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Dougherty DM, Moon TJ, Liang Y, Roache JD, Lamb RJ, Mathias CW, Wasserman AM, Wood EE, Hill-Kapturczak N. Effectiveness of contingency management using transdermal alcohol monitoring to reduce heavy drinking among driving while intoxicated (DWI) arrestees: A randomized controlled trial. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2023; 47:1989-2001. [PMID: 37864527 PMCID: PMC11205128 DOI: 10.1111/acer.15180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 08/18/2023] [Accepted: 08/22/2023] [Indexed: 10/23/2023]
Abstract
BACKGROUND Driving while intoxicated (DWI) is a serious public health problem. However, treatment for DWI arrestees is not readily available. This study examines the effectiveness of a contingency management (CM) procedure using transdermal alcohol concentration (TAC) monitoring to reduce drinking among DWI arrestees. METHOD The study participants were 216 DWI arrestees under pretrial and included both Mandated participants undergoing court-ordered TAC monitoring and Non-Mandated participants wearing a study-provided TAC monitor. Participants were randomly assigned to either a CM (Mandated = 35; Non-Mandated = 74) or a Control condition (Mandated = 37; Non-Mandated = 70) and completed the 8-week intervention. CM participants received $50/week for not exceeding a TAC of 0.02 g/dL during the previous week. Payments to Controls were yoked to the CM group. RESULTS Among Non-Mandated participants, the probability of meeting the contingency was higher and remained stable (about 65%) over time in the CM group, whereas the probability was lower and declined in the Control group, widening the gaps in the probability between the study conditions (16.7%-24.1% greater in the CM group from visit 4 to 8, all p < 0.05). Among Mandated participants, the probability was not significantly different between conditions (p = 0.06-0.95). Furthermore, among Non-Mandated participants, the percentage of heavy drinking days remained low (9.16%-11.37%) in the CM group, whereas it was greater and increased over time (17.43%-26.59%) in the Control group. In Mandated participants, no significant differences in percent heavy drinking days were observed between conditions (p = 0.07-0.10). CONCLUSION We found that contingency effects on alcohol use are more pronounced among frequent and heavy alcohol users, i.e., Non-Mandated DWI arrestees. However, for individuals whose drinking was already suppressed by existing contingencies (i.e., court-mandated TAC monitoring), our CM procedure did not produce additional reductions in drinking.
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Affiliation(s)
| | - Tae-Joon Moon
- Department of Health, Behavior, and Society, University of Texas School of Public Health San Antonio, San Antonio, Texas, USA
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Yuanyuan Liang
- Department of Epidemiology and Public Health, University of Maryland, Baltimore County, Baltimore, Maryland, USA
| | - John D. Roache
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Richard J. Lamb
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Charles W. Mathias
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
- School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | | | - Erin E. Wood
- Department of Psychology, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Nathalie Hill-Kapturczak
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
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Marin MCD, Pedro MOP, Perrotte G, Martins-da-Silva AS, Lassi DLS, Blaas IK, Castaldelli FI, Brisola dos Santos MB, Kortas GT, Campos MW, Torales J, Ventriglio A, Périco CDAM, Negrão AB, Leopoldo K, de Andrade AG, Malbergier A, Castaldelli-Maia JM. Pharmacological Treatment of Alcohol Cravings. Brain Sci 2023; 13:1206. [PMID: 37626562 PMCID: PMC10452441 DOI: 10.3390/brainsci13081206] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 08/03/2023] [Accepted: 08/04/2023] [Indexed: 08/27/2023] Open
Abstract
(1) Background: The treatment of substance addiction is challenging and has persisted for decades, with only a few therapeutic options. Although there are some recommendations for specific treatments for Alcohol Use Disorder (AUD), there is no specific medication used to treat alcohol cravings, which could benefit millions of patients that are suffering from alcoholism. Cravings, or the urge to use drugs, refer to the desire to experience the effects of a previously experienced psychoactive substance. (2) Methods: We included original studies of alcohol abuse or dependence extracted from a controlled, blind, pharmacological treatment study which presented measures and outcomes related to alcohol cravings. (3) Results: Specific drugs used for the treatment of alcoholism, such as Naltrexone and Acamprosate, have had the best results in relieving craving symptoms, as well as promoting abstinence. Baclofen and anticonvulsants such as Gabapentin and Topiramate have shown good results in promoting abstinence and the cessation of cravings. (4) Conclusions: Specific drugs used for the treatment of alcoholism to obtain the best results can be considered the gold standard for promoting abstinence and relieving cravings. Anticonvulsants and Baclofen also had good results, with these medications being considered as second-line ones. Varenicline is an option for alcohol dependents who also concomitantly ingest tobacco.
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Affiliation(s)
- Matheus Cheibub David Marin
- Perdizes Institute (IPer), Clinics Hospital of the Medical School (HCFMUSP), University of São Paulo, São Paulo 05021-001, Brazil; (M.C.D.M.); (D.L.S.L.); (I.K.B.); (G.T.K.); (A.B.N.); (A.G.d.A.); (A.M.)
- Hospital Sírio-Libanês, São Paulo 01308-050, Brazil; (M.O.P.P.); (M.B.B.d.S.)
| | - Maria Olívia Pozzolo Pedro
- Hospital Sírio-Libanês, São Paulo 01308-050, Brazil; (M.O.P.P.); (M.B.B.d.S.)
- Department of Psychiatry, Medical School, University of São Paulo, São Paulo 05403-903, Brazil; (A.S.M.-d.-S.); (K.L.)
| | - Giuliana Perrotte
- Department of Neuroscience, Medical School, FMABC University Center, Santo André 09060-870, Brazil; (G.P.); (C.d.A.-M.P.)
| | - Anderson S. Martins-da-Silva
- Department of Psychiatry, Medical School, University of São Paulo, São Paulo 05403-903, Brazil; (A.S.M.-d.-S.); (K.L.)
| | - Dangela L. S. Lassi
- Perdizes Institute (IPer), Clinics Hospital of the Medical School (HCFMUSP), University of São Paulo, São Paulo 05021-001, Brazil; (M.C.D.M.); (D.L.S.L.); (I.K.B.); (G.T.K.); (A.B.N.); (A.G.d.A.); (A.M.)
| | - Israel Kanaan Blaas
- Perdizes Institute (IPer), Clinics Hospital of the Medical School (HCFMUSP), University of São Paulo, São Paulo 05021-001, Brazil; (M.C.D.M.); (D.L.S.L.); (I.K.B.); (G.T.K.); (A.B.N.); (A.G.d.A.); (A.M.)
- Department of Neuroscience, Medical School, FMABC University Center, Santo André 09060-870, Brazil; (G.P.); (C.d.A.-M.P.)
| | | | | | - Guilherme Trevizan Kortas
- Perdizes Institute (IPer), Clinics Hospital of the Medical School (HCFMUSP), University of São Paulo, São Paulo 05021-001, Brazil; (M.C.D.M.); (D.L.S.L.); (I.K.B.); (G.T.K.); (A.B.N.); (A.G.d.A.); (A.M.)
- Hospital Sírio-Libanês, São Paulo 01308-050, Brazil; (M.O.P.P.); (M.B.B.d.S.)
- Department of Psychiatry, Medical School, University of São Paulo, São Paulo 05403-903, Brazil; (A.S.M.-d.-S.); (K.L.)
| | - Marcela Waisman Campos
- Department of Cognitive Neurology, Neuropsychiatry, and Neuropsychology, Fleni, Buenos Aires C1428AQK, Argentina;
| | - Julio Torales
- Department of Medical Psychology, School of Medical Sciences, Universidad Nacional de Asunción, San Lorenzo 111454, Paraguay;
- Regional Institute of Health Research, Universidad Nacional de Caaguazú, Coronel Oviedo 050106, Paraguay
- School of Health Sciences, Universidad Sudamericana, Pedro Juan Caballero 130112, Paraguay
| | - Antonio Ventriglio
- Department of Experimental Medicine, Medical School, University of Foggia, 71100 Foggia, Italy;
| | | | - André B. Negrão
- Perdizes Institute (IPer), Clinics Hospital of the Medical School (HCFMUSP), University of São Paulo, São Paulo 05021-001, Brazil; (M.C.D.M.); (D.L.S.L.); (I.K.B.); (G.T.K.); (A.B.N.); (A.G.d.A.); (A.M.)
| | - Kae Leopoldo
- Department of Psychiatry, Medical School, University of São Paulo, São Paulo 05403-903, Brazil; (A.S.M.-d.-S.); (K.L.)
| | - Arthur Guerra de Andrade
- Perdizes Institute (IPer), Clinics Hospital of the Medical School (HCFMUSP), University of São Paulo, São Paulo 05021-001, Brazil; (M.C.D.M.); (D.L.S.L.); (I.K.B.); (G.T.K.); (A.B.N.); (A.G.d.A.); (A.M.)
- Hospital Sírio-Libanês, São Paulo 01308-050, Brazil; (M.O.P.P.); (M.B.B.d.S.)
- Department of Psychiatry, Medical School, University of São Paulo, São Paulo 05403-903, Brazil; (A.S.M.-d.-S.); (K.L.)
- Department of Neuroscience, Medical School, FMABC University Center, Santo André 09060-870, Brazil; (G.P.); (C.d.A.-M.P.)
| | - André Malbergier
- Perdizes Institute (IPer), Clinics Hospital of the Medical School (HCFMUSP), University of São Paulo, São Paulo 05021-001, Brazil; (M.C.D.M.); (D.L.S.L.); (I.K.B.); (G.T.K.); (A.B.N.); (A.G.d.A.); (A.M.)
- Department of Psychiatry, Medical School, University of São Paulo, São Paulo 05403-903, Brazil; (A.S.M.-d.-S.); (K.L.)
| | - João Maurício Castaldelli-Maia
- Hospital Sírio-Libanês, São Paulo 01308-050, Brazil; (M.O.P.P.); (M.B.B.d.S.)
- Department of Psychiatry, Medical School, University of São Paulo, São Paulo 05403-903, Brazil; (A.S.M.-d.-S.); (K.L.)
- Department of Neuroscience, Medical School, FMABC University Center, Santo André 09060-870, Brazil; (G.P.); (C.d.A.-M.P.)
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3
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Gheidi A, Fitzpatrick CJ, Gregory JD, Morrow JD. Nicotinic and muscarinic acetylcholine receptor antagonism dose-dependently decreases sign- but not goal-tracking behavior in male rats. Psychopharmacology (Berl) 2023; 240:871-880. [PMID: 36795109 PMCID: PMC10599605 DOI: 10.1007/s00213-023-06328-4] [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: 03/23/2022] [Accepted: 01/27/2023] [Indexed: 02/17/2023]
Abstract
RATIONALE Acetylcholinergic antagonists have shown some promise in reducing addiction-related behaviors in both preclinical and clinical studies. However, the psychological mechanisms by which these drugs are able to affect addictive behavior remain unclear. A particular key process for the development of addiction is the attribution of incentive salience to reward-related cues, which can be specifically measured in animals using a Pavlovian conditioned approach procedure. When confronted with a lever that predicts food delivery, some rats engage with the lever directly (i.e., they sign track), indicating attribution of incentive-motivational properties to the lever itself. In contrast, others treat the lever as a predictive cue and approach the location of impending food delivery (i.e., they goal track), without treating the lever itself as a reward. OBJECTIVES We tested whether systemic antagonism of the either nicotinic or muscarinic acetylcholine receptors would selectively affect sign- or goal-tracking behavior, indicating a selective effect on incentive salience attribution. METHODS A total of 98 male Sprague Dawley rats were either given the muscarinic antagonist scopolamine (100, 50, or 10 µg/kg i.p.) or the nicotinic antagonist mecamylamine (0.3, 1.0, or 3 mg/kg i.p.) before being trained on a Pavlovian conditioned approach procedure. RESULTS Scopolamine dose-dependently decreased sign tracking behavior and increased goal-tracking behavior. Mecamylamine reduced sign-tracking but did not affect goal-tracking behavior. CONCLUSIONS Antagonism of either muscarinic or nicotinic acetylcholine receptors can reduce incentive sign-tracking behavior in male rats. This effect appears to be specifically due to a reduction in incentive salience attribution since goal-tracking either increased or was not affected by these manipulations.
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Affiliation(s)
- Ali Gheidi
- Department of Biomedical Sciences, Mercer University, Macon, USA
| | | | - Jordan D Gregory
- Department of Psychiatry, University of Michigan, Ann Arbor, USA
| | - Jonathan D Morrow
- Neuroscience Graduate Program, University of Michigan, Ann Arbor, USA.
- Department of Psychiatry, University of Michigan, Ann Arbor, USA.
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4
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Kamens HM, Flarend G, Horton WJ. The role of nicotinic receptors in alcohol consumption. Pharmacol Res 2023; 190:106705. [PMID: 36813094 PMCID: PMC10083870 DOI: 10.1016/j.phrs.2023.106705] [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: 12/13/2022] [Revised: 02/14/2023] [Accepted: 02/19/2023] [Indexed: 02/22/2023]
Abstract
The use of alcohol causes significant morbidity and mortality across the globe. Alcohol use disorder (AUD) is defined by the excessive use of this drug despite a negative impact on the individual's life. While there are currently medications available to treat AUD, they have limited efficacy and several side effects. As such, it is essential to continue to look for novel therapeutics. One target for novel therapeutics is nicotinic acetylcholine receptors (nAChRs). Here we systematically review the literature on the involvement of nAChRs in alcohol consumption. Data from both genetic and pharmacology studies provide evidence that nAChRs modulate alcohol intake. Interestingly, pharmacological modulation of all nAChR subtypes examined can decrease alcohol consumption. The reviewed literature demonstrates that nAChRs should continue to be investigated as novel therapeutics for AUD.
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Affiliation(s)
- Helen M Kamens
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA 16802, United States.
| | - Geneva Flarend
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA 16802, United States
| | - William J Horton
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA 16802, United States
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5
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Bjugstad K, Sanberg P. The boundlessness of behavioral neuroscience: A look across 30 years. Neurosci Biobehav Rev 2022; 142:104910. [DOI: 10.1016/j.neubiorev.2022.104910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 10/06/2022] [Indexed: 11/30/2022]
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6
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van Amsterdam J, van den Brink W. Smoking As an Outcome Moderator In the Treatment of Alcohol Use Disorders. Alcohol Alcohol 2022; 57:664-673. [PMID: 35589093 DOI: 10.1093/alcalc/agac027] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/26/2022] [Accepted: 04/28/2022] [Indexed: 11/15/2022] Open
Abstract
AIMS To clarify whether smoking interferes with successful treatment of alcohol use disorder (AUD). METHODS The current systematic review investigates the potential moderating effect of smoking on behavioural and pharmacological treatment of AUD. In addition, this review summarizes the results of randomized controlled trials investigating the effect of smoking cessation treatments in subjects with AUD on drinking outcomes. RESULTS Overall, the results show that 16 out of the 31 pharmacological and psychotherapeutic alcohol treatment studies showed that being a non-smoker or decreased tobacco consumption during AUD treatment is associated with beneficial drinking outcomes, including reduced drinking, later relapse and prolonged alcohol abstinence. As such, smoking predicts poorer drinking outcomes in alcohol treatments. In the stop-smoking studies in patients with AUD, reduced smoking had virtually no effect on drinking behaviours. The inverse association between smoking and drinking outcome observed here indicates that non-smokers may be more successful to attain alcohol abstinence than smokers do. However, this association does not imply per se that smoking triggers alcohol consumption, since it can also mean that alcohol consumption promotes smoking. CONCLUSIONS It is concluded that (continued) tobacco smoking may have a negative moderating effect on the treatment outcome of AUD treatments. To optimize treatment outcome of AUD one may consider informing and counselling patients with AUD about the risks of smoking for treatment outcomes and offering support for smoking cessation.
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Affiliation(s)
- Jan van Amsterdam
- Department of Psychiatry, Academic Medical Center University of Amsterdam, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands
| | - Wim van den Brink
- Department of Psychiatry, Academic Medical Center University of Amsterdam, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands
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7
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Zapukhliak O, Netsyk O, Romanov A, Maximyuk O, Oz M, Holmes GL, Krishtal O, Isaev D. Mecamylamine inhibits seizure-like activity in CA1-CA3 hippocampus through antagonism to nicotinic receptors. PLoS One 2021; 16:e0240074. [PMID: 33711021 PMCID: PMC7954330 DOI: 10.1371/journal.pone.0240074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 03/02/2021] [Indexed: 11/18/2022] Open
Abstract
Cholinergic modulation of hippocampal network function is implicated in multiple behavioral and cognitive states. Activation of nicotinic and muscarinic acetylcholine receptors affects neuronal excitability, synaptic transmission and rhythmic oscillations in the hippocampus. In this work, we studied the ability of the cholinergic system to sustain hippocampal epileptiform activity independently from glutamate and GABA transmission. Simultaneous CA3 and CA1 field potential recordings were obtained during the perfusion of hippocampal slices with the aCSF containing AMPA, NMDA and GABA receptor antagonists. Under these conditions, spontaneous epileptiform discharges synchronous between CA3 and CA1 were recorded. Epileptiform discharges were blocked by addition of the calcium-channel blocker Cd2+ and disappeared in CA1 after a surgical cut between CA3 and CA1. Cholinergic antagonist mecamylamine abolished CA3-CA1 synchronous epileptiform discharges, while antagonists of α7 and α4β2 nAChRs, MLA and DhβE, had no effect. Our results suggest that activation of nicotinic acetylcholine receptors can sustain CA3-CA1 synchronous epileptiform activity independently from AMPA, NMDA and GABA transmission. In addition, mecamylamine, but not α7 and α4β2 nAChRs antagonists, reduced bicuculline-induced seizure-like activity. The ability of mecamylamine to decrease hippocampal network synchronization might be associated with its therapeutic effects in a wide variety of CNS disorders including addiction, depression and anxiety.
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Affiliation(s)
- Olha Zapukhliak
- Department of Cellular Membranology, Bogomoletz Institute of Physiology, Kiev, Ukraine
| | - Olga Netsyk
- Department of Cellular Membranology, Bogomoletz Institute of Physiology, Kiev, Ukraine
| | - Artur Romanov
- Department of Cellular Membranology, Bogomoletz Institute of Physiology, Kiev, Ukraine
| | - Oleksandr Maximyuk
- Department of Cellular Membranology, Bogomoletz Institute of Physiology, Kiev, Ukraine
| | - Murat Oz
- Faculty of Pharmacy, Department of Pharmacology and Therapeutics, Kuwait University, Safat, Kuwait
| | - Gregory L. Holmes
- Neurological Sciences, Larner College of Medicine, University of Vermont, Burlington, Vermont, United States of America
| | - Oleg Krishtal
- Department of Cellular Membranology, Bogomoletz Institute of Physiology, Kiev, Ukraine
| | - Dmytro Isaev
- Department of Cellular Membranology, Bogomoletz Institute of Physiology, Kiev, Ukraine
- * E-mail:
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8
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Roberts W, Verplaetse TL, Ramchandani VA, McKee SA. A Critical Review of Alcohol Administration Guidelines in Laboratory Medication Screening Research: Is It Time to Include Treatment Seekers? Alcohol Clin Exp Res 2020; 45:15-24. [PMID: 33190310 DOI: 10.1111/acer.14514] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 10/28/2020] [Accepted: 11/06/2020] [Indexed: 01/08/2023]
Abstract
Human laboratory studies play an important role in alcohol use disorder (AUD) medication development. Medications that are found to be safe and effective during human laboratory screening will then move to more expensive clinical trials in patient populations. Given the gatekeeping role of human laboratory studies in the medication development pipeline, it is critical that these studies accurately forecast how pharmacotherapies will perform under true-to-life clinical conditions. On the other hand, the design of these studies also must adhere to ethical guidelines: certain aspects of clinical reality cannot be incorporated into screening studies because doing so might place the participant at risk for harm or breach other ethical guidelines. Conventions exist that guide the resolution of these conflicting ideals. This article considers the practice of recruiting non-treatment-seeking heavy drinkers to participate in laboratory screening studies. By convention, volunteers are excluded from laboratory screening studies that involve alcohol administration if they are deemed "treatment seeking," meaning that they recently stopped drinking or are motivated to do so. Although this common practice may reduce risk to participants, findings may not accurately predict medication effects on treatment seekers. Indeed, there is empirical evidence that treatment seekers differ from nontreatment seekers in their responses to medications (Neuropsychopharmacology 2017a; 42: 1776; Am J Drug Alcohol Abuse 2017b; 43: 703; J Psychiatr Res 2006; 40: 383). Here, we argue for the importance of recruiting treatment seekers for this research due to their qualitative difference from nontreatment seekers. We argue that these individuals should be the default population in human laboratory medication screening studies. We conclude by discussing 2 case examples of medication experiments led by our research groups that involved administering medications to treatment seekers.
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Affiliation(s)
- Walter Roberts
- From the Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Terril L Verplaetse
- From the Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Vijay A Ramchandani
- Section on Human Psychopharmacology, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, USA
| | - Sherry A McKee
- From the Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
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9
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Miller CN, Kamens HM. The role of nicotinic acetylcholine receptors in alcohol-related behaviors. Brain Res Bull 2020; 163:135-142. [PMID: 32707263 DOI: 10.1016/j.brainresbull.2020.07.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 06/23/2020] [Accepted: 07/17/2020] [Indexed: 12/29/2022]
Abstract
Alcohol use disorder (AUD) causes an alarming economic and health burden in the United States. Unfortunately, this disease does not exist in isolation; AUD is highly comorbid with nicotine use. Results from both human and animal models demonstrate a genetic correlation between alcohol and nicotine behaviors. These data support the idea of shared genetic and neural mechanisms underlying these behaviors. Nicotine acts directly at nicotinic acetylcholine receptors (nAChR) to have its pharmacological effect. Interestingly, alcohol also acts both directly and indirectly at these receptors. Research utilizing genetically engineered rodents and pharmacological manipulations suggest a role for nAChR in several ethanol behaviors. The current manuscript collates this literature and discusses findings that implicate specific nAChR subunits in ethanol phenotypes. These data suggest future directions for targeting nAChR as novel therapeutics for AUD.
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Affiliation(s)
- C N Miller
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, 16802, United States
| | - H M Kamens
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, 16802, United States.
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10
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Miller CN, Kamens HM. Reduced expression of ethanol sensitization by α3β4 nicotinic acetylcholine receptors in DBA/2J mice. Exp Clin Psychopharmacol 2020; 28:348-354. [PMID: 31580099 PMCID: PMC7117981 DOI: 10.1037/pha0000324] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Alcohol use disorder (AUD) is a leading cause of preventable death in the United States, however existing treatments are ineffective and produce aversive side effects such as nausea and fatigue. One potential therapeutic for AUD is the α3β4 nicotinic acetylcholine receptor (nAChR) antagonist 18-methoxycoronaridine (18-MC). Prior work has shown that 18-MC reduces ethanol consumption in rodent models. The present study sought to further examine the therapeutic potential of 18-MC by testing its effects on nonconsummatory behaviors. We examined 2 behavioral measures: ethanol-induced locomotor stimulation, which measures euphoric properties of the drug, and the expression of locomotor sensitization which models neuroadaptations in response to repeated exposure. We tested dose-dependent effects of 18-MC (0, 10, 20 and 30 mg/kg) administration on ethanol stimulation and locomotor sensitization in female and male DBA/2J mice. 18-MC had no effect on acute ethanol-induced stimulation, but the highest dose (30 mg/kg) significantly decreased the expression of locomotor sensitization. Our results support the involvement of α3β4 nAChR in the expression of ethanol-induced locomotor sensitization and suggest that 18-MC may be a therapeutic for AUD. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
| | - Helen M Kamens
- Corresponding Author: Helen M Kamens, 219 Biobehavioral Health Building, University Park, PA 16802, , Phone: 814-865-1269, Fax: 814-863-7525
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11
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Higuchi S, Miyata H, Hayashi T. Response to 'Nalmefene in alcohol-dependent patients with a high drinking risk: A limited efficacy in reducing alcohol consumption'. Psychiatry Clin Neurosci 2020; 74:219-220. [PMID: 31876051 PMCID: PMC7064995 DOI: 10.1111/pcn.12971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 12/22/2019] [Accepted: 12/23/2019] [Indexed: 11/21/2022]
Affiliation(s)
- Susumu Higuchi
- National Hospital Organization, Kurihama Medical and Addiction Center, Yokosuka, Japan
| | - Hisatsugu Miyata
- Department of Psychiatry, Jikei University School of Medicine, Tokyo, Japan
| | - Takako Hayashi
- Medical Affairs, Otsuka Pharmaceutical Co., Ltd., Tokyo, Japan
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12
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Abstract
PURPOSE OF REVIEW The aim of this study was to provide an update on medication development efforts for alcohol use disorder (AUD) by reviewing recently published (past 2 years) human studies that evaluated medications' effects on alcohol-related outcomes. RECENT FINDINGS Forty-five publications were found suitable for this review. A variety of compounds have been tested in the past 2 years as potential pharmacological options for AUD, including medications that act on multiple targets (topiramate, aripiprazole, quetiapine), calcium channels (gabapentin), gamma-Aminobutyric acid receptors (baclofen, diazepam), glutamate receptors (ifenprodil, memantine, glycine), nicotinic acetylcholine receptors (varenicline, mecamylamine), α1 adrenergic receptors (prazosin, doxazosin), neuroendocrine pathways (oxytocin, a vasopressin receptor 1b antagonist, a ghrelin receptor inverse agonist) and others (samidorphan, ibudilast, N-acetylcysteine, citoline). Important findings and limitations regarding the effects of these medications on alcohol-related outcomes are discussed. SUMMARY There is a critical need to increase the armamentarium of medications for AUD. Human laboratory studies may help screen and prioritize promising targets and compounds before running large clinical trials. Given the complexity of AUD and the heterogeneity of afflicted patients, future studies should also investigate potential moderators and predictors of response to each pharmacological intervention.
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Abstract
PURPOSE OF REVIEW Only a few pharmacological treatments are available for treating alcohol use disorders (AUDs). Disulfiram, naltrexone and acamprosate are Food and Drug Administration (FDA)-approved and nalmefene is EMA-approved in European Union. Off-label medications, such as baclofen, gabapentin, ondansetron and topiramate are medications commonly prescribed for the treatment of AUD. The aim of this review is to give an update on recent randomized controlled trials (RCTs) and reviews evaluating pharmacological treatment for AUD. RECENT FINDINGS A literature search was conducted for pharmacological treatment for alcohol use disorder, published from January 2017 to January 2019. An additional search from two ongoing-study databases was performed. A total of 13 studies, 11 reviews and 7 on-going clinical trials were identified. Interest in studying baclofen as a treatment for AUD was greater compared with other medications, yet with inconclusive results. Three new RCTs of first-line medication naltrexone showed reduction in drinking. SUMMARY Three new published RCTs focus on baclofen and naltrexone. These results are consistent with old findings demonstrating that naltrexone reduces heavy drinking. Several RCT on baclofen do not support the use of baclofen for treatment of AUD. Encouraging results have been reported for topiramate, gabapentin and also varenicline, which might be useful in patients with comorbid nicotine dependence.
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Tobacco use during a clinical trial of mecamylamine for alcohol dependence: Medication effects on smoking and associations with reductions in drinking. J Subst Abuse Treat 2018; 94:91-96. [PMID: 30243424 DOI: 10.1016/j.jsat.2018.08.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 08/06/2018] [Accepted: 08/31/2018] [Indexed: 11/22/2022]
Abstract
Mecamylamine is a nicotinic acetylcholine receptor (nAChR) antagonist that was recently used in a clinical trial to treat alcohol use disorder (AUD) in both smokers and non-smokers. The current manuscript reports a reanalysis of data from this clinical trial in which we examine changes in smoking that occurred over the course of the trial. We focused on examining the effects of mecamylamine on smoking and the association between reductions in alcohol use and smoking. Participants were the subgroup of smokers who participated in the clinical trial of mecamylamine (10 mg/day) to treat their AUD (n = 76). Smoking was assessed prior to randomization and tracked throughout the course of the 12-week medication treatment phase. Participants were categorized as treatment responders or non-responders based on their changes in drinking over the course of the clinical trial. Participants showed a reduction in smoking over the course of the clinical trial, but there were no significant differences in smoking outcomes between the mecamylamine and placebo groups. Among moderate/high dependence smokers, those who successfully reduced drinking showed a significant reduction in cigarettes smoked per day over the clinical trial. Mecamylamine had no detectable effect on smoking outcomes. Reductions in alcohol use predicted more favorable smoking outcomes among moderate/high tobacco dependence smokers irrespective of medication condition. The reduction in smoking among patients who decreased their alcohol use responders highlights an opportunity for patients being treated for AUD to reduce their smoking.
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Cippitelli A, Brunori G, Schoch J, Armishaw CJ, Wu J, Zaveri NT, Giulianotti MA, Welmaker GS, Toll L. Differential regulation of alcohol taking and seeking by antagonism at α4β2 and α3β4 nAChRs. Psychopharmacology (Berl) 2018; 235:1745-1757. [PMID: 29572652 PMCID: PMC5949259 DOI: 10.1007/s00213-018-4883-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 03/13/2018] [Indexed: 12/17/2022]
Abstract
RATIONALE Alcoholism is a serious public health problem throughout the world. Current pharmacotherapies for the treatment of this disorder are poorly effective. Preclinical and clinical findings point to nicotinic acetylcholine receptors (nAChRs) as a promising target for the development of novel and effective medications. Assuage Pharmaceuticals, in collaboration with Torrey Pines Institute for Molecular Studies, has discovered a new class of potent and selective α4β2 nAChR antagonists. OBJECTIVE Here, it was hypothesized that α4β2 nAChR antagonism is a viable approach for treatment of alcohol use disorders. RESULTS When tested in rats, one lead compound, AP-202, attenuated both operant alcohol and nicotine self-administration in a paradigm in which the two reinforcers were concurrently available. The conotoxin TP2212-59, a selective α3β4 nAChR antagonist, was only effective in reducing nicotine self-administration. AP-202 also reduced alcohol but not food responding when alcohol was presented as the only reinforcer, whereas the commercially available α4β2 nAChR antagonist dihydro-β-erythroidine failed to alter alcohol self-administration. AP-202 did not block relapse-like behavior induced by previously alcohol-associated stimuli or yohimbine stress. In a reinstatement paradigm, in which alcohol seeking was triggered by a nicotine challenge, a behavior successfully inhibited by the nonselective nAChR antagonist mecamylamine, AP-202 was not effective, while pretreatment with TP2212-59 abolished nicotine-induced reinstatement of alcohol seeking. CONCLUSIONS These findings suggest differential roles for α4β2 and α3β4 nAChR on alcohol taking and seeking with selective blockade of α4β2 nAChR being more implicated in modulating alcohol taking while selective blockade of α3β4 nAChR is involved in nicotine-induced alcohol seeking.
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Affiliation(s)
- Andrea Cippitelli
- Torrey Pines Institute for Molecular Studies, 11350 SW Village Parkway, Port St. Lucie, FL, 34987, USA.
| | - Gloria Brunori
- Torrey Pines Institute for Molecular Studies, 11350 SW Village Parkway, Port St. Lucie, FL 34987, USA
| | - Jennifer Schoch
- Torrey Pines Institute for Molecular Studies, 11350 SW Village Parkway, Port St. Lucie, FL 34987, USA
| | - Christopher J. Armishaw
- Torrey Pines Institute for Molecular Studies, 11350 SW Village Parkway, Port St. Lucie, FL 34987, USA
| | - Jinhua Wu
- Torrey Pines Institute for Molecular Studies, 11350 SW Village Parkway, Port St. Lucie, FL 34987, USA,Assuage Pharmaceuticals, Inc., 11350 SW Village Parkway, Port St. Lucie, FL 34987, USA
| | - Nurulain T. Zaveri
- Astraea Therapeutics, LLC, 320 Logue Avenue, Mountain View, CA 94043, USA
| | - Marc A. Giulianotti
- Torrey Pines Institute for Molecular Studies, 11350 SW Village Parkway, Port St. Lucie, FL 34987, USA,Assuage Pharmaceuticals, Inc., 11350 SW Village Parkway, Port St. Lucie, FL 34987, USA
| | - Gregory S. Welmaker
- Torrey Pines Institute for Molecular Studies, 11350 SW Village Parkway, Port St. Lucie, FL 34987, USA,Assuage Pharmaceuticals, Inc., 11350 SW Village Parkway, Port St. Lucie, FL 34987, USA
| | - Lawrence Toll
- Torrey Pines Institute for Molecular Studies, 11350 SW Village Parkway, Port St. Lucie, FL 34987, USA,Assuage Pharmaceuticals, Inc., 11350 SW Village Parkway, Port St. Lucie, FL 34987, USA
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Gandelman E, Petrakis I, Kachadourian L, Ralevski E. Negative Affect Intensity and Hostility in Individuals With Alcohol Use Disorder With or Without Posttraumatic Stress Disorder. J Dual Diagn 2018; 14:96-101. [PMID: 29461925 DOI: 10.1080/15504263.2018.1434264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Negative affect intensity and hostility have both been implicated in alcohol use disorders (AUD) and posttraumatic stress disorder (PTSD) when they occur separately, but neither have been compared or explored among those with comorbid AUD and PTSD. This study is a secondary analysis designed to compare levels of negative affect intensity and hostility among those with AUD to those with comorbid AUD and PTSD. METHODS Participants (n = 113) were recruited from the placebo-controlled groups of two distinct 12-week clinical trials (NCT00342563 and NCT00744055). The Short Affect Intensity Scale and Buss-Durkee Hostility Inventory were administered at weeks 0, 4, 8, and 12 to all study participants to assess negative affect intensity and hostility levels, respectively. RESULTS Individuals with comorbid AUD and PTSD showed significantly higher levels of negative affect intensity and hostility than individuals with AUD only. These levels remained relatively stable over the course of the study in spite of all study participants showing clinically significant improvements in AUD severity and PTSD symptomatology (for those with dual diagnosis). CONCLUSIONS Our results indicate that individuals with comorbid AUD and PTSD have higher levels of negative affect and higher levels of hostility compared to individuals with AUD alone. In addition, these heightened levels of negative affect intensity and hostility appear to function somewhat independently of diagnosis severity and symptomatology improvement. To our knowledge, this is the first study to compare negative affect intensity and hostility levels between individuals with AUD alone and those with comorbid AUD and PTSD.
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Affiliation(s)
- Erin Gandelman
- a Department of Psychiatry , Yale University School of Medicine , New Haven , Connecticut , USA.,b Department of Veterans Affairs , VA Connecticut Healthcare System , West Haven , Connecticut , USA
| | - Ismene Petrakis
- a Department of Psychiatry , Yale University School of Medicine , New Haven , Connecticut , USA.,b Department of Veterans Affairs , VA Connecticut Healthcare System , West Haven , Connecticut , USA.,c Mental Illness Research Education and Clinical Center, VA Connecticut Healthcare System , West Haven , Connecticut , USA
| | - Lorig Kachadourian
- a Department of Psychiatry , Yale University School of Medicine , New Haven , Connecticut , USA.,b Department of Veterans Affairs , VA Connecticut Healthcare System , West Haven , Connecticut , USA
| | - Elizabeth Ralevski
- a Department of Psychiatry , Yale University School of Medicine , New Haven , Connecticut , USA.,b Department of Veterans Affairs , VA Connecticut Healthcare System , West Haven , Connecticut , USA.,c Mental Illness Research Education and Clinical Center, VA Connecticut Healthcare System , West Haven , Connecticut , USA
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Designing selective modulators for the nicotinic receptor subtypes: challenges and opportunities. Future Med Chem 2018; 10:433-459. [PMID: 29451400 DOI: 10.4155/fmc-2017-0169] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Nicotinic receptors are membrane proteins involved in several physiological processes. They are considered suitable drug targets for various CNS disorders or conditions, as shown by the large number of compounds which have entered clinical trials. In recent years, nonconventional agonists have been discovered: positive allosteric modulators, allosteric agonists, site-specific agonists and silent desensitizers are compounds able to modulate the receptor interacting at sites different from the orthodox one, or to desensitize the receptor without prior opening. While these new findings can further complicate the pharmacology of these proteins and the design and optimization of ligands, they undoubtedly offer new opportunities to find drugs for the many therapeutic indications involving nicotinic receptors.
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