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Guida CR, Maia JM, Ferreira LFR, Rahdar A, Branco LGS, Soriano RN. Advancements in addressing drug dependence: A review of promising therapeutic strategies and interventions. Prog Neuropsychopharmacol Biol Psychiatry 2024; 134:111070. [PMID: 38908501 DOI: 10.1016/j.pnpbp.2024.111070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Revised: 06/17/2024] [Accepted: 06/19/2024] [Indexed: 06/24/2024]
Abstract
Substance dependence represents a pervasive global concern within the realm of public health. Presently, it is delineated as a persistent and recurrent neurological disorder stemming from drug-triggered neuroadaptations in the brain's reward circuitry. Despite the availability of various therapeutic modalities, there has been a steady escalation in the mortality rate attributed to drug overdoses. Substantial endeavors have been directed towards the exploration of innovative interventions aimed at mitigating cravings and drug-induced repetitive behaviors. Within this review, we encapsulate the most auspicious contemporary treatment methodologies, accentuating meta-analyses of efficacious pharmacological and non-pharmacological approaches: including gabapentin, topiramate, prazosin, physical exercise regimens, and cerebral stimulation techniques.
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Affiliation(s)
- Clara Rodrigues Guida
- Department of Medicine, Federal University of Juiz de Fora, Governador Valadares, MG 35032-620, Brazil
| | - Juliana Marino Maia
- Department of Medicine, Federal University of Juiz de Fora, Governador Valadares, MG 35032-620, Brazil
| | | | - Abbas Rahdar
- Department of Physics, Faculty of Sciences, University of Zabol, Zabol 538-98615, Iran
| | - Luiz G S Branco
- Department of Basic and Oral Biology, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP 14040-904, Brazil; Department of Physiology, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP 14040-900, Brazil.
| | - Renato Nery Soriano
- Division of Physiology and Biophysics, Department of Basic Life Sciences, Federal University of Juiz de Fora, Governador Valadares, MG 35020-360, Brazil.
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2
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Faraji M, Viera-Resto OA, Berrios BJ, Bizon JL, Setlow B. Effects of systemic oxytocin receptor activation and blockade on risky decision making in female and male rats. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.05.13.593981. [PMID: 38798601 PMCID: PMC11118492 DOI: 10.1101/2024.05.13.593981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
The neuropeptide oxytocin is traditionally known for its roles in parturition, lactation, and social behavior. Other data, however, show that oxytocin can modulate behaviors outside of these contexts, including drug self-administration and some aspects of cost-benefit decision making. Here we used a pharmacological approach to investigate the contributions of oxytocin signaling to decision making under risk of explicit punishment. Female and male Long-Evans rats were trained on a risky decision-making task in which they chose between a small, "safe" food reward and a large, "risky" food reward that was accompanied by varying probabilities of mild footshock. Once stable choice behavior emerged, rats were tested in the task following acute intraperitoneal injections of oxytocin or the oxytocin receptor antagonist L-368,899. Neither drug affected task performance in males. In females, however, both oxytocin and L-368,899 caused a dose-dependent reduction in preference for large risky reward. Control experiments showed that these effects could not be accounted for by alterations in food motivation or shock sensitivity. Together, these results reveal a sex-dependent effect of oxytocin signaling on risky decision making in rats.
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Affiliation(s)
- Mojdeh Faraji
- Department of Psychiatry, University of Florida
- Center for Addiction Research and Education, University of Florida
| | | | | | - Jennifer L Bizon
- Center for Addiction Research and Education, University of Florida
- Department of Neuroscience, University of Florida
- McKnight Brain Institute, University of Florida
| | - Barry Setlow
- Department of Psychiatry, University of Florida
- Center for Addiction Research and Education, University of Florida
- McKnight Brain Institute, University of Florida
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Preto MC, Kortas GT, Blaas IK, Lassi DLS, Waisman Campos M, Torales J, Ventriglio A, de Azevedo-Marques Périco C, de Andrade AG, Castaldelli-Maia JM. Unravelling the landscape of Cannabis craving pharmacological treatments: a PRISMA-guided review of evidence. Int Rev Psychiatry 2023; 35:434-449. [PMID: 38299652 DOI: 10.1080/09540261.2023.2231540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 06/27/2023] [Indexed: 02/02/2024]
Abstract
Currently, few treatments are available for craving in general, and none of them have received approval for cannabis craving. The objective of this review is to evaluate existing studies analysing treatments for cannabis craving and explore novel treatment possibilities for these patients. The study followed PRISMA guidelines and conducted an extensive database search. Inclusion criteria included human randomised controlled trials examining drug effects on craving symptoms. Exclusion criteria involved studies unrelated to craving, non-pharmacological treatments, duplicates, and non-English/Spanish/Portuguese articles. Our included 22 studies that investigated a wide range of compounds used for cravings related to other drugs, as well as interventions based on healthcare professionals' empirical knowledge. The current pharmacological treatments largely involve off-label drug use and the utilisation of cannabinoid-based medications, such as combinations of THC and lofexidine, oxytocin, progesterone, and N-acetylcysteine. These emerging treatments show promise and have the potential to revolutionise current clinical practices, but further investigation is needed to establish their efficacy. In this context, it is essential to consider non-pharmacological interventions, such as psychotherapy and behavioural treatments. These approaches play a crucial role in complementing pharmacological interventions and addressing the complex nature of the disorder.
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Affiliation(s)
- Mayra Cruz Preto
- Medical School, Universidade Cidade de São Paulo (UNICID), São Paulo, Brazil
| | - Guilherme Trevizan Kortas
- Perdizes Intitute (IPer), Clinics Hospital of Medical School (HCFMUSP), University of São Paulo, São Paulo, Brazil
- Department of Psychiatry, Medical School, University of São Paulo, São Paulo, Brazil
- Sirio-Libanês Hospital, São Paulo, Brazil
| | - Israel Kanaan Blaas
- Perdizes Intitute (IPer), Clinics Hospital of Medical School (HCFMUSP), University of São Paulo, São Paulo, Brazil
- Department of Neuroscience, Medical School, FMABC University Center, Santo André, Brazil
| | - Dangela Layne Silva Lassi
- Perdizes Intitute (IPer), Clinics Hospital of Medical School (HCFMUSP), University of São Paulo, São Paulo, Brazil
| | - Marcela Waisman Campos
- Department of Cognitive Neurology, Neuropsychiatry, and Neuropsychology, FLENI, Buenos Aires, Argentina
| | - Julio Torales
- Department of Medical Psychology, School of Medical Sciences, University of Asuncion, San Lorenzo, Paraguay
| | - Antonio Ventriglio
- Department of Experimental Medicine, Medical School, Medical School, University of Foggia, Foggia, Italy
| | | | - Arthur Guerra de Andrade
- Perdizes Intitute (IPer), Clinics Hospital of Medical School (HCFMUSP), University of São Paulo, São Paulo, Brazil
- Department of Psychiatry, Medical School, University of São Paulo, São Paulo, Brazil
- Sirio-Libanês Hospital, São Paulo, Brazil
- Department of Neuroscience, Medical School, FMABC University Center, Santo André, Brazil
| | - João Mauricio Castaldelli-Maia
- Department of Psychiatry, Medical School, University of São Paulo, São Paulo, Brazil
- Department of Neuroscience, Medical School, FMABC University Center, Santo André, Brazil
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Mellentin AI, Finn SW, Skøt L, Thaysen-Petersen D, Mistarz N, Fink-Jensen A, Nielsen DG. The Effectiveness of Oxytocin for Treating Substance Use Disorders:A Systematic Review of Randomized Placebo-controlled Trials. Neurosci Biobehav Rev 2023; 151:105185. [PMID: 37119993 DOI: 10.1016/j.neubiorev.2023.105185] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 04/13/2023] [Accepted: 04/16/2023] [Indexed: 05/01/2023]
Abstract
Oxytocin is gaining traction in the treatment of various substance use disorders (SUD). We performed a systematic review assessing the efficacy of oxytocin for treating different SUD. The electronic databases MEDLINE, EMBASE, CENTRAL, and the Cochrane Database of Systematic Reviews were searched for randomized controlled trials examining the effects of oxytocin vs. placebo in SUD samples. Quality assessment was conducted using a Cochrane validated checklist. A total of 17 trials with unique samples were identified. These were conducted on participants with SUD involving alcohol (n = 5), opioids (n = 3), opioids and/or cocaine/other stimulants (n = 3), cannabis (n = 2), or nicotine (n = 4). Across the SUD-groups, oxytocin reduced withdrawal symptoms (3/5 trials), negative emotional states (4/11 trials), cravings (4/11 trials), cue-induced cravings (4/7 trials), and consumption (4/8 trials). Sixteen trials had an overall considerable risk of bias. In conclusion, although oxytocin showed some promising therapeutic effects, the findings are too inconsistent and the trials too heterogeneous to derive any firm conclusions. Sounder methodological and well-powered trials are warranted.
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Affiliation(s)
- Angelina Isabella Mellentin
- Unit of Clinical Alcohol Research (UCAR), University of Southern Denmark. Denmark; Department of Psychiatry, Odense University Hospital, Region of Southern Denmark, Odense, Denmark; Brain Research-Inter-Disciplinary Guided Excellence (BRIDGE), Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Center for Digital Psychiatry (CDP), Mental Health Services in the Region of Southern Denmark, Denmark.
| | - Sara Wallhed Finn
- Unit of Clinical Alcohol Research (UCAR), University of Southern Denmark. Denmark; Unit of Epidemiology of Psychiatric Conditions, Substance use and Social Environment (EPiCSS), Department of Global Public Health, Karolinska Institute, Sweden
| | - Lotte Skøt
- Unit of Clinical Alcohol Research (UCAR), University of Southern Denmark. Denmark
| | - Daniel Thaysen-Petersen
- Mental Health Center Copenhagen, Copenhagen, Mental Health Services, Capital Region of Denmark, Denmark
| | - Nicolaj Mistarz
- Unit of Clinical Alcohol Research (UCAR), University of Southern Denmark. Denmark
| | - Anders Fink-Jensen
- Mental Health Center Copenhagen, Copenhagen, Mental Health Services, Capital Region of Denmark, Denmark
| | - Dorthe Grüner Nielsen
- Unit of Clinical Alcohol Research (UCAR), University of Southern Denmark. Denmark; Drug Treatment Center Odense, Odense C, Denmark
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Hersey M, Bacon AK, Bailey LG, Lee MR, Chen AY, Leggio L, Tanda G. Oxytocin receptors mediate oxytocin potentiation of methylphenidate-induced stimulation of accumbens dopamine in rats. J Neurochem 2023; 164:613-623. [PMID: 36420597 PMCID: PMC10766115 DOI: 10.1111/jnc.15730] [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: 08/29/2022] [Revised: 11/06/2022] [Accepted: 11/07/2022] [Indexed: 11/25/2022]
Abstract
While the illicit use and misuse of stimulants like cocaine and methylphenidate (MP) has increased, there remains no FDA-approved treatments for psychostimulant use disorders (PSUD). Oxytocin (OT) has shown promise as a potential pharmacotherapy for PSUD. Dopamine (DA) neurotransmission plays a significant role in PSUD. We have recently shown that OT blunts the reinforcing effects of MP but, surprisingly, enhanced MP-induced stimulation of DA levels. Such effects have been suggested as a result of activation of OT receptors or, alternatively, could be mediated by direct actions of OT on MP blockade of the DA transporter. Here, we employed fast scan cyclic voltammetry (FSCV) to investigate the effects of systemic OT on MP-induced changes in the dynamics of DA, phasic release and uptake, in the nucleus accumbens shell (NAS) of Sprague-Dawley rats. We also tested the systemic effects of an antagonist of OT receptors, atosiban, to counteract the OT enhancement of dopaminergic effects of MP under microdialysis procedures in the NAS in rats. Administration of OT alone (2 mg/kg; i.p.) did not significantly modify evoked NAS DA dynamics measured by FSCV, and when administered 10 min before MP (0.1, 0.3, 1.0 mg/kg; i.v.), OT did not potentiate MP-induced increases in phasic DA release and did not alter DA clearance rate, suggesting no direct interactions of OT with the MP-induced blockade of DA uptake. Also, OT alone did not elicit significant changes in tonic, extracellular NAS DA levels measured by microdialysis. However, consistent with previous studies, we observed that OT pretreatments (2 mg/kg; i.p.) potentiated MP-induced (0.1, 0.3, 1.0 mg/kg; i.v.) efflux of extracellular NAS DA levels. This effect was abolished when rats were pretreated with atosiban (2 mg/kg; i.p.), suggesting that OT receptors mediate this OT action. Overall, our results suggest that OT receptors mediated OT potentiation of MP-induced stimulation of extracellular NAS DA levels, likely driven by modulation of DA receptor signaling pathways, without affecting MP blockade of DAT.
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Affiliation(s)
| | | | | | - Mary R. Lee
- Veterans Affairs Medical Center, Washington, DC
| | - Andy Y. Chen
- Medication Development Program, NIDA IRP, Baltimore, MD
| | - Lorenzo Leggio
- Medication Development Program, NIDA IRP, Baltimore, MD
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, NIDA/NIAAA IRP, Baltimore, MD
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Baker NL, Neelon B, Ramakrishnan V, Brady KT, Gray KM, Saladin ME, Back SE, Flanagan JC, Guille C, McRae-Clark AL. Sex and drug differences in stress, craving and cortisol response to the trier social stress task. Psychopharmacology (Berl) 2022; 239:2819-2827. [PMID: 35589850 DOI: 10.1007/s00213-022-06163-z] [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] [Received: 06/04/2021] [Accepted: 05/10/2022] [Indexed: 11/27/2022]
Abstract
RATIONALE The hypothalamic-pituitary-adrenal (HPA) axis is a critical hormonal system involved in stress response. A number of studies have investigated the HPA axis response of drug-dependent individuals to stressors. Stress-induced vulnerabilities in the HPA axis may differ in response to chronic use of different substances, possibly leading to different target therapies. There has not been a direct comparison of HPA axis and subjective response between individuals with different types of substance use disorders following a laboratory stress intervention. OBJECTIVES The primary goal of the current study was to compare subjective and neuroendocrine response to the Trier Social Stress Task (TSST) across multiple primary types of substance use disorders and investigate differential response between males and females. METHODS Four hundred participants were drawn from seven studies completed at the Medical University of South Carolina between 2011 and 2021. The TSST was utilized across studies and subjective and neuroendocrine responses measured following completion. Generalized linear mixed effects models and area under the response curve analysis were used to compare both substance type and sex differences. RESULTS The study groups involving individuals with cocaine use disorder had blunted stress, craving and cortisol response following the TSST as compared to other substance use groups. Females in the cocaine groups reported higher subjective stress but lower cortisol than males. CONCLUSIONS The study results indicate that there may be differential effects of substances on the HPA axis, with cocaine using individuals exhibiting more blunting of the HPA axis response as compared to users of other substances.
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Affiliation(s)
- Nathaniel L Baker
- Department of Public Health Sciences, Medical University of South Carolina, 135 Cannon Street, Suite 303, Charleston, SC, 29425, USA.
| | - Brian Neelon
- Department of Public Health Sciences, Medical University of South Carolina, 135 Cannon Street, Suite 303, Charleston, SC, 29425, USA
- Ralph H Johnson Veterans Administration Medical Center, Charleston, SC, USA
| | - Viswanathan Ramakrishnan
- Department of Public Health Sciences, Medical University of South Carolina, 135 Cannon Street, Suite 303, Charleston, SC, 29425, USA
| | - Kathleen T Brady
- Ralph H Johnson Veterans Administration Medical Center, Charleston, SC, USA
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Kevin M Gray
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Michael E Saladin
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
- Department of Health Sciences and Research, Medical University of South Carolina, Charleston, SC, USA
| | - Sudie E Back
- Ralph H Johnson Veterans Administration Medical Center, Charleston, SC, USA
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Julianne C Flanagan
- Ralph H Johnson Veterans Administration Medical Center, Charleston, SC, USA
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Constance Guille
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Aimee L McRae-Clark
- Ralph H Johnson Veterans Administration Medical Center, Charleston, SC, USA
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
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Flanagan J, Chatzittofis A, Boström ADE, Hallberg J, Öberg KG, Arver S, Jokinen J. High Plasma Oxytocin Levels in Men With Hypersexual Disorder. J Clin Endocrinol Metab 2022; 107:e1816-e1822. [PMID: 35108393 PMCID: PMC9016473 DOI: 10.1210/clinem/dgac015] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Indexed: 01/23/2023]
Abstract
CONTEXT Hypersexual disorder (HD) involves excessive, persistent sexual behaviors related to various mood states and the diagnosis compulsive sexual behavior disorder is included as an impulse control disorder in the 11th revision of the International Classification of Diseases. Although the neurobiology behind the disorder is not clear, some studies suggest dysregulated hypothalamic-pituitary-adrenal axis. Oxytocin acts as counterregulatory neuroendocrine hormone to cortisol and is also involved in sexual behavior. OBJECTIVE We hypothesized that oxytocin may play a role in the pathophysiology of HD with compensatory actions to cortisol. DESIGN Longitudinal. SETTING ANOVA clinic (Karolinska University Hospital). PATIENTS OR OTHER PARTICIPANTS 64 males with HD and 38 age-matched healthy volunteers. MAIN OUTCOME MEASURES Plasma oxytocin levels, measured with radioimmunoassay; Hypersexual Disorder Screening Inventory; and Hypersexual Disorder: Current Assessment Scale for assessing hypersexual symptoms. INTERVENTIONS A patient subgroup (n = 30) completed the manual-based group-administered cognitive-behavioral therapy (CBT) program for HD, and posttreatment oxytocin levels were measured. RESULTS Hypersexual men (n = 64) exhibited significantly higher oxytocin plasma levels (mean ± SD: 31.0 ± 9.9 pM) compared with healthy volunteers (16.9 ± 3.9 pM; P < 0.001). There were significant positive correlations between oxytocin levels and the rating scales measuring hypersexual behavior. Patients who completed CBT treatment (n = 30) had a significant reduction of oxytocin plasma levels from pretreatment (30.5 ± 10.1 pM) to posttreatment (20.2 ± 8.0 pM; P < 0.001). CONCLUSIONS The results suggest that the hyperactive oxytocinergic system in hypersexual men may be a compensatory mechanism to attenuate hyperactive stress.
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Affiliation(s)
- John Flanagan
- Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Andreas Chatzittofis
- Medical School, University of Cyprus, Nicosia, Cyprus
- Department of Clinical Sciences/Psychiatry, Umeå University, Umeå,Sweden
- Correspondence: Andreas Chatzittofis, MD, PhD, University of Cyprus, Medical School, Palaios dromos Lefkosias Lemesou No.215/6 2029 Aglantzia, Nicosia, Cyprus.
| | - Adrian Desai E Boström
- Department of Clinical Sciences/Psychiatry, Umeå University, Umeå,Sweden
- Neuropaediatric Unit, Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
| | - Jonas Hallberg
- Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Katarina Görts Öberg
- Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Stefan Arver
- Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Jussi Jokinen
- Department of Clinical Sciences/Psychiatry, Umeå University, Umeå,Sweden
- Department of Clinical Neuroscience/Psychiatry, Karolinska Institutet, Stockholm, Sweden
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Zimmermann S, Thomas BC, Krisam J, Limprecht R, Klose C, Stenger M, Pourbaix M, Ries M, Vollstaedt-Klein S, Koopmann A, Lenz B, Kiefer F, Bach P. ON-ICE trial: Investigation of the combined effects of oxytocin and naltrexone on stress-induced and alcohol cue-induced craving in alcohol use disorder-Study protocol of a phase II randomised double-blind placebo-controlled parallel-group trial. BMJ Open 2022; 12:e059672. [PMID: 35410938 PMCID: PMC9003596 DOI: 10.1136/bmjopen-2021-059672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Although alcohol dependence (AD) is highly prevalent, only few medications are approved for its treatment. While currently approved medications, such as naltrexone (NTX), reduce craving and relapse risk to a certain extent, new approaches are needed to complement these pharmaca. One potential compound is oxytocin (OXY), which proved beneficial effects on alcohol craving and stress reactivity in preliminary clinical studies and synergism with NTX effects. METHODS AND ANALYSIS This clinical phase II trial is a monocentre two-armed, placebo (PLC)-controlled, 1:1 randomised, double-blind, parallel-group study. 62 participants with AD will be randomised to receive either intranasal OXY spray (24 IU) or PLC spray plus oral NTX (50 mg) for 2 days, and alcohol craving will be assessed using a validated combined stress-exposure and cue-exposure experiments and MRI. The primary outcome will be the intensity of alcohol craving, assessed using the Alcohol Urge Questionnaire (AUQ), 60 min after OXY/PLC application, directly after the stress and cue exposures. Secondary outcomes include subjective stress, negative affect, cortisol and OXY plasma levels, and neural response to alcohol and emotional cues and natural rewards. Follow-up drinking data were collected over 90 days. The primary efficacy analysis will test the difference between the verum and the PLC group in the distribution of AUQ craving scores. Appropriate statistical analysis will be used for the evaluation of the secondary outcomes. ETHICS AND DISSEMINATION This trial has been approved by the ethics committee of Heidelberg University and competent authority. All participants in the trial will provide written informed consent. The study will be conducted according to the principles of the Declaration of Helsinki and in accordance to the German Medicinal Products act. Results of this study will be disseminated in peer-reviewed scientific journals and deidentified data, and the statistical analysis plan will be made available via open-access online repositories. TRIAL REGISTRATION NUMBERS EudraCT 2021-003610-40 and NCT05093296.
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Affiliation(s)
- Sina Zimmermann
- Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Mannheim, Germany
| | - Bettina C Thomas
- Coordination Centre for Clinical Trials (KKS), Medical Faculty, University Hospital Heidelberg, Heidelberg, Germany
| | - Johannes Krisam
- Institute of Medical Biometry (IMBI), University of Heidelberg, Heidelberg, Germany
| | - Ronald Limprecht
- Institute of Medical Biometry (IMBI), University of Heidelberg, Heidelberg, Germany
| | - Christina Klose
- Institute of Medical Biometry (IMBI), University of Heidelberg, Heidelberg, Germany
| | - Manuel Stenger
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Mannheim, Germany
| | - Madeleine Pourbaix
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Mannheim, Germany
| | - Marcel Ries
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Mannheim, Germany
| | - Sabine Vollstaedt-Klein
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Mannheim, Germany
| | - Anne Koopmann
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Mannheim, Germany
| | - Bernd Lenz
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Mannheim, Germany
| | - Falk Kiefer
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Mannheim, Germany
| | - Patrick Bach
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Mannheim, Germany
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Wang J, Zou Z. Establishment of a biomarker of peripheral stress in opioid addicts based on the hypothalamic-pituitary-adrenal axis-The improvement effect of exercise. Front Psychiatry 2022; 13:1072896. [PMID: 36569629 PMCID: PMC9768425 DOI: 10.3389/fpsyt.2022.1072896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 11/21/2022] [Indexed: 12/12/2022] Open
Abstract
PURPOSE This study aims to investigate the relationship between peripheral blood oxytocin (OT), vasopressin (AVP), and subjectively perceived stress and cortisol in male opioid addicts based on the hypothalamic-pituitary-adrenal (HPA) axis. We also investigate the impact of exercise on reducing subjectively perceived stress, craving level, negative reinforcement, anxiety, sleep quality, plasma OT, AVP, and cortisol levels. METHODS Participants were divided into 28 subjects in the low-stress control group (LSC group), 29 subjects in the medium-high stress control group (MTHSC group), and 28 subjects in the moderate-high-stress exercise group (MTHSE group), based on their subjectively perceived stress levels. Subjects in the MTHSE group performed 12 weeks of combined aerobic resistance training (60 min per day, 5 days per week). Plasma OT, AVP, and cortisol concentrations were analyzed via Elisa. PSQI was used to assess the subjective perceived stress, craving, negative reinforcement, anxiety, and sleep quality level, respectively. Mixed-effects ANOVA and Pearson correlation analysis were employed to explore the impact and correlation between different parameters. RESULT Plasma OT levels significantly increased (95% CI: -7.48, -2.26), while plasma AVP (95% CI: 2.90, 4.10), and cortisol (95% CI: 19.76, 28.17) levels significantly decreased in the MTHSE group after exercise. The PSS (95% CI: 1.756, 4.815), "Desire and Intention" (95% CI: 1.60, 2.71), and "Negative reinforcement" (95% CI: 0.85, 1.90) (DDQ), SAS (95% CI: 17.51, 26.06), and PSQI (95% CI: 1.18, 3.25) scores of the MTHSE group were significantly decreased after exercise. Plasma OT, plasma cortisol, craving, negative reinforcement and anxiety were negatively correlated. Plasma AVP was positively correlated with craving. CONCLUSION As an auxiliary treatment, exercise improves the plasma OT, AVP, and cortisol levels of opioid addicts, and reduces their subjective perceived stress level, desire, negative reinforcement level, anxiety level, and sleep quality. In addition, peripheral plasma OT, AVP, and cortisol may play a role as potential peripheral biomarkers to predict stress in male opioid addicts.
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Affiliation(s)
- Jingsong Wang
- Xiangsihu College, Guangxi University for Nationalities, Nanning, China
| | - Zhibing Zou
- Xiangsihu College, Guangxi University for Nationalities, Nanning, China
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10
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Azadbakht A, Salehi M, Maracy MR, Banafshe HR. The Effects of Oxytocin on Craving, Mental Health Parameters, and Stress Hormones in Methamphetamine-Dependent Patients Undergoing Matrix Treatment Model: A Randomized, Double-Blind Clinical Trial. Eur Addict Res 2022; 28:340-349. [PMID: 35917806 DOI: 10.1159/000525443] [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] [Received: 02/18/2021] [Accepted: 05/11/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Methamphetamine (METH) dependence is an increasing public health problem with a wide range of mental and physical adverse effects. Recent studies report that oxytocin (OXT) has potential therapeutic properties in drug dependence. Hence, the present study was designed to evaluate the effects of OXT on craving, mental health (depression and anxiety), and stress hormones (ACTH and cortisol) in METH-dependent patients undergoing matrix treatment model (MTM), an intensive outpatient approach for stimulant abuse treatment. METHODS This randomized placebo-controlled clinical trial was conducted in 42 METH-dependent patients undergoing MTM to receive either intranasal OXT 40 IU (n = 21) or normal saline as placebo (n = 21) for 4 weeks. Clinical and biochemical parameters were measured at baseline and end of trials in METH-dependent patients. RESULTS Our findings indicated that OXT administration for 4 weeks is associated with a significant improvement in the craving and depression scores, respectively (p < 0.001 and p < 0.001), but there was no significant difference for anxiety scores compared with the placebo group. In addition, OXT administration significantly decreased cortisol (p < 0.001) and ACTH levels (p < 0.002). CONCLUSIONS These findings suggest that OXT can be considered as a new potential therapeutic for the treatment of METH-dependent patients undergoing MTM. Further studies are required to explore the effectiveness and safety of OXT.
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Affiliation(s)
- Abbas Azadbakht
- Department of Addiction Studies, School of Medical, Kashan University of Medical Sciences, Kashan, Iran
| | - Mehrdad Salehi
- Department of Psychiatry, Behavioral Sciences Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Reza Maracy
- Department of Epidemiology and Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamid Reza Banafshe
- Physiology Research Center, Institute for Basic Sciences, Kashan University of Medical Sciences, Kashan, Iran
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11
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Noël Raby W, Heller M, Milliaressis D, Jean Choi C, Basaraba C, Pavlicova M, Alschuler DM, Levin FR, Church S, Nunes EV. Intranasal oxytocin may improve odds of abstinence in cocaine-dependent patients: results from a preliminary study. DRUG AND ALCOHOL DEPENDENCE REPORTS 2021; 2:100016. [PMID: 36845891 PMCID: PMC9948893 DOI: 10.1016/j.dadr.2021.100016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 11/19/2021] [Accepted: 12/06/2021] [Indexed: 11/17/2022]
Abstract
Background Oxytocin (OT) treatment in drug addiction studies have suggested potential therapeutic benefits. There is a paucity of clinical trial studies of oxytocin in cocaine use disorders. Method This was a 6-week randomized, double-blind, outpatient clinical trial study investigating the effect of daily Intranasal Oxytocin (24 IU) on cocaine use by cocaine use disorder patients. After a 7-day inpatient abstinence induction stage, patients were randomized to intranasal oxytocin or intranasal placebo. During the outpatient phase, cocaine use disorder patients were required to present themselves to the research staff 3 times a week for witnessed randomized medication administration, to provide a urine sample for qualitative toxicology, and complete mandatory assessments, including the Time-Line-Follow Back. For the interim days, patients were given an "at-home" bottle that was weighed at each clinic visit to monitor compliance. Results Neither administration of Intranasal placebo (n = 11) or Oxytocin (n = 15) induced at least 3 weeks of continuous abstinence. However, from week 3, the odds of weekly abstinence increased from 4.61 (95% CI = 1.05, 20.3) to 15.0 (CI = 1.18, 190.2) by week 6 for the Intranasal Oxytocin group (t = 2.12, p = 0.037), though there was no significant group difference overall in the odds of abstinence over time (F1,69 = 1.73, p = 0.19). More patients on Intranasal Oxytocin dropped out (p = 0.0005). Conclusions Intranasal Oxytocin increased the odds of weekly abstinence in Cocaine patients after 2 weeks compared to PBO, but was associated with a higher dropout rate. (ClinicalTrials.gov 02,255,357, 10/2014).
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Affiliation(s)
- Wilfrid Noël Raby
- Division on Substance Abuse, Department of Psychiatry, Montefiore Medical Center, Albert Einstein College of Medicine, 1510 Waters Place, 2nd Floor, Bronx, NY 10461, United States of America
- Division on Substance Use Disorders, Department of Psychiatry, Columbia University Irving Medical Center and the New York State Psychiatric Institute, New York, NY, United States of America
- Corresponding author at: Division on Substance Abuse, Department of Psychiatry, Montefiore Medical Center, Albert Einstein College of Medicine, 1510 Waters Place, 2nd Floor, Bronx, NY 10461, United States of America.
| | - Matthew Heller
- Division on Substance Use Disorders, Department of Psychiatry, Columbia University Irving Medical Center and the New York State Psychiatric Institute, New York, NY, United States of America
| | - Demetrios Milliaressis
- Division on Substance Use Disorders, Department of Psychiatry, Columbia University Irving Medical Center and the New York State Psychiatric Institute, New York, NY, United States of America
| | - C. Jean Choi
- Division of Mental Health Data Science, New York State Psychiatric Institute, New York, NY, United States of America
| | - Cale Basaraba
- Division of Mental Health Data Science, New York State Psychiatric Institute, New York, NY, United States of America
| | - Martina Pavlicova
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, United States of America
| | - Daniel M. Alschuler
- Division of Mental Health Data Science, New York State Psychiatric Institute, New York, NY, United States of America
| | - Frances R. Levin
- Division on Substance Use Disorders, Department of Psychiatry, Columbia University Irving Medical Center and the New York State Psychiatric Institute, New York, NY, United States of America
| | - Sarah Church
- Wholeview Wellness Centers, 369 Lexington Avenue, Suite 14A, New York City, NY 10017, United States of America
| | - Edward V. Nunes
- Division on Substance Use Disorders, Department of Psychiatry, Columbia University Irving Medical Center and the New York State Psychiatric Institute, New York, NY, United States of America
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12
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Martin EL, Doncheck EM, Reichel CM, McRae-Clark AL. Consideration of sex as a biological variable in the translation of pharmacotherapy for stress-associated drug seeking. Neurobiol Stress 2021; 15:100364. [PMID: 34345636 PMCID: PMC8319013 DOI: 10.1016/j.ynstr.2021.100364] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 06/23/2021] [Accepted: 07/08/2021] [Indexed: 12/01/2022] Open
Abstract
Stress is a frequent precipitant of relapse to drug use. Pharmacotherapies targeting a diverse array of neural systems have been assayed for efficacy in attenuating stress-induced drug-seeking in both rodents and in humans, but none have shown enough evidence of utility to warrant routine use in the clinic. We posit that a critical barrier in effective translation is inattention to sex as a biological variable at all phases of the research process. In this review, we detail the neurobiological systems implicated in stress-induced relapse to cocaine, opioids, methamphetamine, and cannabis, as well as the pharmacotherapies that have been used to target these systems in rodent models, the human laboratory, and in clinical trials. In each of these areas we additionally describe the potential influences of biological sex on outcomes, and how inattention to fundamental sex differences can lead to biases during drug development that contribute to the limited success of large clinical trials. Based on these observations, we determine that of the pharmacotherapies discussed only α2-adrenergic receptor agonists and oxytocin have a body of research with sufficient consideration of biological sex to warrant further clinical evaluation. Pharmacotherapies that target β-adrenergic receptors, other neuroactive peptides, the hypothalamic-pituitary-adrenal axis, neuroactive steroids, and the endogenous opioid and cannabinoid systems require further assessment in females at the preclinical and human laboratory levels before progression to clinical trials can be recommended.
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Affiliation(s)
- Erin L Martin
- Department of Neuroscience, Medical University of South Carolina, Charleston, SC, 29425, USA
| | - Elizabeth M Doncheck
- Department of Neuroscience, Medical University of South Carolina, Charleston, SC, 29425, USA
| | - Carmela M Reichel
- Department of Neuroscience, Medical University of South Carolina, Charleston, SC, 29425, USA
| | - Aimee L McRae-Clark
- Department of Neuroscience, Medical University of South Carolina, Charleston, SC, 29425, USA.,Department of Psychiatry, Medical University of South Carolina, Charleston, SC, 29425, USA
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13
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Houghton B, Kouimtsidis C, Duka T, Paloyelis Y, Bailey A. Can intranasal oxytocin reduce craving in automated addictive behaviours? A systematic review. Br J Pharmacol 2021; 178:4316-4334. [PMID: 34235724 DOI: 10.1111/bph.15617] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 06/21/2021] [Accepted: 06/28/2021] [Indexed: 12/24/2022] Open
Abstract
Existing pharmacotherapies for managing craving, a strong predictor of relapse to automated addictive behaviours, are limited in efficacy and characterised by increased health risks associated with their pharmacological profile. Preclinical studies have identified oxytocin as a promising pharmacotherapy with anticraving properties for addictive behaviours. Here, we provide the first systematic review of 17 human studies (n = 722; 30% female) investigating the efficacy of intranasal oxytocin to reduce craving or consumption in addictive behaviours. We identify intranasal oxytocin as a method that warrants further investigation regarding its capacity to decrease cue-induced, acute stress-induced or withdrawal-related craving and relapse related to alcohol, cannabis, opioids, cocaine or nicotine, including a potential role as ad hoc medication following exposure to drug-related cues. Future studies should investigate the role of factors such as treatment regimens and sample characteristics, including the role of the amygdala, which we propose as a distinct mechanism mediating oxytocin's anticraving properties.
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Affiliation(s)
- Ben Houghton
- Pharmacology Section, Institute of Medical and Biomedical Education, St George's University of London, London, UK
| | | | - Theodora Duka
- Behavioural and Clinical Neuroscience, School of Psychology, University of Sussex, Brighton, UK
| | - Yannis Paloyelis
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Alexis Bailey
- Pharmacology Section, Institute of Medical and Biomedical Education, St George's University of London, London, UK
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14
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Melkonian AJ, Flanagan JC, Calhoun CD, Hogan JN, Back SE. Craving Moderates the Effects of Intranasal Oxytocin on Anger in Response to Social Stress Among Veterans With Co-Occurring Posttraumatic Stress Disorder and Alcohol Use Disorder. J Clin Psychopharmacol 2021; 41:465-469. [PMID: 34121063 DOI: 10.1097/jcp.0000000000001434] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE/BACKGROUND Posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) commonly co-occur among US military veterans. Oxytocin may have therapeutic value in treating both conditions. The potential for oxytocin to augment affective features common to PTSD and AUD, such as anger, is relevant to inform emerging treatments. METHODS/PROCEDURES We examined the influence of intranasally administered oxytocin on connections between alcohol craving and stress-induced anger in a sample of 73 veterans (91.3% men) with co-occurring PTSD and AUD. Participants self-administered oxytocin (40 IU) or placebo (saline) 45 minutes before completing the Trier Social Stress Task (TSST). Self-reports of alcohol craving and anger were assessed pre- and post-TSST using a modified visual analog scale. Multiple regression analysis, including main effects for group, baseline craving, and their interaction, was used to predict post-TSST anger. FINDINGS/RESULTS A marginally significant interaction was observed, suggesting a positive association between baseline craving and anger for those in the oxytocin group (B = 0.65, P = 0.01). Among those reporting low craving, participants in the oxytocin group reported significantly lower post-TSST anger than those in the placebo group. IMPLICATIONS/CONCLUSIONS The current study is among the first to examine relevant psychosocial moderators that may influence the effects of oxytocin among veterans with comorbid PTSD and AUD. Although oxytocin attenuated ratings of anger after a stress task among those with low baseline craving, findings suggest that oxytocin may not be as effective at reducing anger, a highly salient factor in PTSD, for individuals experiencing high levels of craving. Findings are consistent with the social salience hypothesis and suggest that individual differences in alcohol craving should be considered when evaluating oxytocin as a potential treatment for individuals with comorbid PTSD and AUD.
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Affiliation(s)
| | | | - Casey D Calhoun
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC
| | - Jasara N Hogan
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC
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15
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al'Absi M, Allen AM. Impact of Acute and Chronic Cannabis Use on Stress Response Regulation: Challenging the Belief That Cannabis Is an Effective Method for Coping. Front Psychol 2021; 12:687106. [PMID: 34276511 PMCID: PMC8283823 DOI: 10.3389/fpsyg.2021.687106] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 05/21/2021] [Indexed: 11/16/2022] Open
Abstract
Although research has only recently started to examine the impact of cannabis use on stress response, there is some evidence that indicates acute and chronic impacts of cannabis on these processes. In this paper, we review processes involved in regulating the stress response and we review the influence of acute and chronic exposure to cannabis on patterns and regulation of the stress response. We also highlight the role of stress as a risk factor for initiation and maintenance of cannabis use. In this context, we examine moderating variables, including sex and life adversity. In light of recent observations indicating increasing prevalence of cannabis use during pregnancy, we provide additional focus on cannabis use in this vulnerable population, including how acute and chronic stress may predispose some individuals to use cannabis during pregnancy. While this line of research is in its infancy, we review available articles that focus on the perinatal period and that examined the association between cannabis use and various life stressors, including partner violence, job loss, and lack of housing. We also review psychiatric co-morbidities (e.g., post-traumatic stress disorder, anxiety). A better understanding of the way stress and cannabis use relate within the general population, as well as within certain subgroups that may be at a greater risk of using and/or at greater risk for adverse outcomes of use, may lead to the development of novel prevention and intervention approaches.
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Affiliation(s)
- Mustafa al'Absi
- Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, MN, United States
| | - Alicia M Allen
- Department of Family and Community Medicine, University of Arizona, Tucson, AZ, United States
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16
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Sanna F, De Luca MA. The potential role of oxytocin in addiction: What is the target process? Curr Opin Pharmacol 2021; 58:8-20. [PMID: 33845377 DOI: 10.1016/j.coph.2021.03.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 02/26/2021] [Accepted: 03/05/2021] [Indexed: 01/27/2023]
Abstract
Oxytocin regulates a variety of centrally-mediated functions, ranging from socio-sexual behavior, maternal care, and affiliation to fear, stress, anxiety. In the past years, both clinical and preclinical studies characterized oxytocin for its modulatory role on reward-related neural substrates mainly involving the interplay with the mesolimbic and mesocortical dopaminergic pathways. This suggests a role of this nonapeptide on the neurobiology of addiction raising the possibility of its therapeutic use. Although far from a precise knowledge of the underlying mechanisms, the putative role of the bed nucleus of the stria terminalis as a key structure where oxytocin may rebalance altered neurochemical processes and neuroplasticity involved in dependence and relapse has been highlighted. This view opens new opportunities to address the health problems related to drug misuse.
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Affiliation(s)
- Fabrizio Sanna
- Department of Biomedical Sciences, University of Cagliari, Monserrato, Cagliari 09042, Italy
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17
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Kapetaniou GE, Reinhard MA, Christian P, Jobst A, Tobler PN, Padberg F, Soutschek A. The role of oxytocin in delay of gratification and flexibility in non-social decision making. eLife 2021; 10:e61844. [PMID: 33821797 PMCID: PMC8024008 DOI: 10.7554/elife.61844] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 03/24/2021] [Indexed: 01/03/2023] Open
Abstract
Oxytocin is well-known for its impact on social cognition. This specificity for the social domain, however, has been challenged by findings suggesting a domain-general allostatic function for oxytocin by promoting future-oriented and flexible behavior. In this pre-registered study, we tested the hypothesized domain-general function of oxytocin by assessing the impact of intranasal oxytocin (24 IU) on core aspects of human social (inequity aversion) and non-social decision making (delay of gratification and cognitive flexibility) in 49 healthy volunteers (within-subject design). In intertemporal choice, patience was higher under oxytocin than under placebo, although this difference was evident only when restricting the analysis to the first experimental session (between-group comparison) due to carry-over effects. Further, oxytocin increased cognitive flexibility in reversal learning as well as generosity under conditions of advantageous but not disadvantageous inequity. Our findings show that oxytocin affects both social and non-social decision making, supporting theoretical accounts of domain-general functions of oxytocin.
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Affiliation(s)
- Georgia Eleni Kapetaniou
- Department of Psychology, Ludwig Maximilian University MunichMunichGermany
- Graduate School for Systemic Neurosciences, Department of Biology, Ludwig Maximilian University MunichMunichGermany
| | - Matthias A Reinhard
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University MunichMunichGermany
| | - Patricia Christian
- Department of Psychology, Ludwig Maximilian University MunichMunichGermany
- Graduate School for Systemic Neurosciences, Department of Biology, Ludwig Maximilian University MunichMunichGermany
| | - Andrea Jobst
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University MunichMunichGermany
| | - Philippe N Tobler
- Zurich Center for Neuroeconomics, Department of Economics, University of ZurichZurichSwitzerland
- Neuroscience Center Zurich, University of Zurich, Swiss Federal Institute of Technology ZurichZurichSwitzerland
| | - Frank Padberg
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University MunichMunichGermany
| | - Alexander Soutschek
- Department of Psychology, Ludwig Maximilian University MunichMunichGermany
- Graduate School for Systemic Neurosciences, Department of Biology, Ludwig Maximilian University MunichMunichGermany
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18
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Ferrer-Pérez C, Reguilón MD, Miñarro J, Rodríguez-Arias M. Oxytocin Signaling as a Target to Block Social Defeat-Induced Increases in Drug Abuse Reward. Int J Mol Sci 2021; 22:ijms22052372. [PMID: 33673448 PMCID: PMC7956822 DOI: 10.3390/ijms22052372] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 02/21/2021] [Accepted: 02/23/2021] [Indexed: 12/15/2022] Open
Abstract
There is huge scientific interest in the neuropeptide oxytocin (OXT) due to its putative capacity to modulate a wide spectrum of physiological and cognitive processes including motivation, learning, emotion, and the stress response. The present review seeks to increase the understanding of the role of OXT in an individual’s vulnerability or resilience with regard to developing a substance use disorder. It places specific attention on the role of social stress as a risk factor of addiction, and explores the hypothesis that OXT constitutes a homeostatic response to stress that buffers against its negative impact. For this purpose, the review summarizes preclinical and clinical literature regarding the effects of OXT in different stages of the addiction cycle. The current literature affirms that a well-functioning oxytocinergic system has protective effects such as the modulation of the initial response to drugs of abuse, the attenuation of the development of dependence, the blunting of drug reinstatement and a general anti-stress effect. However, this system is dysregulated if there is continuous drug use or chronic exposure to stress. In this context, OXT is emerging as a promising pharmacotherapy to restore its natural beneficial effects in the organism and to help rebalance the functions of the addicted brain.
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Affiliation(s)
- Carmen Ferrer-Pérez
- Department of Psychology and Sociology, University of Zaragoza, C/Ciudad Escolar s/n, 44003 Teruel, Spain;
| | - Marina D. Reguilón
- Unit of Research Psychobiology of Drug Dependence, Department of Psychobiology, Facultad de Psicología, Universitat de Valencia, Avda. Blasco Ibáñez, 21, 46010 Valencia, Spain; (M.D.R.); (J.M.)
| | - José Miñarro
- Unit of Research Psychobiology of Drug Dependence, Department of Psychobiology, Facultad de Psicología, Universitat de Valencia, Avda. Blasco Ibáñez, 21, 46010 Valencia, Spain; (M.D.R.); (J.M.)
| | - Marta Rodríguez-Arias
- Unit of Research Psychobiology of Drug Dependence, Department of Psychobiology, Facultad de Psicología, Universitat de Valencia, Avda. Blasco Ibáñez, 21, 46010 Valencia, Spain; (M.D.R.); (J.M.)
- Correspondence:
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19
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Sundar M, Patel D, Young Z, Leong KC. Oxytocin and Addiction: Potential Glutamatergic Mechanisms. Int J Mol Sci 2021; 22:ijms22052405. [PMID: 33673694 PMCID: PMC7957657 DOI: 10.3390/ijms22052405] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 02/25/2021] [Accepted: 02/25/2021] [Indexed: 11/16/2022] Open
Abstract
Recently, oxytocin (OXT) has been investigated for its potential therapeutic role in addiction. OXT has been found to diminish various drug-seeking and drug-induced behaviors. Although its behavioral effects are well-established, there is not much consensus on how this neuropeptide exerts its effects. Previous research has given thought to how dopamine (DA) may be involved in oxytocinergic mechanisms, but there has not been as strong of a focus on the role that glutamate (Glu) has. The glutamatergic system is critical for the processing of rewards and the disruption of glutamatergic projections produces the behaviors seen in drug addicts. We introduce the idea that OXT has direct effects on Glu transmission within the reward processing pathway. Thus, OXT may reduce addictive behaviors by restoring abnormal drug-induced changes in the glutamatergic system and in its interactions with other neurotransmitters. This review offers insight into the mechanisms through which a potentially viable therapeutic target, OXT, could be used to reduce addiction-related behaviors.
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20
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Abstract
Cannabis use disorder (CUD) is an underappreciated risk of using cannabis that affects ~10% of the 193 million cannabis users worldwide. The individual and public health burdens are less than those of other forms of drug use, but CUD accounts for a substantial proportion of persons seeking treatment for drug use disorders owing to the high global prevalence of cannabis use. Cognitive behavioural therapy, motivational enhancement therapy and contingency management can substantially reduce cannabis use and cannabis-related problems, but enduring abstinence is not a common outcome. No pharmacotherapies have been approved for cannabis use or CUD, although a number of drug classes (such as cannabinoid agonists) have shown promise and require more rigorous evaluation. Treatment of cannabis use and CUD is often complicated by comorbid mental health and other substance use disorders. The legalization of non-medical cannabis use in some high-income countries may increase the prevalence of CUD by making more potent cannabis products more readily available at a lower price. States that legalize medical and non-medical cannabis use should inform users about the risks of CUD and provide information on how to obtain assistance if they develop cannabis-related mental and/or physical health problems.
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21
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Che X, Cai J, Liu Y, Xu T, Yang J, Wu C. Oxytocin signaling in the treatment of drug addiction: Therapeutic opportunities and challenges. Pharmacol Ther 2021; 223:107820. [PMID: 33600854 DOI: 10.1016/j.pharmthera.2021.107820] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2021] [Indexed: 12/13/2022]
Abstract
Drug addiction is one of the leading causes of mortality worldwide. Despite great advances were achieved in understanding the neurobiology of drug addiction, the therapeutic options are severely limited, with poor effectiveness and serious side effects. The neuropeptide oxytocin (OXT) is well known for its effects on uterine contraction, sexual/maternal behaviors, social affiliation, stress and learning/memory by interacting with the OXT receptor and other neuromodulators. Emerging evidence suggests that the acute or chronic exposure to drugs can affect the OXT system. Additionally, OXT administration can ameliorate a wide range of abused drug-induced neurobehavioral changes. Overall, OXT not only suppresses drug reward in the binge stage of drug addiction, but also reduces stress responses and social impairments during the withdrawal stage and, finally, prevents drug/cue/stress-induced reinstatement. More importantly, clinical studies have also shown that OXT can exert beneficial effects on reducing substance use disorders of a series of drugs, such as heroin, cocaine, alcohol, cannabis and nicotine. Thus, the present review focuses on the role of OXT in treating drug addiction, including the preclinical and clinical therapeutic potential of OXT and its analogs on the neurobiological perspectives of drugs, to provide a better insight of the efficacy of OXT as a clinical addiction therapeutic agent.
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Affiliation(s)
- Xiaohang Che
- Department of Pharmacology, Shenyang Pharmaceutical University, Shenyang, PR China; Key Laboratory of New Drug Screening of Liaoning Province, Shenyang Pharmaceutical University, Shenyang, PR China; Key Laboratory of New Drug Pharmacodynamics Evaluation of Liaoning Province, Shenyang Pharmaceutical University, Shenyang, PR China
| | - Jialing Cai
- Department of Pharmacology, Shenyang Pharmaceutical University, Shenyang, PR China
| | - Yueyang Liu
- Department of Pharmacology, Shenyang Pharmaceutical University, Shenyang, PR China; Key Laboratory of New Drug Screening of Liaoning Province, Shenyang Pharmaceutical University, Shenyang, PR China; Key Laboratory of New Drug Pharmacodynamics Evaluation of Liaoning Province, Shenyang Pharmaceutical University, Shenyang, PR China
| | - Tianyu Xu
- Department of Pharmacology, Shenyang Pharmaceutical University, Shenyang, PR China
| | - Jingyu Yang
- Department of Pharmacology, Shenyang Pharmaceutical University, Shenyang, PR China; Key Laboratory of New Drug Screening of Liaoning Province, Shenyang Pharmaceutical University, Shenyang, PR China; Key Laboratory of New Drug Pharmacodynamics Evaluation of Liaoning Province, Shenyang Pharmaceutical University, Shenyang, PR China.
| | - Chunfu Wu
- Department of Pharmacology, Shenyang Pharmaceutical University, Shenyang, PR China; Key Laboratory of New Drug Screening of Liaoning Province, Shenyang Pharmaceutical University, Shenyang, PR China; Key Laboratory of New Drug Pharmacodynamics Evaluation of Liaoning Province, Shenyang Pharmaceutical University, Shenyang, PR China.
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22
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The vagus nerve mediates the suppressing effects of peripherally administered oxytocin on methamphetamine self-administration and seeking in rats. Neuropsychopharmacology 2021; 46:297-304. [PMID: 32450570 PMCID: PMC7852687 DOI: 10.1038/s41386-020-0719-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Revised: 05/11/2020] [Accepted: 05/14/2020] [Indexed: 02/01/2023]
Abstract
The neuropeptide oxytocin has emerged as a promising pharmacotherapy for methamphetamine (METH) addiction, and clinical trials of intranasal oxytocin are underway. However, there is debate as to how peripherally administered oxytocin alters brain signalling to modulate addiction processes. Interestingly, there is evidence for functional interactions between peripheral oxytocin administration and the vagus nerve. Therefore, this study investigated whether the effects of peripherally administered oxytocin require vagal signalling to reduce METH self-administration and reinstatement of METH-seeking behaviours. Male and female Sprague-Dawley rats underwent surgery for jugular catheterisation and either subdiaphragmatic vagotomy (SDV) or a sham operation. Rats were trained to self-administer METH, and the effect of peripherally administered oxytocin on METH intake was assessed. Rats then underwent extinction, and effects of oxytocin were assessed on cue- and METH-induced reinstatement of METH-seeking. Oxytocin treatment robustly attenuated METH intake in both sexes, and SDV entirely prevented the suppressant effect of oxytocin (0.3 mg/kg) on METH intake, and partially prevented the effects of 1 mg/kg oxytocin in both sexes. After extinction, SDV decreased the suppressing effects of oxytocin on cue- and METH-primed reinstatement in males, but not females. SDV was functionally confirmed by measuring food intake following administration of the vagal dependent peptide, cholecyostokin-8. Our data suggest that vagus nerve signalling is required for the inhibitory effects of peripherally administered oxytocin on METH self-administration and reinstatement, and that this vagal dependency is partially mediated by sex and drug withdrawal. This study has implications for the use of oxytocin as a therapy for METH use disorder for both sexes.
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Melby K, Gråwe RW, Aamo TO, Skovlund E, Spigset O. Efficacy of Self-Administered Intranasal Oxytocin on Alcohol Use and Craving After Detoxification in Patients With Alcohol Dependence. A Double-Blind Placebo-Controlled Trial. Alcohol Alcohol 2020; 56:565-572. [PMID: 33352584 PMCID: PMC8406061 DOI: 10.1093/alcalc/agaa133] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 11/11/2020] [Accepted: 11/11/2020] [Indexed: 12/31/2022] Open
Abstract
Aims The aim of this study was to assess the efficacy of self-administered intranasal oxytocin on alcohol dependence after detoxification. Methods In a double-blind, randomized, placebo-controlled trial, 38 patients fulfilling the criteria for ICD-10 diagnosis of alcohol dependence received either 8 IU oxytocin or placebo at their own discretion up to thrice daily for 4 weeks, after completing detoxification. Primary outcome was alcohol intake specified as the amount of alcohol consumed, the number of days to relapse into alcohol use and the proportion of subjects relapsing. Secondary outcomes were self-reported symptoms of craving, sleep and mental distress. Results There were no significant differences between the oxytocin group and the placebo group in daily alcohol intake in total (mean 1.3 ± 2.9 vs. 2.0 ± 5.0 units; P = 0.63) or on drinking days (mean 8.4 ± 2.7 vs. 7.7 ± 6.0 units; P = 0.76), in the number of days until relapse (P = 0.91) or in the proportion of subjects relapsing (37.5 vs. 41.2%; P = 0.84). Neither were there any statistically significant differences in any other outcomes, except a larger decrease in self-reported nervousness in the oxytocin group (P = 0.022). Conclusion The results were inconclusive as to whether intranasal oxytocin reduced the time to relapse, degree of craving or total amount of alcohol consumed after detoxification. However, the oxytocin group had a larger decrease in self-reported nervousness.
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Affiliation(s)
- Katrine Melby
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology - NTNU, Trondheim, Norway.,Blue Cross Lade Addiction Treatment Centre, Trondheim, Norway.,Department of Clinical Pharmacology, St. Olav University Hospital, Trondheim, Norway
| | - Rolf W Gråwe
- Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology - NTNU, Trondheim, Norway.,Department of Research and Development, Division of Psychiatry, St. Olav University Hospital, Trondheim, Norway
| | - Trond O Aamo
- Blue Cross Lade Addiction Treatment Centre, Trondheim, Norway.,Department of Clinical Pharmacology, St. Olav University Hospital, Trondheim, Norway
| | - Eva Skovlund
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology - NTNU, Trondheim, Norway
| | - Olav Spigset
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology - NTNU, Trondheim, Norway.,Department of Clinical Pharmacology, St. Olav University Hospital, Trondheim, Norway
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Patel D, Sundar M, Lorenz E, Leong KC. Oxytocin Attenuates Expression, but Not Acquisition, of Sucrose Conditioned Place Preference in Rats. Front Behav Neurosci 2020; 14:603232. [PMID: 33384589 PMCID: PMC7769941 DOI: 10.3389/fnbeh.2020.603232] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Accepted: 11/17/2020] [Indexed: 01/02/2023] Open
Abstract
Maladaptation of reward processing for natural rewards, such as sucrose or sugar, may play a role in the development of diseases such as obesity and diabetes. Furthermore, uncovering mechanisms to disrupt or reverse maladaptation of reward-seeking behaviors for natural reinforcers can provide insight into treatment of such diseases, as well as disorders such as addiction. As such, studying the effects of potential pharmacotherapeutics on maladaptive sugar-seeking behavior offers valuable clinical significance. Sucrose conditioned place preference (CPP) paradigms can offer insight into aspects of reward processes as it provides a way to assess acquisition and expression of context-reward associations. The present study examined the effect of peripheral oxytocin injections on sucrose CPP in rats. Oxytocin, when administered prior to CPP test, attenuated expression of sucrose CPP. However, oxytocin, when administered during sucrose conditioning, did not affect subsequent place preference. These findings suggest oxytocin sufficiently attenuates expression of sucrose-associated place preference.
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Affiliation(s)
- Devon Patel
- Department of Psychology, Trinity University, San Antonio, TX, United States
| | - Megana Sundar
- Department of Psychology, Trinity University, San Antonio, TX, United States
| | - Eva Lorenz
- Department of Psychology, Trinity University, San Antonio, TX, United States
| | - Kah-Chung Leong
- Department of Psychology, Trinity University, San Antonio, TX, United States
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25
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Examining sex, adverse childhood experiences, and oxytocin on neuroendocrine reactivity in smokers. Psychoneuroendocrinology 2020; 120:104752. [PMID: 32634745 PMCID: PMC7502468 DOI: 10.1016/j.psyneuen.2020.104752] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 05/12/2020] [Accepted: 05/29/2020] [Indexed: 11/21/2022]
Abstract
Adverse childhood experiences (ACE) are associated with greater neuroendocrine responses to social stress in substance users. The neuropeptide oxytocin might attenuate this relationship. Given sex differences in ACE exposure and neuroendocrine stress reactivity, it is unknown whether this association is similar for males and females. Therefore, this secondary analysis evaluated the interactive effect of sex, ACE, and acute oxytocin administration on neuroendocrine stress responses in adult cigarette smokers (N = 144). Participants completed the Adverse Childhood Experiences Questionnaire at screening and were randomized to receive intranasal oxytocin or placebo before undergoing the Trier Social Stress Task (TSST). Cortisol levels were assessed at pre- and post-medication administration and at 20 and 40 min following the TSST. Generalized linear mixed models were developed to predict post-TSST cortisol levels. Predictors included treatment assignment (placebo vs. oxytocin), sex (male vs. female), ACE (0-10 total score), pre-medication cortisol levels, and minutes since medication administration. The hypothesized three-way interaction between sex, oxytocin, and ACE scores was significant. Linear associations between ACE scores and cortisol reactivity indicated higher ACE scores were associated with attenuated cortisol response in females, regardless of treatment condition. For males, higher ACE scores were associated with heightened cortisol response, an effect that was attenuated by oxytocin. Results indicate that the association between ACE and neuroendocrine reactivity to social stress, as well as the attenuating effect of oxytocin, is differentially impacted by sex. Males with greater childhood adversity may be more likely to benefit from oxytocin's anxiolytic properties.
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Van Hedger K, Bershad AK, Lee R, de Wit H. Effects of Intranasal Oxytocin on Stress-Induced Cigarette Craving in Daily Smokers. Nicotine Tob Res 2020; 22:89-95. [PMID: 30085292 DOI: 10.1093/ntr/nty159] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Cigarette smoking is a well-known public health concern, and there is an urgent need to develop new treatments to reduce smoking or facilitate abstinence. One factor that is known to contribute to relapse is stress, making the stress response an important target for treatment. The neuropeptide oxytocin (OT) is believed to have stress-reducing effects, and in addition there is evidence that it reduces drug craving. The purpose of the present study was to examine the effects of intranasal OT on stress-induced cigarette craving in regular smokers after 12 h of abstinence. METHOD Daily smokers (n = 48) completed a stress induction task and a nonstressful control task at two different sessions, receiving intranasal OT (40 IU) or placebo (PBO) before or after the task. Subjects were randomly assigned to one of three groups: Group PP (n = 16) received PBO before and after the stress/control tasks, Group OP (n = 16) received OT before the tasks and PBO after, and Group PO (n = 16) received PBO before the tasks and OT shortly after completing the tasks. Cigarette craving as well as subjective and physiological responses to stress was assessed. RESULTS OT did not alter responses to stress, whether it was administered before or after the stressful task, on measures of cigarette craving, anxiety, heart rate, blood pressure, and cortisol levels. CONCLUSIONS The current study findings do not support several previous reports that OT reduced either stress or drug craving. IMPLICATIONS This study finds a null result of the neuropeptide oxytocin on stress-induced cigarette craving. Reporting null findings is part of the process of identifying potential treatments for addictive disorders.
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Affiliation(s)
- Kathryne Van Hedger
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL
| | - Anya K Bershad
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL
| | - Royce Lee
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL
| | - Harriet de Wit
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL
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27
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Sherman BJ, Baker NL, Brady KT, Joseph JE, Nunn LM, McRae-Clark A. The effect of oxytocin, gender, and ovarian hormones on stress reactivity in individuals with cocaine use disorder. Psychopharmacology (Berl) 2020; 237:2031-2042. [PMID: 32388622 PMCID: PMC8210538 DOI: 10.1007/s00213-020-05516-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 04/01/2020] [Indexed: 12/22/2022]
Abstract
RATIONALE Cocaine use disorder (CUD) is associated with dysregulation of the hypothalamic-pituitary-adrenal axis, which plays a critical role in the human stress response. Men and women with CUD differ in reactivity to social stressors. The hypothalamic neuropeptide oxytocin is involved in anxiolytic and natural reward processes, and has shown therapeutic potential for addictive disorders and stress reduction. OBJECTIVES To examine the impact of oxytocin (oxytocin (OXY) vs. placebo (PBO)) and gender (female (F) vs. male (M)) on response to a social stress task in individuals with CUD. To explore whether ovarian hormones moderate this stress response. METHODS One hundred twelve adults with CUD were randomized to receive 40 IU intranasal oxytocin (n = 56) or matching placebo (n = 56). Forty minutes after drug administration, participants were exposed to a social stressor. Generalized linear mixed models were used to examine neuroendocrine (cortisol) and subjective (craving, stress) response at pre-stressor, stressor + 0, + 10, + 30, + 60 min. RESULTS Gender moderated the effect of oxytocin on neuroendocrine response (p = 0.048); women receiving oxytocin (F + OXY) showed blunted cortisol response compared to the other three groups (F + PBO; M + OXY; M + PBO). There was a main effect of gender on subjective stress response; women reported greater stress following the stressor compared to men (p = 0.016). Oxytocin had no significant effect on craving or stress, and gender did not moderate the effect of oxytocin on either measure. Higher endogenous progesterone was associated with lower craving response in women (p = 0.033). CONCLUSIONS Oxytocin may have differential effects in men and women with CUD. Women may be at greater risk for relapse in response to social stressors, but ovarian hormones may attenuate this effect.
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Affiliation(s)
- Brian J Sherman
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 125 Doughty Street, Suite 190, Charleston, SC, 29425, USA.
| | - Nathaniel L Baker
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Kathleen T Brady
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 125 Doughty Street, Suite 190, Charleston, SC, 29425, USA
- Ralph H. Johnson VA Medical Center, Charleston, SC, USA
| | - Jane E Joseph
- Department of Neuroscience, Medical University of South Carolina, Charleston, USA
| | - Lisa M Nunn
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 125 Doughty Street, Suite 190, Charleston, SC, 29425, USA
| | - Aimee McRae-Clark
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 125 Doughty Street, Suite 190, Charleston, SC, 29425, USA
- Ralph H. Johnson VA Medical Center, Charleston, SC, USA
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Flanagan JC, Mitchell JM, Baker NL, Woolley J, Wangelin B, Back SE, McQuaid JR, Neylan TC, Wolfe WR, Brady KT. Enhancing prolonged exposure therapy for PTSD among veterans with oxytocin: Design of a multisite randomized controlled trial. Contemp Clin Trials 2020; 95:106074. [PMID: 32561468 DOI: 10.1016/j.cct.2020.106074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 06/06/2020] [Accepted: 06/12/2020] [Indexed: 12/17/2022]
Abstract
Posttraumatic stress disorder (PTSD) is the most highly prevalent mental health disorder among U.S. military Veterans. Prolonged Exposure (PE) therapy is one of the most widely used evidence-based treatments for PTSD, but there is substantial room for improvement in outcomes and retention rates. Accumulating data suggest that oxytocin offers a promising pharmacological approach towards achieving this goal. Therefore, the primary objective of this two-site Phase II study is to examine the ability of oxytocin (vs. placebo) administration combined with PE therapy to (1) reduce PTSD symptom severity, (2) accelerate the rate of PTSD symptom improvement, and (3) improve PE adherence and retention rates. To accomplish these objectives, we will employ a randomized, double-blind, placebo-controlled trial and use standardized, repeated dependent measures of change at five time points (baseline, mid-treatment, end of treatment, and 3 and 6 month follow-up). Intranasal oxytocin (40 IU) will be administered directly prior to each PE therapy session. Findings from this study will provide critical new information regarding the efficacy of oxytocin to augment psychosocial treatment for PTSD, as well as information regarding the physiological mechanisms underlying PTSD and positive treatment response. ClinicalTrials.gov Identifier: NCT04228289.
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Affiliation(s)
- Julianne C Flanagan
- Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, USA; Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, USA.
| | - Jennifer M Mitchell
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA; Department of Neurology, University of California San Francisco, San Francisco, CA, USA; San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA.
| | - Nathaniel L Baker
- Department of Public Health Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, USA.
| | - Joshua Woolley
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA; San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA.
| | - Bethany Wangelin
- Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, USA; Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, USA.
| | - Sudie E Back
- Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, USA; Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, USA.
| | - John R McQuaid
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA; San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA.
| | - Thomas C Neylan
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA; Department of Neurology, University of California San Francisco, San Francisco, CA, USA; San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA.
| | - William R Wolfe
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA; San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA.
| | - Kathleen T Brady
- Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, USA; Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, USA.
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Leone RM, Jarnecke AM, Back SE, Brady KT, Flanagan JC. The moderating role of infidelity on the relation between oxytocin and conflict behaviors among substance misusing couples. Exp Clin Psychopharmacol 2020; 28:251-257. [PMID: 31556677 PMCID: PMC7096267 DOI: 10.1037/pha0000320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The neuropeptide oxytocin (OT) may be beneficial to augmenting behavioral therapies for couples given its ability to alleviate stress reactivity and increase pro-social behavior. However, there is growing evidence demonstrating inconsistent effects of OT on social behavior. Infidelity may represent a relational vulnerability that modulates the OT response. The present study hypothesized that actor and partner emotional and physical infidelity would be associated with less adaptive conflict behaviors, and moderate the OT response, such that participants randomized to a OT condition, compared to placebo, who report more infidelity would show less adaptive conflict behaviors. Participants were 30 couples (N = 60) wherein one or both partners engaged in recent hazardous drinking or illicit drug use. Partners completed a 10-min dyadic conflict task in the laboratory, self-administered a single intranasal dose of OT (40 IU) or placebo, and then completed the same 10-min dyadic conflict task following a 45-min wait period. Couple conflict behaviors were observed during the conflict tasks and assessed using a validated coding system. Actor partner interdependence models detected significant interactions between drug condition and physical infidelity, such that among individuals in the OT group, verses individuals in the placebo group, (a) who reported greater physical infidelity had greater distress maintaining attributions and (b) whose partners reported greater physical infidelity had fewer relationship enhancing attributions. Results are consistent with the social salience hypothesis of OT and suggest that physical infidelity appears to serve as a contextual vulnerability that may decreases positive and increase negative behaviors during conflict. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
| | | | - Sudie E. Back
- Medical University of South Carolina,Ralph H. Johnson VA Medical Center, Charleston, South Carolina
| | - Kathleen T. Brady
- Medical University of South Carolina,Ralph H. Johnson VA Medical Center, Charleston, South Carolina
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Peris J, Steck MR, Krause EG. Oxytocin treatment for alcoholism: Potential neurocircuitry targets. Neuropharmacology 2020; 171:108091. [PMID: 32304701 DOI: 10.1016/j.neuropharm.2020.108091] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Revised: 03/19/2020] [Accepted: 04/03/2020] [Indexed: 12/19/2022]
Abstract
Oxytocin (OT) has gained considerable interest in recent years as a potential treatment for alcoholism and other substance use disorders. Evidence continues to mount that OT administered either centrally, peripherally or intranasally can decrease ethanol intake in both humans and animal models. The potential mechanisms for the ability of OT to decrease ethanol reward, and importantly, cue- and stress-induced ethanol relapse, are explored by reviewing the specific neuronal circuits involved in mediating these actions and their sensitivity to OT. In addition to dopamine neurons that project from ventral tegmental area (VTA) to nucleus accumbens (NAc) to signal positively reinforcing events, OT receptors (OxTR) are also expressed by dopamine neurons that project from VTA to brain regions that can convey aversive properties of a stimulus. Moreover, OxTR are expressed by non-dopaminergic neurons in the VTA, such as GABA and glutamate neurons, which can both modulate the activity of dopamine VTA neurons locally (in opposite directions) or can project to other brain regions, including the NAc, where it can alter either positive reinforcement or aversion caused by ethanol. The ability of OT to regulate limbic circuitry and the hypothalamic-pituitary-adrenal axis is discussed as a potential mechanism for the ability of OT to inhibit ethanol-induced negative reinforcement. Together, understanding the diversity and complexity of OT regulation of ethanol reward may contribute to more effective use of OT as pharmacotherapy for alcohol use disorder. This article is part of the special issue on Neuropeptides.
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Affiliation(s)
- Joanna Peris
- Department of Pharmacodynamics, University of Florida, Gainesville, FL, 32610, USA.
| | - Madeline R Steck
- Department of Pharmacodynamics, University of Florida, Gainesville, FL, 32610, USA
| | - Eric G Krause
- Department of Pharmacodynamics, University of Florida, Gainesville, FL, 32610, USA
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Van Hedger K, Kushner MJ, Lee R, de Wit H. Oxytocin Reduces Cigarette Consumption in Daily Smokers. Nicotine Tob Res 2020; 21:799-804. [PMID: 29701814 DOI: 10.1093/ntr/nty080] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 04/24/2018] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Despite widespread knowledge of the dangers of cigarette consumption, smoking continues to be a public health concern. One compound that has shown potential for treatment in preclinical models is the neuropeptide oxytocin (OT). The purpose of the present study was to examine the effects of intranasal oxytocin on cigarette craving, behavioral economic demand for cigarettes, and cigarette consumption, in regular smokers after 18 hours of abstinence. METHOD Otherwise healthy daily smokers (n = 35) completed two sessions where they received OT (40 IU intranasal) or placebo (PBO) and completed measures of craving and cigarette demand, and they were given six opportunities to smoke partial cigarettes in exchange for money. RESULTS On average participants smoked few cigarettes after receiving OT than after receiving PBO, and they reported less desire for additional cigarettes during the smoking period. OT did not affect cigarette demand or standardized measures of cigarette craving. CONCLUSIONS This study suggests that OT decreases some indices of smoking desire and consumption, providing modest support for the idea that OT might be effective for reducing cigarette smoking. IMPLICATIONS This study provides new evidence that oxytocin might have clinical value in the treatment of addictive disorders, in this case tobacco addiction. The study adds to a growing literature suggesting that this neuropeptide, which is mainly known for its role in social bonding and attachment, may also affect mood and motivational states relevant to addiction.
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Affiliation(s)
- Kathryne Van Hedger
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL
| | - Meredith J Kushner
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL
| | - Royce Lee
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL
| | - Harriet de Wit
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL
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King CE, Gano A, Becker HC. The role of oxytocin in alcohol and drug abuse. Brain Res 2020; 1736:146761. [PMID: 32142721 DOI: 10.1016/j.brainres.2020.146761] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 02/28/2020] [Accepted: 03/02/2020] [Indexed: 02/07/2023]
Abstract
The neuropeptide oxytocin (OXT) plays a key role in adaptive processes associated with reward, tolerance, memory and stress responses. Through interactions with brain reward and stress systems, OXT is known to play a role in several neuropsychiatric disorders, particularly those that involve altered social integration, such as alcohol and drug addiction (Heilig et al., 2016). As such, there is growing interest in the oxytocin system as a potential therapeutic target for the treatment of alcohol and substance use disorders. Accumulating preclinical evidence suggests that administration of OXT influences the development of tolerance, sensitization and withdrawal symptoms, and modulates numerous alcohol/drug-seeking and alcohol/drug-taking behaviors. Further, there is some evidence to suggest that OXT may help to reverse neuroadaptations that occur as a result of chronic alcohol or drug exposure. To date, there have been only a handful of clinical studies conducted in alcohol and drug dependent populations. This review summarizes the preclinical and clinical literature on the effects of OXT administration on alcohol- and drug-related behaviors. In addition, we discuss OXT interactions with the hypothalamic-pituitaryadrenal axis and multiple neurotransmitter systems within addiction circuitry.
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Affiliation(s)
- Courtney E King
- Charleston Alcohol Research Center, Department of Psychiatry and Neuroscience, Medical University of South Carolina & VAMC, Charleston, SC 29425, United States
| | - Anny Gano
- Charleston Alcohol Research Center, Department of Psychiatry and Neuroscience, Medical University of South Carolina & VAMC, Charleston, SC 29425, United States
| | - Howard C Becker
- Charleston Alcohol Research Center, Department of Psychiatry and Neuroscience, Medical University of South Carolina & VAMC, Charleston, SC 29425, United States.
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McClure EA, Baker NL, Gray KM, Hood CO, Tomko RL, Carpenter MJ, Ramakrishnan VR, Buchanan CJ, Saladin ME. The influence of gender and oxytocin on stress reactivity, cigarette craving, and smoking in a randomized, placebo-controlled laboratory relapse paradigm. Psychopharmacology (Berl) 2020; 237:543-555. [PMID: 31792646 PMCID: PMC7024045 DOI: 10.1007/s00213-019-05392-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 11/04/2019] [Indexed: 12/11/2022]
Abstract
RATIONALE Female cigarette smokers tend to show greater cessation failure compared with males. Variables that contribute to the maintenance of smoking, including stress and craving, may differentially impact male and female smokers. Novel pharmacotherapies, such as oxytocin, may attenuate stress reactivity and craving in smokers, but work in this area is limited. OBJECTIVES This study assessed the influence of gender and oxytocin on stress reactivity, craving, and smoking in a randomized, placebo-controlled laboratory relapse paradigm. METHODS Male and female adult cigarette smokers (ages 18-45) were enrolled (women oversampled 2:1) and completed a laboratory session, in which intranasal oxytocin or placebo was administered followed by a laboratory social stress task. The role of gender and oxytocin were assessed on measures of stress reactivity, cigarette craving, latency to smoke in a resistance task, subjective responses to smoking, and ad-libitum smoking. RESULTS Participants (N = 144) had a mean age of 31 were 63% female and 56% White. Following stress induction, female smokers evidenced greater subjective stress than males, though males demonstrated greater neuroendocrine reactivity and smoking intensity than females. No gender differences were demonstrated for craving. Oxytocin did not attenuate any aspect of stress reactivity, craving, smoking, or subjective responses to smoking compared with placebo. CONCLUSIONS Gender differences in stress reactivity were shown in the hypothesized direction, but oxytocin appeared to exert little impact on subjective or behavioral metrics. Results highlight the complex relationship between gender, stress, and smoking, as well as the implications for oxytocin as a potential pharmacotherapy for smoking cessation.
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Affiliation(s)
- Erin A McClure
- Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, USA.
| | - Nathaniel L Baker
- Department of Public Health Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Kevin M Gray
- Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Caitlyn O Hood
- Department of Psychology, College of Arts & Sciences, University of Kentucky, Lexington, KY, USA
| | - Rachel L Tomko
- Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Matthew J Carpenter
- Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, USA
- Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA
| | - Viswanathan R Ramakrishnan
- Department of Public Health Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Cole J Buchanan
- College of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Michael E Saladin
- Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, SC, USA
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Fan XY, Shi G, Zhao P. Methylation in Syn and Psd95 genes underlie the inhibitory effect of oxytocin on oxycodone-induced conditioned place preference. Eur Neuropsychopharmacol 2019; 29:1464-1475. [PMID: 31735530 DOI: 10.1016/j.euroneuro.2019.10.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 10/02/2019] [Accepted: 10/29/2019] [Indexed: 12/12/2022]
Abstract
Oxycodone (Oxy) is one of the most effective analgesics in medicine, but is associated with the development of dependence. Recent studies demonstrating epigenetic changes in the brain after exposure to opiates have provided an insight into possible mechanisms underlying addiction. Oxytocin (OT), an endogenous neuropeptide well known for preventing drug abuse, is a promising pharmacotherapy to counteract addiction. Therefore, we explored the mechanism of Oxy addiction and the role of OT in Oxy-induced epigenetic alterations. In this study, drug-induced changes in conditioned place preference (CPP), i.e. the expression of synaptic proteins and synaptic density in the ventral tegmental area (VTA) were measured. We also sought to identify DNA methyltransferases (DNMTs), ten-eleven translocations (TETs), global 5-methylcytosine (5-mC), and DNA methylation of two genes implicated in plasticity (Synaptophysin, Syn; Post-synaptic density protein 95, Psd95). Oxy (3.0 mg/kg, i.p.) induced CPP acquisition in Sprague-Dawley rats. Oxy down-regulated DNMT1 and up-regulated TET1-3, leading to a decrease in global 5-mC levels and differential demethylation at exon 1 of Syn and exon 2 of Psd95. These changes in DNA methylation of Syn and Psd95 elevated the expression of synaptic proteins (SYN, PSD95) and synaptic density in the VTA. Pretreatment with OT (2.5 µg, i.c.v.) via its receptor specifically blocked Oxy CPP, normalized synaptic density, and regulated DNMT1 and TET2-3 causing reverse of DNA demethylation of Syn and Psd95. DNA methylation is an important gene regulation mechanism underlying Oxy CPP, and OT - via its receptor - could specifically inhibit Oxy addiction.
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Affiliation(s)
- Xin-Yu Fan
- Department of Anesthesiology, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, 110004, Shenyang, China
| | - Guang Shi
- Department of Neurology, Liaoning Provincial People's Hospital, Shenyang, China
| | - Ping Zhao
- Department of Anesthesiology, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, 110004, Shenyang, China.
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Joseph JE, McRae-Clark A, Sherman BJ, Baker NL, Moran-Santa Maria M, Brady KT. Neural correlates of oxytocin and cue reactivity in cocaine-dependent men and women with and without childhood trauma. Psychopharmacology (Berl) 2019:10.1007/s00213-019-05360-7. [PMID: 31701163 PMCID: PMC8815182 DOI: 10.1007/s00213-019-05360-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 09/11/2019] [Indexed: 02/07/2023]
Abstract
RATIONALE Women with cocaine use disorder have worse treatment outcomes compared with men. Sex differences in cocaine addiction may be driven by differences in neurobiology or stress reactivity. Oxytocin is a potential therapeutic for stress reduction in substance use disorders, but no studies have examined the effect of oxytocin on neural response to drug cues in individuals with cocaine use disorders or potential sex differences in this response. OBJECTIVES The goal of this study was to examine the effect of intranasal oxytocin on cocaine cue reactivity in cocaine dependence, modulated by gender and history of childhood trauma. METHODS Cocaine-dependent men with (n = 24) or without (n = 19) a history of childhood trauma and cocaine-dependent women with (n = 16) or without (n = 8) a history of childhood trauma completed an fMRI cocaine cue reactivity task under intranasal placebo or oxytocin (40 IU) on two different days. fMRI response was measured in the right amygdala and dorsomedial prefrontal cortex (DMPFC). RESULTS In the DMPFC, oxytocin reduced fMRI response to cocaine cues across all subject groups. However, in the amygdala, only men with a history of childhood trauma showed a significantly reduced fMRI response to cocaine cues on oxytocin versus placebo, while women with a history of childhood trauma showed an enhanced amygdala response to cocaine cues following oxytocin administration. Cocaine-dependent subjects with no history of childhood trauma showed no effect of oxytocin on amygdala response. CONCLUSIONS Oxytocin can reduce cue reactivity in cocaine dependence, but its effect is modified by sex and childhood trauma history. Whereas men with cocaine dependence may benefit from oxytocin administration, additional studies are needed to determine whether oxytocin can be an effective therapeutic for cocaine-dependent women.
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Affiliation(s)
- Jane E Joseph
- Department of Neuroscience, Medical University of South Carolina, 96 Jonathan Lucas St., Clinical Sciences Building Room 325E, Charleston, SC, 29425, USA.
| | - Aimee McRae-Clark
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 96 Jonathan Lucas St., Clinical Sciences Building Room 325E, Charleston, SC, 29425, USA
- Ralph H. Johnson VA Medical Center, Charleston, SC, USA
| | - Brian J Sherman
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 96 Jonathan Lucas St., Clinical Sciences Building Room 325E, Charleston, SC, 29425, USA
| | - Nathaniel L Baker
- Department of Public Health Sciences, Medical University of South Carolina, 96 Jonathan Lucas St., Clinical Sciences Building Room 325E, Charleston, SC, 29425, USA
| | - Megan Moran-Santa Maria
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 96 Jonathan Lucas St., Clinical Sciences Building Room 325E, Charleston, SC, 29425, USA
| | - Kathleen T Brady
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 96 Jonathan Lucas St., Clinical Sciences Building Room 325E, Charleston, SC, 29425, USA
- Ralph H. Johnson VA Medical Center, Charleston, SC, USA
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Joseph JE, Vaughan BK, Camp CC, Baker NL, Sherman BJ, Moran-Santa Maria M, McRae-Clark A, Brady KT. Oxytocin-Induced Changes in Intrinsic Network Connectivity in Cocaine Use Disorder: Modulation by Gender, Childhood Trauma, and Years of Use. Front Psychiatry 2019; 10:502. [PMID: 31379621 PMCID: PMC6658612 DOI: 10.3389/fpsyt.2019.00502] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Accepted: 06/25/2019] [Indexed: 12/11/2022] Open
Abstract
Cocaine use disorder (CUD) is a major public health concern with devastating social, economic, and mental health implications. A better understanding of the underlying neurobiology and phenotypic variations in individuals with CUD is necessary for the development of effective and targeted treatments. In this study, 39 women and 54 men with CUD completed a 6-min resting-state functional magnetic resonance imaging scan after intranasal oxytocin (OXY) or placebo administration. Graph-theory network analysis was used to quantify functional connectivity changes caused by OXY in striatum, anterior cingulate cortex (ACC), insula, and amygdala nodes of interest. OXY increased connectivity in the right ACC and left amygdala in males, whereas OXY increased connectivity in the right ACC and right accumbens in females. Machine learning was then used to associate treatment response (placebo minus OXY) in nodes of interest with years of cocaine use and severity of childhood trauma separately for males and females. Childhood trauma and years of cocaine use were associated with OXY-induced changes in ACC connectivity for both men and women, but connectivity changes in the amygdala were associated with years of cocaine use in men and connectivity changes in the right insula were associated with years of cocaine use in women. These findings suggest that salience network nodes (ACC and insula) are potential OXY treatment targets in CUD, with the amygdala as a treatment target for men and the accumbens as a treatment target for women.
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Affiliation(s)
- Jane E. Joseph
- Department of Neuroscience, Medical University of South Carolina, Charleston, SC, United States
| | - Brandon K. Vaughan
- Department of Neuroscience, Medical University of South Carolina, Charleston, SC, United States
| | - Christopher C. Camp
- Department of Neuroscience, Medical University of South Carolina, Charleston, SC, United States
| | - Nathaniel L. Baker
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Brian J. Sherman
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Megan Moran-Santa Maria
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Aimee McRae-Clark
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
- Ralph H. Johnson VA Medical Center, Charleston, SC, United States
| | - Kathleen T. Brady
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
- Ralph H. Johnson VA Medical Center, Charleston, SC, United States
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Estes MK, Freels TG, Prater WT, Lester DB. Systemic oxytocin administration alters mesolimbic dopamine release in mice. Neuroscience 2019; 408:226-238. [DOI: 10.1016/j.neuroscience.2019.04.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 03/28/2019] [Accepted: 04/02/2019] [Indexed: 12/16/2022]
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Design of a randomized controlled trial examining the efficacy of oxytocin to enhance alcohol behavioral couple therapy. Contemp Clin Trials 2019; 82:1-8. [PMID: 31063869 DOI: 10.1016/j.cct.2019.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Revised: 04/20/2019] [Accepted: 05/02/2019] [Indexed: 12/15/2022]
Abstract
Combining pharmacological interventions with evidence-based behavioral interventions may help optimize treatment outcomes for alcohol use disorder (AUD). While several effective behavioral interventions for AUD have been developed, the vast majority target individual patients, despite evidence that behavioral interventions for couples have the ability to outperform individual treatments for AUD. Alcohol Behavioral Couples Therapy (ABCT) is an evidence-based behavioral intervention for couples that has been shown to significantly reduce AUD severity as well as improve relationship functioning. Accumulating evidence suggests that the neuropeptide oxytocin has the ability to reduce alcohol craving and consumption, symptoms of tolerance and withdrawal, and ameliorate neurobiological deficits associated with AUD. Furthermore, oxytocin has demonstrated the ability to increase prosocial behavior and cognition, and restore sensitivity to natural rewards such as interpersonal relationships. No study to date has examined the ability of oxytocin to enhance ABCT. Thus, the primary objective of this Phase II study is to examine the effects of oxytocin versus placebo in combination with ABCT in reducing AUD severity and improving relationship functioning. We also will utilize neuroimaging techniques before and after treatment to investigate the underlying pathophysiology of AUD among couples and identify prognostic indicators of treatment outcome. The findings from this study might provide critical new information to help inform clinical practice and accelerate research on the pharmacological treatment of AUD.
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Flanagan JC, Mitchell JM. Augmenting Treatment for Posttraumatic Stress Disorder and Co-Occurring Conditions with Oxytocin. ACTA ACUST UNITED AC 2019; 6:132-142. [PMID: 31763133 DOI: 10.1007/s40501-019-00171-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Purpose of review The goal of this manuscript is to review the extant literature examining the neurobiological and behavioral mechanisms underlying the potential utility of intranasal oxytocin as a novel pharmacologic intervention for the treatment of posttraumatic stress disorder (PTSD), and for the treatment of co-morbid PTSD and alcohol and substance use disorders. Recent findings Research indicates that intranasal oxytocin is a low-cost and easily accessible medication with an excellent safety profile. Oxytocin holds promise for facilitating more effective PTSD treatment, particularly when used in combination with evidence-supported psychotherapy interventions. There is still a significant need to identify the mechanisms of action underlying oxytocin treatment of PTSD, and to maximize methods of nasal spray delivery, examine dose-response outcomes, and clarify the characteristics of individuals and populations that are most likely to benefit from adjunctive oxytocin treatment. Summary Collectively, preclinical and human laboratory research suggest that oxytocin may be an effective mechanism by which treatment outcomes for PTSD and common comorbidities can be enhanced. Adequately powered randomized controlled trials are needed to address efficacy, identify predictors of treatment outcome, and to assess the use of intranasal oxytocin within appropriate PTSD populations.
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Affiliation(s)
- Julianne C Flanagan
- Department of Psychiatry, Medical University of South Carolina, Charleston, SC
| | - Jennifer M Mitchell
- Department of Neurology, University of California San Francisco, San Francisco, CA.,Department of Psychiatry, University of California San Francisco, San Francisco, CA
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Solomon DT, Nietert PJ, Calhoun C, Smith DW, Back SE, Barden E, Brady KT, Flanagan JC. Effects of Oxytocin on Emotional and Physiological Responses to Conflict in Couples with Substance Misuse. ACTA ACUST UNITED AC 2019; 7:91-102. [PMID: 30740265 DOI: 10.1037/cfp0000103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Social stress, especially dyadic conflict among couples, is an important correlate of addiction. Several authors have suggested that the neuropeptide oxytocin (OT) may be useful in the treatment of couples with substance misuse. However, the literature examining OT among couples is scant and has yielded mixed findings. The current study examined the effects of OT versus placebo on emotional (e.g., warmth and anger) and physiological (e.g., skin conductance and heart rate) reactivity to a conflict resolution task in 30 heterosexual couples (N=60) in which one or both members misused substances. Using a randomized, double-blind, placebo-controlled design, both partners within each dyad were randomized to the same treatment condition. Participants completed a standardized conflict resolution task at baseline and 45 minutes following drug self-administration. Physiological measures were examined continuously during the laboratory tasks and emotional reactivity was self-reported at baseline and at 5 time points over the course of 1 hour following the second conflict resolution task. Results of a multi-level growth curve model accounting for baseline scores, gender and drug condition indicate that positive emotional experiences and skin conductance measures increased over the 5 time points. Neither drug condition nor gender was significantly related to outcomes, and no interaction effects were observed. These findings highlight the complexities involved in translational OT research and suggest that the impact of OT on key outcomes requires further exploration in regards to OT's potential therapeutic benefit.
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Affiliation(s)
| | | | - Casey Calhoun
- Medical University of South Carolina, Charleston, SC
| | | | - Sudie E Back
- Medical University of South Carolina, Charleston, SC.,Ralph H. Johnson VAMC, Charleston, SC
| | - Eileen Barden
- Medical University of South Carolina, Charleston, SC
| | - Kathleen T Brady
- Medical University of South Carolina, Charleston, SC.,Ralph H. Johnson VAMC, Charleston, SC
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Flanagan JC, Allan NP, Calhoun CD, Badour CL, Moran-Santa Maria M, Brady KT, Back SE. Effects of oxytocin on stress reactivity and craving in veterans with co-occurring PTSD and alcohol use disorder. Exp Clin Psychopharmacol 2019; 27:45-54. [PMID: 30382728 PMCID: PMC6355345 DOI: 10.1037/pha0000232] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) are highly prevalent and commonly co-occur. The dual diagnosis of PTSD/AUD is associated with serious negative sequalae, and there are currently no effective pharmacological treatments for this comorbidity. Both PTSD and AUD are characterized by dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, which helps modulate stress reactivity. Oxytocin, a neuropeptide that attenuates HPA axis dysregulation, may be beneficial for individuals with co-occurring PTSD/AUD. Thus, the current study examined the effects of intranasal oxytocin (40 IU) as compared with placebo on stress reactivity (e.g., cortisol) as well as subjective alcohol craving in response to a laboratory stress task (Trier Social Stress Task). Participants were 67 male U.S. military veterans with current PTSD and AUD (oxytocin n = 32, placebo n = 35; overall mean age = 49.06 years). Baseline cortisol levels were examined as a moderator of outcome. The findings revealed that oxytocin marginally attenuated cortisol reactivity in response to the stress task. Furthermore, oxytocin's effect was moderated by baseline cortisol level, such that oxytocin mitigated cortisol reactivity to a greater extent among participants with higher, as compared with lower, baseline cortisol. Oxytocin did not reduce craving. Although preliminary, the findings are the first to examine oxytocin in co-occurring PTSD/AUD. The findings from this study contribute to the growing literature examining the potential utility of oxytocin among individuals with psychiatric disorders, such as PTSD and substance use disorders. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Julianne C. Flanagan
- Medical University of South Carolina, Department of Psychiatry and Behavioral Sciences
| | | | - Casey D. Calhoun
- Medical University of South Carolina, Department of Psychiatry and Behavioral Sciences
| | | | | | - Kathleen T. Brady
- Medical University of South Carolina, Department of Psychiatry and Behavioral Sciences
- Ralph H. Johnson VAMC
| | - Sudie E. Back
- Medical University of South Carolina, Department of Psychiatry and Behavioral Sciences
- Ralph H. Johnson VAMC
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Reed SC, Haney M, Manubay J, Campagna BR, Reed B, Foltin RW, Evans SM. Sex differences in stress reactivity after intranasal oxytocin in recreational cannabis users. Pharmacol Biochem Behav 2018; 176:72-82. [PMID: 30521833 DOI: 10.1016/j.pbb.2018.11.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 10/30/2018] [Accepted: 11/26/2018] [Indexed: 12/25/2022]
Abstract
Cannabis is the most widely used illicit drugs and the changing legal, political and cultural climate will likely increase cannabis use further. One factor that may underlie the transition from recreational use to problematic use is stress. The hormone oxytocin (OXT) modulates stress and may have therapeutic efficacy for substance use disorders, but few studies have examined OXT in cannabis users. Another factor is sex; although more men smoke cannabis, the transition from recreational to problematic use is faster in women. Using a within-subjects design, the effects of intranasal (i.n.) oxytocin (OXT; 40 IU) administration on stress reactivity (using the Trier Social Stress Test; TSST) and cannabis (5.6% THC) self-administration was assessed in recreational cannabis using men (n = 31) and women (n = 32) relative to i.n. placebo (PBO) and no-stress (NST) conditions. The TSST produced expected subjective and cardiovascular effects compared to the NST. However, in the i.n. OXT-TSST condition, positive subjective effects were lower and negative subjective effects were higher in women compared to PBO administration and compared to men. Further, latency to self-administer cannabis was longer in women than men and women self-administered less cannabis than men regardless of stress condition. There were no differences in cannabis craving as a function of sex, stress, or medication. These results suggest that OXT administration may lead to greater stress reactivity in recreational cannabis users, particularly women, and support growing evidence that sex differences should be carefully considered when examining the therapeutic potential of OXT.
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Affiliation(s)
- Stephanie C Reed
- New York State Psychiatric Institute, New York, NY, United States of America; Columbia University Medical Center, New York, NY, United States of America.
| | - Margaret Haney
- New York State Psychiatric Institute, New York, NY, United States of America; Columbia University Medical Center, New York, NY, United States of America
| | - Jeanne Manubay
- New York State Psychiatric Institute, New York, NY, United States of America; Columbia University Medical Center, New York, NY, United States of America
| | - Bianca R Campagna
- New York State Psychiatric Institute, New York, NY, United States of America
| | - Brian Reed
- Rockefeller University, New York, NY, United States of America
| | - Richard W Foltin
- New York State Psychiatric Institute, New York, NY, United States of America; Columbia University Medical Center, New York, NY, United States of America
| | - Suzette M Evans
- New York State Psychiatric Institute, New York, NY, United States of America; Columbia University Medical Center, New York, NY, United States of America
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Ferrer-Pérez C, Castro-Zavala A, Luján MÁ, Filarowska J, Ballestín R, Miñarro J, Valverde O, Rodríguez-Arias M. Oxytocin prevents the increase of cocaine-related responses produced by social defeat. Neuropharmacology 2018; 146:50-64. [PMID: 30448423 DOI: 10.1016/j.neuropharm.2018.11.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 11/08/2018] [Accepted: 11/09/2018] [Indexed: 12/17/2022]
Abstract
The neuropeptide oxytocin (OXT) plays a critical role in the regulation of social and emotional behaviors. OXT plays a role in stress response and in drug reward, but to date no studies have evaluated its implication in the long-lasting increase of the motivational effects of cocaine induced by repeated social defeat (RSD). During the social defeat procedure, 1 mg/kg of OXT was administered 30 min before each episode of RSD. Three weeks after the last defeat, the effects of cocaine on the conditioned place preference (CPP), locomotor sensitization and the self-administration (SA) paradigms were evaluated. The influence of OXT on the levels of BDNF in the prefrontal cortex (PFC), striatum and hippocampus was also measured. Our results confirm that raising the levels of OXT during social defeat stress can block the long-lasting effects of this type of stress. OXT counteracts the anxiety induced by social defeat and modifies BDNF levels in all the structures we have studied. Moreover, OXT prevents RSD-induced increases in the motivational effects of cocaine. Administration of OXT before each social defeat blocked the social defeat-induced increment in the conditioned rewarding effects of cocaine in the CPP, favored the extinction of cocaine-associated memories in both the CPP and SA, and decreased reinstatement of cocaine-seeking behavior in the SA. In conclusion, the long-lasting effects of RSD are counteracted by administering OXT prior to stress, and changes in BDNF expression may underlie these protective effects.
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Affiliation(s)
- Carmen Ferrer-Pérez
- Unit of Research on Psychobiology of Drug Dependence, Department of Psychobiology, Faculty of Psychology, Universitat de València, Valencia, Spain
| | - Adriana Castro-Zavala
- Neurobiology of Behavior Research Group (GReNeC-NeuroBio), Department of Health and Experimental Sciences, University Pompeu Fabra, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Miguel Ángel Luján
- Neurobiology of Behavior Research Group (GReNeC-NeuroBio), Department of Health and Experimental Sciences, University Pompeu Fabra, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Joanna Filarowska
- Department of Pharmacology and Pharmacodynamics, Medical University of Lublin, Chodzki 4a, 20-093, Lublin, Poland
| | - Raúl Ballestín
- Unit of Research on Psychobiology of Drug Dependence, Department of Psychobiology, Faculty of Psychology, Universitat de València, Valencia, Spain
| | - José Miñarro
- Unit of Research on Psychobiology of Drug Dependence, Department of Psychobiology, Faculty of Psychology, Universitat de València, Valencia, Spain
| | - Olga Valverde
- Neurobiology of Behavior Research Group (GReNeC-NeuroBio), Department of Health and Experimental Sciences, University Pompeu Fabra, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Marta Rodríguez-Arias
- Unit of Research on Psychobiology of Drug Dependence, Department of Psychobiology, Faculty of Psychology, Universitat de València, Valencia, Spain.
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Baracz SJ, Everett NA, Cornish JL. The impact of early life stress on the central oxytocin system and susceptibility for drug addiction: Applicability of oxytocin as a pharmacotherapy. Neurosci Biobehav Rev 2018; 110:114-132. [PMID: 30172802 DOI: 10.1016/j.neubiorev.2018.08.014] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 08/23/2018] [Accepted: 08/27/2018] [Indexed: 12/14/2022]
Abstract
Early life trauma is strongly associated with an increased vulnerability to abuse illicit drugs and the impairment of neural development. This includes alterations to the development of the oxytocin system, which plays a pivotal role in the regulation of social behaviours and emotion. Dysregulation of this important system also contributes to increased susceptibility to develop drug addiction. In this review, we provide an overview of the animal models of early life stress that are widely used, and discuss the impact that early life stress has on drug-taking behaviour in adolescence and adulthood in both sexes. We link this to the changes that early life stress has on the endogenous oxytocin system, and how exogenously administered oxytocin may help to re-establish functioning of the system, and in turn, reduce drug-taking behaviour.
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Affiliation(s)
- Sarah J Baracz
- Department of Psychology, Macquarie University, North Ryde, NSW, 2109, Australia.
| | - Nicholas A Everett
- Department of Psychology, Macquarie University, North Ryde, NSW, 2109, Australia
| | - Jennifer L Cornish
- Department of Psychology, Macquarie University, North Ryde, NSW, 2109, Australia
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Abstract
Interest for the use of oxytocin as a treatment for addiction began over 40years ago. Better known for its roles in parturition, lactation and pair bonding, oxytocin also has anxiolytic properties, reduces immune and inflammatory responses, and has a role in learning and memory. In this chapter, oxytocin effects on addiction processes are described by highlighting research findings that have used oxytocin within current preclinical animal models of addiction, relapse, or craving. First, we provide a brief background of the endogenous oxytocin system followed by descriptions of the behavioral models used to study addiction, including models of drug taking and seeking. Then we review recent preclinical studies that have used oxytocin as a therapeutic intervention throughout multiple stages of the addiction cycle from a behavioral and neurobiological perspective. These models encompass the entire range of the addiction cycle including acquisition and maintenance of drug taking, withdrawal and craving during periods of drug abstinence, and ultimately relapse. We then posit several theories about how oxytocin interacts with both drug and social reward, as well as presenting a mechanistic account of how specific oxytocin receptor localization may contribute to oxytocin's efficacy as an addiction therapeutic.
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Abstract
Accumulating research indicates oxytocin plays a significant role in regulating the behavioral and neurobiological responses to stress. Evidence from preclinical models suggests the effect of oxytocin on stress-responsivity appears to be dependent on individual characteristics, including sex. Although the interaction between oxytocinergic and stress systems has been widely studied in rodents, recent efforts have been made to examine the interface between these two systems in humans. This brief review examines how administration of oxytocin can influence the neuroendocrine, behavioral, and neural responses to stress, explores how sex may impact these effects, and provides considerations for future work.
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Vena A, King A, Lee R, de Wit H. Intranasal Oxytocin Does Not Modulate Responses to Alcohol in Social Drinkers. Alcohol Clin Exp Res 2018; 42:1725-1734. [PMID: 29917245 DOI: 10.1111/acer.13814] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 06/12/2018] [Indexed: 01/08/2023]
Abstract
BACKGROUND Preclinical and clinical evidence suggest that the neuropeptide oxytocin may be of value in treating alcohol use disorder, by either reducing the rewarding effects of alcohol or reducing negative affect induced by alcohol withdrawal. However, the effect of a single dose of oxytocin on subjective and psychomotor responses to alcohol in social drinkers is not known. METHODS This study examined the effect of intranasal oxytocin on subjective, behavioral, and physiological responses to a moderate dose of alcohol (0.8 g/kg) in young adult social drinkers. Participants (N = 35) completed 2 study sessions at which they consumed beverages containing alcohol (ALC; N = 20) or placebo (NoALC; N = 15) in combination with intranasal oxytocin (40 IU with a 20 IU booster) or placebo. They received oxytocin at one session and placebo at the other session (order counterbalanced) 20 minutes before consuming beverages. Subjective mood and drug effects ratings, heart rate and blood pressure, and 4 behavioral tasks (flanker task, digit span, go/no-go, and pursuit rotor) were the primary outcome measures. RESULTS ALC produced its expected subjective and behavioral effects; including feeling intoxicated and impaired performance on the digit span and go/no-go tasks. Oxytocin alone had no significant subjective or physiological effects, and it did not affect responses to alcohol on any measure. CONCLUSIONS We can conclude that, under these conditions, a single dose of intranasal oxytocin does not alter the effects of acute alcohol in healthy young adult social drinkers. Further research is needed to determine whether oxytocin alters responses to alcohol under different conditions, and to determine its potential as an aid in treatment for substance use disorders.
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Affiliation(s)
- Ashley Vena
- Department of Psychiatry and Behavioral Neuroscience (AV, AK, RL, HdW), University of Chicago, Chicago, Illinois
| | - Andrea King
- Department of Psychiatry and Behavioral Neuroscience (AV, AK, RL, HdW), University of Chicago, Chicago, Illinois
| | - Royce Lee
- Department of Psychiatry and Behavioral Neuroscience (AV, AK, RL, HdW), University of Chicago, Chicago, Illinois
| | - Harriet de Wit
- Department of Psychiatry and Behavioral Neuroscience (AV, AK, RL, HdW), University of Chicago, Chicago, Illinois
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Jurek B, Neumann ID. The Oxytocin Receptor: From Intracellular Signaling to Behavior. Physiol Rev 2018; 98:1805-1908. [DOI: 10.1152/physrev.00031.2017] [Citation(s) in RCA: 408] [Impact Index Per Article: 68.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
The many facets of the oxytocin (OXT) system of the brain and periphery elicited nearly 25,000 publications since 1930 (see FIGURE 1 , as listed in PubMed), which revealed central roles for OXT and its receptor (OXTR) in reproduction, and social and emotional behaviors in animal and human studies focusing on mental and physical health and disease. In this review, we discuss the mechanisms of OXT expression and release, expression and binding of the OXTR in brain and periphery, OXTR-coupled signaling cascades, and their involvement in behavioral outcomes to assemble a comprehensive picture of the central and peripheral OXT system. Traditionally known for its role in milk let-down and uterine contraction during labor, OXT also has implications in physiological, and also behavioral, aspects of reproduction, such as sexual and maternal behaviors and pair bonding, but also anxiety, trust, sociability, food intake, or even drug abuse. The many facets of OXT are, on a molecular basis, brought about by a single receptor. The OXTR, a 7-transmembrane G protein-coupled receptor capable of binding to either Gαior Gαqproteins, activates a set of signaling cascades, such as the MAPK, PKC, PLC, or CaMK pathways, which converge on transcription factors like CREB or MEF-2. The cellular response to OXT includes regulation of neurite outgrowth, cellular viability, and increased survival. OXTergic projections in the brain represent anxiety and stress-regulating circuits connecting the paraventricular nucleus of the hypothalamus, amygdala, bed nucleus of the stria terminalis, or the medial prefrontal cortex. Which OXT-induced patterns finally alter the behavior of an animal or a human being is still poorly understood, and studying those OXTR-coupled signaling cascades is one initial step toward a better understanding of the molecular background of those behavioral effects.
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Affiliation(s)
- Benjamin Jurek
- Department of Behavioural and Molecular Neurobiology, Institute of Zoology, University of Regensburg, Regensburg, Germany
| | - Inga D. Neumann
- Department of Behavioural and Molecular Neurobiology, Institute of Zoology, University of Regensburg, Regensburg, Germany
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Sahlem GL, Tomko RL, Sherman BJ, Gray KM, McRae-Clark AL. Impact of cannabis legalization on treatment and research priorities for cannabis use disorder. Int Rev Psychiatry 2018; 30:216-225. [PMID: 29956576 PMCID: PMC6322658 DOI: 10.1080/09540261.2018.1465398] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
An increasing proportion of the world has legalized cannabis for medicinal or recreational use. The legalization trend appears to be continuing. These changes in the legislative landscape may have important health, treatment, and research implications. This review discusses public health outcomes that may be impacted by increases in cannabis availability and use. It additionally considers potential research and treatment priorities in the face of widespread cannabis legalization.
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Affiliation(s)
- Gregory L. Sahlem
- Department of Psychiatry, Medical University of South Carolina, Charleston, SC, USA
| | - Rachel L. Tomko
- Department of Psychiatry, Medical University of South Carolina, Charleston, SC, USA
| | - Brian J. Sherman
- Department of Psychiatry, Medical University of South Carolina, Charleston, SC, USA
| | - Kevin M. Gray
- Department of Psychiatry, Medical University of South Carolina, Charleston, SC, USA
| | - Aimee L. McRae-Clark
- Department of Psychiatry, Medical University of South Carolina, Charleston, SC, USA,Ralph H. Johnson VA Medical Center, Charleston, SC, USA
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Oxytocin Reduces Alcohol Cue-Reactivity in Alcohol-Dependent Rats and Humans. Neuropsychopharmacology 2018; 43:1235-1246. [PMID: 29090683 PMCID: PMC5916348 DOI: 10.1038/npp.2017.257] [Citation(s) in RCA: 84] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 10/08/2017] [Accepted: 10/24/2017] [Indexed: 12/25/2022]
Abstract
Approved pharmacological treatments for alcohol use disorder are limited in their effectiveness, and new drugs that can easily be translated into the clinic are warranted. One of those candidates is oxytocin because of its interaction with several alcohol-induced effects. Alcohol-dependent rats as well as post-mortem brains of human alcoholics and controls were analyzed for the expression of the oxytocin system by qRT-PCR, in situ hybridization, receptor autoradiography ([125I]OVTA binding), and immunohistochemistry. Alcohol self-administration and cue-induced reinstatement behavior was measured after intracerebroventricular injection of 10 nM oxytocin in dependent rats. Here we show a pronounced upregulation of oxytocin receptors in brain tissues of alcohol-dependent rats and deceased alcoholics, primarily in frontal and striatal areas. This upregulation stems most likely from reduced oxytocin expression in hypothalamic nuclei. Pharmacological validation showed that oxytocin reduced cue-induced reinstatement response in dependent rats-an effect that was not observed in non-dependent rats. Finally, a clinical pilot study (German clinical trial number DRKS00009253) using functional magnetic resonance imaging in heavy social male drinkers showed that intranasal oxytocin (24 IU) decreased neural cue-reactivity in brain networks similar to those detected in dependent rats and humans with increased oxytocin receptor expression. These studies suggest that oxytocin might be used as an anticraving medication and thus may positively affect treatment outcomes in alcoholics.
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