015 a 2018. O estudo teve como desfecho o consumo de psicoestimulantes. Foram coletadas informações sobre o uso de cafeína, metilfenidato, piracetam, modafinil, bebidas energéticas, metilenodioximetanfetamina (ecstasy) e anfetaminas. O questionário foi composto de duas etapas. Na primeira, foram recolhidas informações demográficas, sobre hábitos e qualidade de vida. Na segunda, questionou-se sobre o consumo de substâncias estimulantes, abordando a frequência de uso, efeitos percebidos e a motivação para o consumo, assim como o início do consumo durante o curso.Resultados: a prevalência de uso dessas substâncias aumentou de 58% para 68% de 2015 a 2018. A proporção de acadêmicos que começaram a usar psicoestimulantes durante a faculdade, aumentou de 15% para 30%. Essa proporção aumentou conforme o ano do curso, passando de 25% no primeiro ano para 38% no quarto ano. Esse resultado foi atribuído, principalmente, ao uso de metilfenidato, cuja prevalência aumentou de 21% para 56% durante o período do estudo.Conclusões: o consumo de psicoestimulantes entre estudantes de medicina foi alto e o início de seu consumo durante a faculdade aumentou ao longo dos anos. Seu uso tem sido percebido como eficaz pela maioria dos usuários, o que pode dificultar o gerenciamento do uso indevido dessas substâncias.
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42
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Summit AG, Noel NE. Assessing motivations and gender as factors in college students' views of nonmedical prescription stimulant use. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2021:1-7. [PMID: 34270397 DOI: 10.1080/07448481.2021.1942005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 04/01/2021] [Accepted: 06/08/2021] [Indexed: 06/13/2023]
Abstract
Introduction: Two prominent motivation categories of college student nonmedical prescription stimulant use (NMUPS) are for academic and recreational purposes. However, little research focuses on these motivations' association with college students' NMUPS views. Further, limited research assesses if user gender influences views. Methods: The current online scenario study implemented a 2 × 2 factorial design assessing 148 college undergraduates' (75% females; Mage = 19.18; SDage = 1.30) NMUPS views based on user motivation and gender. Participants reported their drug use stigmatization, prescription stimulant expectancies (ie, anticipated drug use beliefs and outcomes), and personal substance use. Results and Discussion: Results showed that user gender did not influence participants' NMUPS views; however, participants viewed academic use less negatively compared to recreational use, thus highlighting the need to educate students on the negative consequences of NMUPS, even when use is for academically related tasks. Furthermore, exploratory analyses showed drug use stigmatization and prescription stimulant expectancies predicted participant NMUPS views.Supplemental data for this article can be accessed online at https://doi.org/10.1080/07448481.2021.1942005.
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Affiliation(s)
- Alynna G Summit
- Department of Psychology, University of North Carolina Wilmington, Wilmington, North Carolina, USA
| | - Nora E Noel
- Department of Psychology, University of North Carolina Wilmington, Wilmington, North Carolina, USA
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43
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Cutando L, Puighermanal E, Castell L, Tarot P, Bertaso F, Bonnavion P, Kerchove d'Exaerde A, Isingrini E, Galante M, Dallerac G, Pascoli V, Lüscher C, Giros B, Valjent E. Regulation of GluA1 phosphorylation by d-amphetamine and methylphenidate in the cerebellum. Addict Biol 2021; 26:e12995. [PMID: 33368923 DOI: 10.1111/adb.12995] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 10/21/2020] [Accepted: 11/13/2020] [Indexed: 01/14/2023]
Abstract
Prescription stimulants, such as d-amphetamine or methylphenidate are used to treat suffering from attention-deficit hyperactivity disorder (ADHD). They potently release dopamine (DA) and norepinephrine (NE) and cause phosphorylation of the α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor subunit GluA1 in the striatum. Whether other brain regions are also affected remains elusive. Here, we demonstrate that d-amphetamine and methylphenidate increase phosphorylation at Ser845 (pS845-GluA1) in the membrane fraction of mouse cerebellum homogenate. We identify Bergmann glial cells as the source of pS845-GluA1 and demonstrate a requirement for intact NE release. Consequently, d-amphetamine-induced pS845-GluA1 was prevented by β1-adenoreceptor antagonist, whereas the blockade of DA D1 receptor had no effect. Together, these results indicate that NE regulates GluA1 phosphorylation in Bergmann glial cells in response to prescription stimulants.
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Affiliation(s)
- Laura Cutando
- IGF University of Montpellier, CNRS, Inserm Montpellier France
| | - Emma Puighermanal
- IGF University of Montpellier, CNRS, Inserm Montpellier France
- Neurosciences Institute, Department of Cell Biology, Physiology and Immunology Autonomous University of Barcelona Barcelona Spain
| | - Laia Castell
- IGF University of Montpellier, CNRS, Inserm Montpellier France
| | - Pauline Tarot
- IGF University of Montpellier, CNRS, Inserm Montpellier France
| | | | - Patricia Bonnavion
- Laboratory of Neurophysiology, ULB Neuroscience Institute Université Libre de Bruxelles (ULB) Brussels Belgium
| | - Alban Kerchove d'Exaerde
- Laboratory of Neurophysiology, ULB Neuroscience Institute Université Libre de Bruxelles (ULB) Brussels Belgium
| | - Elsa Isingrini
- Integrative Neuroscience and Cognition Center University of Paris, CNRS Paris France
- Department of Psychiatry, Douglas Hospital McGill University Montreal Quebec Canada
| | - Micaela Galante
- Pharmacologie et Biochimie de la Synapse, Institut des Neurosciences Paris‐Saclay University of Paris‐Saclay, University of Paris‐Sud, CNRS, UMR Orsay France
| | - Glenn Dallerac
- Pharmacologie et Biochimie de la Synapse, Institut des Neurosciences Paris‐Saclay University of Paris‐Saclay, University of Paris‐Sud, CNRS, UMR Orsay France
| | - Vincent Pascoli
- Department of Basic Neurosciences, Medical Faculty University of Geneva Geneva Switzerland
| | - Christian Lüscher
- Department of Basic Neurosciences, Medical Faculty University of Geneva Geneva Switzerland
| | - Bruno Giros
- Integrative Neuroscience and Cognition Center University of Paris, CNRS Paris France
- Department of Psychiatry, Douglas Hospital McGill University Montreal Quebec Canada
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Elfferich AM. Social Justice Theories as the Basis for Public Policy on Psychopharmacological
Cognitive Enhancement. CANADIAN JOURNAL OF BIOETHICS 2021. [DOI: 10.7202/1077629ar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Psychopharmacological cognitive enhancements could lead to a higher quality of life
of healthy individuals with lower cognitive capacities, but the current regulatory framework
does not seem to enable access to this group. This article discusses why Sen’s Capability
Approach could open up such access, while two other modern social justice theories –
utilitarianism and Rawls’ Justice as Fairness – could not. In short, the utilitarian
approach is proven to be inadequate, due to practical reasons and having a low chance of
real-world success. Rawls’ Justice as Fairness seems to be problematic because of
conflicting stances that follow from his First Principle of Justice. The Capability Approach
has the greatest chance of success in the context of these substances, because of arguments
that can be identified under the banners of agency/self-respect and the way the public views
those who take the capability path out of their poor situation. The article also discusses
general and practical problems with psychopharmacological cognitive enhancement that should
be addressed when writing new policy on this topic.
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Evaluating the reliability of hair analysis in monitoring the compliance of ADHD patients under treatment with Lisdexamphetamine. PLoS One 2021; 16:e0248747. [PMID: 33784320 PMCID: PMC8009440 DOI: 10.1371/journal.pone.0248747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 03/04/2021] [Indexed: 11/19/2022] Open
Abstract
Considering the high clinical and forensic relevance of pharmaco-adherence during lisdexamphetamine (LDX) treatment for attention-deficit/hyperactivity disorder (ADHD), the aim here was to evaluate hair analysis as a tool for monitoring compliance in patients currently undergoing long term treatment with LDX, by detecting possible interruptions of medication intake or changes in dosage. For this purpose, a total of 24 patients from an outpatient clinic for ADHD were recruited. Hair and urine samples were taken after three consecutive therapy sessions over a 7-month period and analyzed for amphetamine (AMP) enantiomers and other drugs, using chiral and achiral liquid chromatography-tandem mass spectrometry (LC-MS/MS). Participants also provided information on the condition of their hair, the consumption of illegal psychotropic substances and the regularity of taking LDX. Two participants withdrew from the study early. Urine analyses were positive for D-AMP in all urine samples and therapy sessions, except in two patients who did not take LDX on a daily basis. D-AMP was detected in all hair samples; however, no correlation was found between prescribed dose/day and D-AMP concentrations in proximal hair segments. Qualitative interpretation of hair analysis showed that 18 of the 22 study completers were compliant concerning the intake of LDX without additional consumption of illegal D,L-AMP. Analysis of urine taken during the therapy sessions showed no correlation between D-AMP concentrations and prescribed dosage, with or without normalization for creatinine. In conclusion, chiral LC-MS/MS hair analysis might represent a non-invasive way to confirm LDX use within the approximate period covered by the hair segment tested, but it does not allow for quantitative therapeutic drug monitoring because of interindividual variability of concentrations in hair. Drug concentrations in hair at different stages of long-term treatment should thus be interpreted with caution by clinicians and forensic experts alike when making assessments of treatment adherence.
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Mykletun A, Widding-Havneraas T, Chaulagain A, Lyhmann I, Bjelland I, Halmøy A, Elwert F, Butterworth P, Markussen S, Zachrisson HD, Rypdal K. Causal modelling of variation in clinical practice and long-term outcomes of ADHD using Norwegian registry data: the ADHD controversy project. BMJ Open 2021; 11:e041698. [PMID: 33468528 PMCID: PMC7817799 DOI: 10.1136/bmjopen-2020-041698] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 11/30/2020] [Accepted: 12/21/2020] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Attention-deficit/hyperactivity disorder (ADHD) is among the most common mental disorders in children and adolescents, and it is a strong risk factor for several adverse psychosocial outcomes over the lifespan. There are large between-country and within-country variations in diagnosis and medication rates. Due to ethical and practical considerations, a few studies have examined the effects of receiving a diagnosis, and there is a lack of research on effects of medication on long-term outcomes.Our project has four aims organised in four work packages: (WP1) To examine the prognosis of ADHD (with and without medication) compared with patients with other psychiatric diagnoses, patients in contact with public sector child and adolescent psychiatric outpatient clinics (without diagnosis) and the general population; (WP2) Examine within-country variation in ADHD diagnoses and medication rates by clinics' catchment area; and(WP3) Identify causal effects of being diagnosed with ADHD and (WP4) ADHD medication on long-term outcomes. METHOD AND ANALYSIS Our project links several nationwide Norwegian registries. The patient sample is all persons aged 5-18 years that were in contact with public sector child and adolescent psychiatric outpatient clinics in 2009-2011. Our comparative analysis of prognosis will be based on survival analysis and mixed-effects models. Our analysis of variation will apply mixed-effects models and generalised linear models. We have two identification strategies for the effect of being diagnosed with ADHD and of receiving medication on long-term outcomes. Both strategies rely on using preference-based instrumental variables, which in our project are based on provider preferences for ADHD diagnosis and medication. ETHICS AND DISSEMINATION The project is approved by the Regional Ethics Committee, Norway (REC number 2017/2150/REC south-east D). All papers will be published in open-access journals and results will be presented in national and international conferences. TRIAL REGISTRATION NUMBERS ISRCTN11573246 and ISRCTN11891971.
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Affiliation(s)
- Arnstein Mykletun
- Department of Community Medicine, University of Tromso Faculty of Health Sciences, Tromso, Norway
- Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital, Bergen, Norway
- Centre for Work and Mental Health, Nordland Hospital, Bodø, Norway
- Division for Health Services, Norwegian Institute of Public Health, Oslo, Norway
| | - Tarjei Widding-Havneraas
- Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Ashmita Chaulagain
- Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Ingvild Lyhmann
- Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Ingvar Bjelland
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Anne Halmøy
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Felix Elwert
- Department of Sociology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Peter Butterworth
- Research School of Population Health, The Australian National University, Canberra, Victoria, Australia
| | | | | | - Knut Rypdal
- Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital, Bergen, Norway
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Fuermaier ABM, Tucha O, Koerts J, Tucha L, Thome J, Faltraco F. Feigning ADHD and stimulant misuse among Dutch university students. J Neural Transm (Vienna) 2021; 128:1079-1084. [PMID: 33439363 PMCID: PMC8295135 DOI: 10.1007/s00702-020-02296-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 12/20/2020] [Indexed: 12/03/2022]
Abstract
The increasing number of university students seeking diagnosis of attention-deficit/hyperactivity disorder (ADHD), and findings of an increased stimulant misuse among university students, has raised concerns regarding the credibility of the symptoms of those students. However, most of our current knowledge refers to university students in North America and less is known about this issue on European campuses. The present survey aimed to collect opinions on feigning ADHD and to estimate the prevalence of stimulant misuse among 1071 university students in the Netherlands. The majority of students expressed liberal attitudes towards feigning ADHD. Also, a substantial number of respondents considered feigning ADHD themselves or know someone who feigns ADHD. Furthermore, 68% of students assumed benefits of taking stimulants without prescription and 16% have indeed already taken stimulants without prescription. Feigning ADHD and misuse of prescription medication are prevalent issues among Dutch students. The results underline the need for a careful diagnostic evaluation of individuals for ADHD. Furthermore, efforts are required in order to prevent stimulant drug trafficking and misuse among university students.
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Affiliation(s)
- Anselm B M Fuermaier
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands.
| | - Oliver Tucha
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands.,Department of Psychiatry and Psychotherapy, University of Rostock, Rostock, Germany
| | - Janneke Koerts
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
| | - Lara Tucha
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands.,Department of Psychiatry and Psychotherapy, University of Rostock, Rostock, Germany
| | - Johannes Thome
- Department of Psychiatry and Psychotherapy, University of Rostock, Rostock, Germany
| | - Frank Faltraco
- Department of Psychiatry and Psychotherapy, University of Rostock, Rostock, Germany
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48
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Zhang L, McCarthy DM, Eskow Jaunarajs KL, Biederman J, Spencer TJ, Bhide PG. Frontal Cortical Monoamine Release, Attention, and Working Memory in a Perinatal Nicotine Exposure Mouse Model Following Kappa Opioid Receptor Antagonism. Cereb Cortex 2021; 31:483-496. [PMID: 32869057 DOI: 10.1093/cercor/bhaa238] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 08/01/2020] [Accepted: 08/03/2020] [Indexed: 02/27/2024] Open
Abstract
Perinatal nicotine exposure (PNE) produces frontal cortical hypo-dopaminergic state and attention and working memory deficits consistent with neurodevelopmental disorders such as attention deficit hyperactivity disorder (ADHD). Methylphenidate alleviates ADHD symptoms by increasing extracellular dopamine and noradrenaline. Kappa opioid receptor (KOR) antagonism may be another mechanism to achieve the same results because KOR activation inhibits frontal cortical dopamine release. We administered the selective KOR antagonist norbinaltorphimine (norBNI) (20 mg/kg; intraperitoneal) or methylphenidate (0.75 mg/kg; intraperitoneal) to PNE mouse model and examined frontal cortical monoamine release, attention, and working memory. Both compounds increased dopamine and noradrenaline release but neither influenced serotonin release. Both compounds improved object-based attention and working memory in the PNE group, with norBNI's effects evident at 2.5 h and 5.5 h but absent at 24 h. Methylphenidate's effects were evident at 0.5 h but not at 2.5 h. norBNI's effects temporally coincided with frontal cortical c-Jun N-terminal kinase phosphorylation. norBNI did not alter tissue dopamine content in the nucleus accumbens, offering preliminary support for lack of reinforcement.
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Affiliation(s)
- Lin Zhang
- Biomedical Sciences, Florida State University College of Medicine, Tallahassee, FL 32306, USA
| | - Deirdre M McCarthy
- Biomedical Sciences, Florida State University College of Medicine, Tallahassee, FL 32306, USA
| | | | - Joseph Biederman
- Pediatric Psychopharmacology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Thomas J Spencer
- Pediatric Psychopharmacology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Pradeep G Bhide
- Biomedical Sciences, Florida State University College of Medicine, Tallahassee, FL 32306, USA
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49
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Erasmus N, Kotzé C. Medical Students' Attitudes Towards Pharmacological Cognitive Enhancement With Methylphenidate. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2020; 44:721-726. [PMID: 32974792 DOI: 10.1007/s40596-020-01303-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 08/17/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE The aim of this study was to assess medical students' perception of pharmacological cognitive enhancement (PCE) with methylphenidate and to determine whether this perception differs between junior and senior medical students. METHODS The second and fifth year medical student groups of 2017 at a specific university completed self-administered questionnaires in order to investigate if there were a difference in their attitudes towards methylphenidate use for PCE. RESULTS A total of 353 students were included as follows: 135 second year and 218 fifth year students. Fifth year students were more aware of PCE with methylphenidate than second year students (94% versus 87%; p value = 0.02). Many students (second year = 86%; fifth year = 71%; p value = 0.2469) were of the opinion that methylphenidate could enhance academic performance. Sixty-six percent of all the students were concerned about the fairness of PCE; 93% were concerned about the harmfulness of methylphenidate. There were no statistical significant differences in the attitudes towards methylphenidate use for PCE between the two groups of junior and senior students. CONCLUSION In both groups, the majority of students were against the use of methylphenidate for PCE in students without attention deficit and hyperactivity disorder. Their attitudes regarding the use of methylphenidate for non-medical purposes did not differ significantly. Addressing the topic of PCE with medical students is essential, and the impact on their practice can be an important direction for future research.
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Affiliation(s)
- Nelly Erasmus
- Weskoppies Psychiatric Hospital, University of Pretoria, Pretoria, Gauteng, South Africa
| | - Carla Kotzé
- Weskoppies Psychiatric Hospital, University of Pretoria, Pretoria, Gauteng, South Africa.
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50
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Philbin MM, Greene ER, Martins SS, LaBossier NJ, Mauro PM. Medical, Nonmedical, and Illegal Stimulant Use by Sexual Identity and Gender. Am J Prev Med 2020; 59:686-696. [PMID: 32981768 PMCID: PMC7577928 DOI: 10.1016/j.amepre.2020.05.025] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 05/13/2020] [Accepted: 05/17/2020] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Major knowledge gaps regarding medical and nonmedical prescription stimulant use and illegal stimulant use (i.e., cocaine/crack/methamphetamine) by sexual identity and gender have implications for individuals' health and well-being. This study improves stimulant use measurement by differentiating the type of stimulant use and focusing on lesbian, gay, and bisexual subpopulations. METHODS Data were pooled for adults in the 2015-2017 National Survey on Drug Use and Health (n=126,463; analyzed in 2019). Gender-stratified logistic regression models examined associations between sexual identity and past-year illegal stimulant use. Gender-stratified multinomial logistic regression models estimated odds of (1) medical use only versus no past-year prescription stimulant use, (2) any nonmedical stimulant use versus no past-year use, and (3) any nonmedical stimulant use versus medical use only. RESULTS Illegal stimulant use varied by sexual identity (men: gay, 9.2%; bisexual, 7.5%; heterosexual, 3.2%; women: gay/lesbian, 3.2%; bisexual, 7.8%; heterosexual, 1.5%), as did nonmedical prescription stimulant use. Relative to same-gender heterosexuals, gay (AOR=2.61, 95% CI=2.00, 3.40) and bisexual (AOR=1.70, 95% CI=1.24, 2.33) men had higher odds of past-year illegal stimulant use, as did gay/lesbian (AOR=1.63, 95% CI=1.16, 2.28) and bisexual (AOR=2.70, 95% CI=2.23, 3.26) women. Sexual minorities reported higher odds of nonmedical prescription stimulant use than heterosexuals. Any nonmedical prescription opioid use was reported by 26.4% of people who reported nonmedical stimulant use and 27.0% of people who reported illegal stimulant use. CONCLUSIONS Lesbian, gay, and bisexual individuals had a higher prevalence of stimulant use than their heterosexual counterparts. This has important implications for health disparities, especially given the high levels of polysubstance use. Taking a multilevel approach is crucial to reduce stimulant-related harms for lesbian, gay, and bisexual individuals.
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Affiliation(s)
- Morgan M Philbin
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, New York.
| | - Emily R Greene
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York
| | - Silvia S Martins
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York
| | | | - Pia M Mauro
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York
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