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Sherwood Brown E, McArdle M, Palka J, Bice C, Ivleva E, Nakamura A, McNutt M, Patel Z, Holmes T, Tipton S. A randomized, double-blind, placebo-controlled proof-of-concept study of ondansetron for bipolar and related disorders and alcohol use disorder. Eur Neuropsychopharmacol 2021; 43:92-101. [PMID: 33402258 DOI: 10.1016/j.euroneuro.2020.12.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 12/04/2020] [Accepted: 12/15/2020] [Indexed: 01/17/2023]
Abstract
Bipolar disorder is associated with high rates of alcohol use disorder. However, little is known about the treatment of this dual diagnosis population. Previous studies suggest that ondansetron decreases alcohol use, particularly in people with specific single nucleotide polymorphism (SNP) alleles. A 12-week, randomized, double-blind, placebo-controlled trial of ondansetron was conducted in 70 outpatients with bipolar spectrum disorders and early onset alcohol use disorder. Outcome measures included alcohol use, assessed with the Timeline Followback method, Penn Alcohol Craving Scale (PACS), Hamilton Rating Scale for Depression (HRSD), Inventory of Depressive Symptomatology-Self-report, and Young Mania Rating Scale. SNPs rs1042173, rs1176713 and rs1150226 were explored as predictors of response. Participants had a mean age of 44.9 ± 9.4 years, were mostly men (60.0%), and African American (51.4%). Mean ondansetron exit dose was 3.23 ± 2.64 mg. No significant between-group differences in alcohol use measures were observed. However, a significant reduction in HRSD scores was observed (p = 0.045). Inclusion of SNPs increased effect sizes for some alcohol-related outcomes and the HRSD. Ondansetron was well tolerated. This proof-of-concept study is the first report on ondansetron in bipolar people with bipolar disorders and alcohol use disorder. Alcohol use did not demonstrate a significant between-group difference. However, the findings suggest that ondansetron may be associated with reduction in depressive symptom severity in persons with bipolar illnesses and alcohol use disorder. A larger trial is needed to examine the effects of ondansetron on bipolar depression.
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Affiliation(s)
- E Sherwood Brown
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX, USA.
| | - Meagan McArdle
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Jayme Palka
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Collette Bice
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Elena Ivleva
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Alyson Nakamura
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Markey McNutt
- The Eugene McDermott Center for Human Growth and Development, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Zena Patel
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Traci Holmes
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Shane Tipton
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX, USA
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Sawyer KS, Maleki N, Urban T, Marinkovic K, Karson S, Ruiz SM, Harris GJ, Oscar-Berman M. Alcoholism gender differences in brain responsivity to emotional stimuli. eLife 2019; 8:e41723. [PMID: 31038125 PMCID: PMC6491039 DOI: 10.7554/elife.41723] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 03/29/2019] [Indexed: 11/20/2022] Open
Abstract
Men and women may use alcohol to regulate emotions differently, with corresponding differences in neural responses. We explored how the viewing of different types of emotionally salient stimuli impacted brain activity observed through functional magnetic resonance imaging (fMRI) from 42 long-term abstinent alcoholic (25 women) and 46 nonalcoholic (24 women) participants. Analyses revealed blunted brain responsivity in alcoholic compared to nonalcoholic groups, as well as gender differences in those activation patterns. Brain activation in alcoholic men (ALCM) was significantly lower than in nonalcoholic men (NCM) in regions including rostral middle and superior frontal cortex, precentral gyrus, and inferior parietal cortex, whereas activation was higher in alcoholic women (ALCW) than in nonalcoholic women (NCW) in superior frontal and supramarginal cortical regions. The reduced brain reactivity of ALCM, and increases for ALCW, highlighted divergent brain regions and gender effects, suggesting possible differences in the underlying basis for development of alcohol use disorders.
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Affiliation(s)
- Kayle S Sawyer
- Psychology Research ServiceVA Healthcare SystemBostonUnited States
- Department of Anatomy and NeurobiologyBoston University School of MedicineBostonUnited States
- Department of RadiologyMassachusetts General HospitalBostonUnited States
- Sawyer Scientific, LLCBostonUnited States
| | - Nasim Maleki
- Psychology Research ServiceVA Healthcare SystemBostonUnited States
- Department of PsychiatryMassachusetts General HospitalBostonUnited States
| | - Trinity Urban
- Department of RadiologyMassachusetts General HospitalBostonUnited States
| | - Ksenija Marinkovic
- Department of PsychologySan Diego State UniversitySan DiegoUnited States
| | - Steven Karson
- Department of Computer ScienceDartmouth CollegeHanoverUnited States
| | - Susan M Ruiz
- Department of Anatomy and NeurobiologyBoston University School of MedicineBostonUnited States
| | - Gordon J Harris
- Department of RadiologyMassachusetts General HospitalBostonUnited States
- 3D Imaging ServiceMassachusetts General HospitalBostonUnited States
| | - Marlene Oscar-Berman
- Department of Anatomy and NeurobiologyBoston University School of MedicineBostonUnited States
- Department of PsychiatryBoston University School of MedicineBostonUnited States
- Department of NeurologyBoston University School of MedicineBostonUnited States
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Lytle MC, Vaughan MD, Rodriguez EM, Shmerler DL. Working with LGBT Individuals: Incorporating Positive Psychology into Training and Practice. PSYCHOLOGY OF SEXUAL ORIENTATION AND GENDER DIVERSITY 2014; 1:335-347. [PMID: 25544947 PMCID: PMC4276565 DOI: 10.1037/sgd0000064] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This paper examines how positive psychology principles can be incorporated into clinical training and practice to work with lesbian, gay, bisexual and transgender (LGBT) clients. LGBT psychology literature has all too often relied on heterosexual and cisgender reference groups as the norm with respect to psychological health, primarily framing the experiences of LGBT individuals through the lens of psychopathology. As a result, strengths that could be ascribed to the LGBT experience have been overlooked within training and practice. While positive psychology is actively being incorporated into clinical and counseling psychology curricula, broadening the paradigm to include LGBT individuals has generally not been included in the discussion. Specific recommendations for training psychologists to incorporate and foster positive social institutions, positive subjective experiences and character strengths when working with LGBT clients and celebrating their unique experiences are provided.
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Penberthy JK, Hook JN, Hettema J, Farrell-Carnahan L, Ingersoll K. Depressive symptoms moderate treatment response to brief intervention for prevention of alcohol exposed pregnancy. J Subst Abuse Treat 2013; 45:335-42. [PMID: 23810264 DOI: 10.1016/j.jsat.2013.05.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2012] [Revised: 05/15/2013] [Accepted: 05/20/2013] [Indexed: 11/28/2022]
Abstract
The previously published randomized controlled trial, EARLY, tested the efficacy of a motivational interviewing (MI) plus feedback condition against a video information (VI) condition and an informational brochure (IB) condition in reducing drinking and/or increasing contraception effectiveness, and found that drinking and rates of effective contraception improved in all conditions. In this reanalysis of the data from EARLY, potential moderating effects of depressive, global distress, and anxiety symptoms in response to the three brief interventions to reduce alcohol exposed pregnancy risk were examined. Women with higher levels of depression at baseline reported greater improvements in the MI plus feedback condition versus the VI and IB conditions with depression moderating both drinking and contraceptive effectiveness. Global distress moderated only drinking behavior in the MI plus feedback but not other groups and anxiety was not a moderator of outcome in any of the intervention groups. Depressed or distressed women at risk for AEP may benefit from an AEP risk reduction intervention that incorporates interaction with a treatment provider versus educational information provided via video or written materials.
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Affiliation(s)
- J Kim Penberthy
- Center for Addiction Research and Education, Department of Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine, P.O. Box 800623, Charlottesville, VA 22908, USA.
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