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Robinson JD, Cui Y, Karam-Hage M, Kypriotakis G, Versace F, Ait-Daoud Tiouririne N, Anthenelli RM, Cinciripini PM. Topiramate decreases the salience of motivationally relevant visual cues among smokers with alcohol use disorder. Alcohol Clin Exp Res 2022; 46:384-395. [PMID: 35037278 PMCID: PMC8920769 DOI: 10.1111/acer.14771] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 12/17/2021] [Accepted: 01/03/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND There is preliminary evidence that the anticonvulsant topiramate increases the likelihood of both smoking and alcohol abstinence among smokers with alcohol use disorder (AUD), but its therapeutic mechanism has not been determined. We used event-related potentials (ERPs) to evaluate topiramate's effect on the salience of drug-related, emotional, and neutral pictorial cues to identify whether one of its potential therapeutic mechanisms involves reduction of the salience of motivationally relevant cues. METHODS Participants enrolled in a multisite clinical trial treating smokers with AUD were randomly assigned to receive placebo, low-dose topiramate (up to 125 mg/day), or high-dose topiramate (up to 250 mg/day), along with brief behavioral compliance enhancement treatment. A subsample (n = 101) completed ERP assessments at baseline (1 week pre-medication) and week 5 (5 weeks on medication; 1 week pre-quit). We assessed the salience of pleasant, unpleasant, cigarette-related, alcohol-related, and neutral pictorial cues using the late positive potential (LPP) ERP component and measured self-reported substance use, reinforcement, craving, and withdrawal. RESULTS Five weeks of high-dose topiramate treatment decreased LPP amplitudes in response to both emotional (pleasant and unpleasant) and drug-related cues (alcohol and cigarette), but not to neutral cues. However, results showed that the LPPs were not significant mediators of the relationship between topiramate dose and post-quit measures of substance use, reinforcement, craving, or withdrawal. CONCLUSIONS These findings suggest that high-dose topiramate (up to 250 mg/day) decreases the motivational salience of both drug-related and emotional cues among smokers with AUD. However, the nonsignificant mediation analyses preclude any firm conclusions about whether this effect represents one of topiramate's therapeutic mechanisms of action.
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Affiliation(s)
- Jason D. Robinson
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Yong Cui
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Maher Karam-Hage
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - George Kypriotakis
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Francesco Versace
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Nassima Ait-Daoud Tiouririne
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Robert M. Anthenelli
- Pacific Treatment and Research Center, Department of Psychiatry, University of California, San Diego, Health Sciences, La Jolla, California, USA
| | - Paul M. Cinciripini
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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Patock-Peckham JA, Belton DA, D'Ardenne K, Tein JY, Bauman DC, Infurna FJ, Sanabria F, Curtis J, Morgan-Lopez AA, McClure SM. Dimensions of childhood trauma and their direct and indirect links to PTSD, impaired control over drinking, and alcohol-related-problems. Addict Behav Rep 2020; 12:100304. [PMID: 33364313 PMCID: PMC7752722 DOI: 10.1016/j.abrep.2020.100304] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 09/06/2020] [Accepted: 09/17/2020] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Post-Traumatic Stress Disorder (PTSD) develops after experiencing events that evoke fear, helplessness, or horror. The Hyperarousablity Hypothesis suggests that those with PTSD may drink more to dampen physiological reactivity. We examined the direct and indirect relationships between childhood trauma (e.g., physical-neglect, emotional-abuse, physical-abuse, sexual-abuse) versus an emotionally-supportive-family on PTSD, impaired control over drinking (IC), alcohol-use, and alcohol-related-problems. IC reflects consuming more alcohol than one originally intended. METHODS We fit a multiple-group SEM to data on 835 participants. Mediational analyses were conducted by using the (K = 20,000) bootstrap technique with confidence intervals. RESULTS Physical-neglect was directly linked to more IC among both genders. Emotional abuse was also found to be directly linked to more PTSD among both genders. Furthermore, PTSD was directly linked to more impaired control over alcohol use (IC) among both genders. Mediational analyses showed that physical-neglect was indirectly linked to more alcohol-related-problems through increased IC. Having an emotionally supportive family was directly linked to fewer PTSD symptoms among women. For both genders, emotional abuse was indirectly linked to more alcohol-related-problems through more PTSD symptoms, impaired control over alcohol use difficulties, and in turn, more alcohol-use. Sexual abuse was indirectly linked to increased alcohol-related- problems through increased PTSD symptoms and more IC, and in turn, more alcohol-use among men. CONCLUSIONS Recalled childhood trauma (sexual and emotional abuse) may contribute to PTSD symptoms and dysregulated drinking. In conclusion, our data suggest that reducing PTSD symptoms may assist individuals in regaining control over their drinking.
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Affiliation(s)
| | - Daniel A. Belton
- Arizona State University, Department of Psychology, Tempe, AZ, 85287, USA
| | | | - Jenn-Yun Tein
- Arizona State University, Department of Psychology, Tempe, AZ, 85287, USA
| | - Dylan C. Bauman
- Arizona State University, Department of Psychology, Tempe, AZ, 85287, USA
| | - Frank J. Infurna
- Arizona State University, Department of Psychology, Tempe, AZ, 85287, USA
| | - Federico Sanabria
- Arizona State University, Department of Psychology, Tempe, AZ, 85287, USA
| | - John Curtis
- Arizona State University, Department of Psychology, Tempe, AZ, 85287, USA
| | | | - Samuel M. McClure
- Arizona State University, Department of Psychology, Tempe, AZ, 85287, USA
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Vijeepallam K, Pandy V, Murugan DD, Naidu M. Methanolic extract of Mitragyna speciosa Korth leaf inhibits ethanol seeking behaviour in mice: involvement of antidopaminergic mechanism. Metab Brain Dis 2019; 34:1713-1722. [PMID: 31396844 DOI: 10.1007/s11011-019-00477-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 07/30/2019] [Indexed: 12/11/2022]
Abstract
In the current study, the effect of methanolic extract of Mitragyna speciosa leaf (MMS) against the rewarding and reinforcing properties of ethanol using a mouse model of conditioned place preference (CPP) and runway model of drug self-administration was studied. Subsequently, the effect of MMS on dopamine level in the nucleus accumbens (NAc) of the mouse brain was further investigated. From the data obtained, MMS (50 and 75 mg/kg, p.o.) significantly reversed the ethanol-place preference in mice, which is similar to the effect observed in the reference drugs acamprosate (300 mg/kg, p.o.) and clozapine (1 mg/kg, p.o.) treatment groups in CPP test. Likewise, the escalating doses of ethanol-conditioned mice reduced the runtime to reach goal box, infers the positive reinforcing effects of alcohol. Interestingly, MMS (50, 75 and 100 mg/kg, p.o.) significantly prolonged the runtime in ethanol-conditioned mice. Besides, MMS (50 and 75 mg/kg, p.o.) and reference drugs; acamprosate (300 mg/kg, p.o.) and clozapine (1 mg/kg, p.o.) treated mice significantly decreased the alcohol-induced elevated dopamine level in the NAc region of the brain. Overall, this study provides first evidence that MMS inhibits ethanol seeking behaviour in mice. Based on these findings, we suggest that Mitragyna speciosa may well be utilized for novel drug development to combat alcohol dependence.
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Affiliation(s)
- Kamini Vijeepallam
- Department of Pharmacology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Vijayapandi Pandy
- Department of Pharmacology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
- Department of Pharmacology, Chalapathi Institute of Pharmaceutical Sciences, Chalapathi Nagar, Lam, Guntur, Andhra Pradesh, 522034, India.
| | - Dharmani Devi Murugan
- Department of Pharmacology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Murali Naidu
- Department of Anatomy, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
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Stein MD, Kenney SR, Anderson BJ, Bailey GL. Loaded: Gun involvement among opioid users. Drug Alcohol Depend 2018; 187:205-211. [PMID: 29680676 PMCID: PMC5959793 DOI: 10.1016/j.drugalcdep.2018.03.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 02/26/2018] [Accepted: 03/08/2018] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Despite ample research examining how alcohol use relates to gun involvement, little is known about the relationship between opioids and gun involvement. In the current study, we examined correlates of gun possession, accessibility, and related behaviors in an opioid dependent sample. METHODS Between October 2016 and April 2017, we surveyed persons entering a brief, inpatient opioid detoxification (n = 386) and 51 contemporaneous persons seeking alcohol detoxification at the same facility in Massachusetts and recorded their lifetime experiences with gun involvement. RESULTS Participants averaged 33 years of age, 74% were male, 83% were White, and 64% had a history of incarceration. Opioid users had significantly higher rates of gun involvement than persons in alcohol detoxification; for example, 31.3% (vs. 3.9%) had carried a gun for protection, 45.1% (vs. 25.5%) had been threatened with a gun, and 13.8% (vs. 2.0%) had shot at another person. Among persons misusing opioids, male and non-White respondents, and those with a history of incarceration or poorer self-control reported greater gun involvement. CONCLUSIONS Opioid users, both men and women, lead gun-involved lives.
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Affiliation(s)
- Michael D Stein
- Behavioral Medicine and Addictions Research, Butler Hospital, 345 Blackstone Blvd., Providence, RI 02906, USA; Boston University School of Public Health, 715 Albany St., Boston, MA 02118, USA.
| | - Shannon R Kenney
- Behavioral Medicine and Addictions Research, Butler Hospital, 345 Blackstone Blvd., Providence, RI 02906, USA; Boston University School of Public Health, 715 Albany St., Boston, MA 02118, USA
| | - Bradley J Anderson
- Behavioral Medicine and Addictions Research, Butler Hospital, 345 Blackstone Blvd., Providence, RI 02906, USA
| | - Genie L Bailey
- Stanley Street Treatment and Resources, Inc., Fall River, MA 02720, USA; Warren Alpert Medical School of Brown University, 222 Richmond St., Providence, RI 02912, USA
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Fellows LK. The Cognitive Neuroscience of Human Decision Making: A Review and Conceptual Framework. ACTA ACUST UNITED AC 2016; 3:159-72. [PMID: 15653813 DOI: 10.1177/1534582304273251] [Citation(s) in RCA: 159] [Impact Index Per Article: 19.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Decision making, the process of choosing between options, is a fundamental human behavior that has been studied intensively by disciplines ranging from cognitive psychology to economics. Despite the importance of this behavior, the neural substrates of decision making are only beginning to be understood. Impaired decision making is recognized in neuropsychiatric conditions such as dementia and drug addiction, and the inconsistencies and biases of healthy decision makers have been intensively studied. However, the tools of cognitive neuroscience have only recently been applied to understanding the brain basis of this complex behavior. This article reviews the literature on the cognitive neuroscience of human decision making, focusing on the roles of the frontal lobes, and provides a conceptual framework for organizing this disparate body of work.
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Barrett SP, Jemcov A, Darredeau C. Patterns and Effects of Alcohol and Psychostimulant Co-administration: a Brief Review of Pharmacological Considerations and Subjective Responses. CURRENT ADDICTION REPORTS 2016. [DOI: 10.1007/s40429-016-0080-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Dopamine receptor agonists modulate voluntary alcohol intake independently of individual levels of alcohol intake in rats. Psychopharmacology (Berl) 2016; 233:2715-25. [PMID: 27236784 PMCID: PMC4917576 DOI: 10.1007/s00213-016-4330-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 04/27/2016] [Indexed: 02/03/2023]
Abstract
RATIONALE Individual susceptibility to alcohol use disorder has been related to functional changes in dopaminergic neurotransmission. OBJECTIVES The aim of the current work was to assess the effects of selective dopamine D1 and D2 receptor agonists and antagonists on alcohol consumption in rats that differ in individual levels of alcohol intake. METHODS The effects of the dopamine D1 receptor agonist SKF 82958, the dopamine D1 receptor antagonist SCH 23390, the dopamine D2 receptor agonist sumanirole and the dopamine D2 receptor antagonist L741,626 on alcohol consumption and preference were assessed at different time points after treatment in subgroups of low and high alcohol drinking rats (LD and HD) using an intermittent alcohol access paradigm. RESULTS SKF 82958 decreased alcohol intake and alcohol preference throughout the 24-h session. Sumanirole decreased alcohol intake during the first 2 h, but increased alcohol intake during the remainder of the session. The effects of SKF 82958 and sumanirole on alcohol intake and alcohol preference were comparable in LD and HD. By contrast, the dopamine receptor antagonists SCH 23390 and L741,626 did not alter alcohol consumption in either group at any time point. CONCLUSIONS These data indicate that stimulation of dopamine D1 receptors reduces alcohol intake, but that endogenous dopamine does not play a primary role in alcohol consumption. Moreover, the difference in alcohol consumption between LD and HD does not involve altered dopamine signaling.
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The antipsychotic aripiprazole selectively prevents the stimulant and rewarding effects of morphine in mice. Eur J Pharmacol 2014; 742:139-44. [DOI: 10.1016/j.ejphar.2014.09.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2014] [Revised: 09/01/2014] [Accepted: 09/02/2014] [Indexed: 01/23/2023]
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Haass-Koffler CL, Leggio L, Kenna GA. Pharmacological approaches to reducing craving in patients with alcohol use disorders. CNS Drugs 2014; 28:343-60. [PMID: 24573997 PMCID: PMC3990000 DOI: 10.1007/s40263-014-0149-3] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Research on the concept of craving may lead to better understanding of the biobehavioural circuitries that contribute to the complexity of alcohol use disorders (AUDs). The experiences described as craving or desire to drink are often associated with physical responses such as increased salivation and heart rate, and alteration of stress hormones, as well as psychological responses such as anxiety and depression. Greater craving has been associated with an increased probability of alcohol relapse. Reversal of craving, which is understood as a symptom of protracted abstinence, offers the possibility of preventing relapses and treating alcoholism. Various medications have been studied to establish whether they are able to reduce craving; however, the results obtained from clinical studies have been inconsistent. Here, we review the interdisciplinary models developed to evaluate craving, then the different approaches used to assess and measure craving and, finally, the medications utilized and tested to lessen craving in patients suffering from AUDs.
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Affiliation(s)
| | - Lorenzo Leggio
- Center for Alcohol & Addiction Studies, Brown University, Providence, Rhode Island, USA
- Intramural Research Program, National Institute on Drug Abuse (NIDA), National Institutes of Health (NIH), Baltimore, Maryland, USA
| | - George A. Kenna
- Center for Alcohol & Addiction Studies, Brown University, Providence, Rhode Island, USA
- Department of Psychiatry and Human Behavior, Brown University, Providence, Rhode Island, USA
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Leeman RF, Beseler CL, Helms CM, Patock-Peckham JA, Wakeling VA, Kahler CW. A brief, critical review of research on impaired control over alcohol use and suggestions for future studies. Alcohol Clin Exp Res 2014; 38:301-8. [PMID: 24117468 PMCID: PMC3946792 DOI: 10.1111/acer.12269] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2013] [Accepted: 07/12/2013] [Indexed: 11/30/2022]
Abstract
Impaired control, defined as "a breakdown of an intention to limit consumption" (Heather et al. J Stud Alcohol 1993; 54, 701), has historically been considered an important aspect of addiction. Despite recognition of its importance to addiction and potential value as an early indicator of problem drinking risk, we argue that impaired control over alcohol use has not received sufficient research attention. In an effort to spark further research, the present critical review offers brief discussion of the current state of knowledge regarding impaired control and avenues for future research. Three main research areas are addressed: (i) epidemiology; (ii) measurement issues; and (iii) potential mechanisms underlying relationships between impaired control and subsequent problem drinking. Measurement issues include complexities involved in self-report assessment of impaired control, development and validation of human and animal laboratory models, and impaired control's relationship to other constructs (i.e., impulsivity and other difficulties with self-control; symptoms of dependence such as craving). We discuss briefly 2 potential mechanisms that may help to explain why some drinkers experience impaired control while others do not: neurobiological dysfunction and family history/genetics. Suggestions for future research are focused on ways in which the impaired control construct may enhance prediction of who might be at particular risk of subsequent problem drinking and to facilitate intervention to reduce problem alcohol use.
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Affiliation(s)
- Robert F Leeman
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
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Viana TG, Almeida-Santos AF, Aguiar DC, Moreira FA. Effects of aripiprazole, an atypical antipsychotic, on the motor alterations induced by acute ethanol administration in mice. Basic Clin Pharmacol Toxicol 2012; 112:319-24. [PMID: 23157340 DOI: 10.1111/bcpt.12036] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2012] [Accepted: 10/31/2012] [Indexed: 11/30/2022]
Abstract
Aripiprazole is an antipsychotic that acts as a partial agonist at dopamine receptors. As the effects of most drugs of abuse converge to enhance dopamine-mediated neurotransmission, the present study was designed to test the hypothesis that aripiprazole would inhibit the acute effects of ethanol, a widely abused substance. Male Swiss mice received acute injections and were evaluated for motor activity in three distinct tests. In the open field, ethanol (1.5, 2.5 and 3.5 g/kg) induced an increase in locomotion in a U-shaped dose-related fashion, whereas aripiprazole (0.1, 1 and 10 mg/kg) did not affect this parameter. All the doses of the antipsychotic were able to prevent the stimulant effects of 2.5 g/kg of ethanol. In the rotarod test, ethanol (2.5 and 3.5 g/kg) reduced the latency to fall from the apparatus, an effect also observed with the higher dose of aripiprazole. Contrary to what was observed in the open field, this antipsychotic did not interfere with the effects of ethanol in motor balance. Finally, we tested animals in the wire hang test, in which ethanol, but not aripiprazole, reduced latency to fall at all doses. In this test, aripiprazole did not change ethanol effects. The present data lead to the conclusion that aripiprazole prevents the stimulant effects of ethanol on locomotion, without interfering with the motor impairment induced by this drug.
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Affiliation(s)
- Thercia G Viana
- Department of Pharmacology, Institute of Biological Sciences, Federal University of Minas Gerais (Universidade Federal de Minas Gerais), Belo Horizonte, MG, Brazil
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Sun HQ, Liu Y, Li P, Bao YP, Sheng LX, Zhang RL, Cao YJ, Di XL, Yang FD, Wang F, Luo YX, Lu L. Effects of acute combined serotonin and dopamine depletion on cue-induced drinking intention/desire and cognitive function in patients with alcohol dependence. Drug Alcohol Depend 2012; 124:200-6. [PMID: 22325080 DOI: 10.1016/j.drugalcdep.2012.01.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2011] [Revised: 12/31/2011] [Accepted: 01/01/2012] [Indexed: 12/22/2022]
Abstract
BACKGROUND Alcohol cues can precipitate the desire to drink and cause relapse in recovering alcohol-dependent patients. Serotonin and dopamine may play a role in alcohol cue-induced craving. Acute combined tryptophan (Trp), tyrosine (Tyr), and phenylalanine (Phe) depletion (CMD) in the diet attenuates the synthesis of serotonin and dopamine in the human brain. However, no study of the effects of acute CMD has been previously conducted. Therefore, we investigated whether the attenuation of serotonin and dopamine synthesis changes cue-induced alcohol craving in recently abstinent alcoholics. METHODS In this double-blind, randomized, placebo-controlled, crossover design, 12 male patients who met the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, criteria for alcohol dependence were divided into two conditions: (1) monoamine depletion (i.e., consumption of a concentrated amino acid beverage that resulted in a rapid and significant decrease in plasma-free Tyr/Phe/Trp) and (2) balanced condition (i.e., consumption of a similar beverage that contained Tyr/Phe/Trp). The participants were scheduled for two experimental sessions, with an interval of ≥7 days. The cue-induced craving test session was conducted 6h after each amino acid beverage administration. Drinking urge, blood pressure, heart rate, working memory, and attention/psychomotor performance were assessed before and after administration. RESULTS Compared with the balanced condition, the monoamine depletion condition significantly increased drinking intention/desire and diastolic blood pressure. Cognitive performance was not different between the two conditions. CONCLUSIONS Acute combined serotonin and dopamine depletion may increase drinking intention/desire and diastolic blood pressure without influencing cognitive function.
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Affiliation(s)
- Hong-Qiang Sun
- National Institute on Drug Dependence, Peking University, Beijing 100191, China.
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Leeman RF, Patock-Peckham JA, Potenza MN. Impaired control over alcohol use: An under-addressed risk factor for problem drinking in young adults? Exp Clin Psychopharmacol 2012; 20:92-106. [PMID: 22182417 PMCID: PMC3613490 DOI: 10.1037/a0026463] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Impaired control over alcohol use may be defined as "a breakdown of an intention to limit consumption in a particular situation" (Heather, Tebbutt, Mattick, & Zamir, 1993, p. 701) and has long been considered an important feature of alcohol dependence. Evidence suggests impaired control is highly relevant to young adult problem drinking. In the natural history of problem drinking, impaired control tends to develop early and may predict alcohol-related problems prospectively in undergraduates. Impaired control over alcohol use may be a facet of generalized behavioral undercontrol specifically related to drinking. In particular, impaired control is theoretically and empirically related to impulsivity. The question of whether impaired control represents a facet of impulsivity or a related but separate construct requires further study. However, theoretical arguments and empirical evidence suggest that there are unique qualities to the constructs. Specifically, existing data suggest that self-report measures of impaired control and impulsivity over alcohol use relate distinctly to problem drinking indices in young adults. Several lines of future research concerning impaired control are suggested, using the impulsivity literature as a guide. We conclude that impaired control is a valuable construct to the study of young adult problem drinking and that measures of impaired control should be included in more young adult alcohol studies. The extent to which impaired control over the use of other substances and impaired control over engagement in other addictive behaviors are clinically relevant constructs requires additional study.
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Affiliation(s)
- Robert F Leeman
- Department of Psychiatry, Yale University School of Medicine, Substance Abuse Center, CMHC, 34 Park Street, Room S200, New Haven, CT 06519, USA.
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Guardia J, Roncero C, Galan J, Gonzalvo B, Burguete T, Casas M. A double-blind, placebo-controlled, randomized pilot study comparing quetiapine with placebo, associated to naltrexone, in the treatment of alcohol-dependent patients. Addict Behav 2011; 36:265-9. [PMID: 21146937 DOI: 10.1016/j.addbeh.2010.11.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2010] [Revised: 09/21/2010] [Accepted: 11/04/2010] [Indexed: 11/24/2022]
Abstract
The objective of this study was to determine whether quetiapine plus naltrexone is more effective than naltrexone alone for the treatment of alcohol-dependent patients. This was a double-blind, randomized clinical trial where eligible alcohol-dependent patients were randomized to receive naltrexone (50mg/day) plus quetiapine (25-200mg/day) or naltrexone (50mg/day) plus placebo for 12 weeks, and afterwards patients received naltrexone alone during 4 additional weeks. The primary efficacy measures were percent days abstinent, drinks per drinking day, and the relapse rate. Sixty-two patients received a single-blind treatment with placebo plus naltrexone, and they were thereafter randomly assigned to quetiapine plus naltrexone (n=30) or placebo plus naltrexone (n=32). Eleven (36.7%) patients in the quetiapine-treated group and 4 (12.5%) patients in the placebo-treated group withdrew before they completed 12 weeks of treatment. There were no statistically significant differences for any primary drinking outcomes between treatment groups. Both regimens were well tolerated. This study failed to demonstrate any additional benefit from the combination of quetiapine and naltrexone compared to naltrexone alone on drinking outcomes.
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Droblenkov AV, Karelina NR. Structural characteristics of neurons and macrogliocytes in interconnected regions of the mesoaccumbocingulate dopaminergic system in rats. NEUROSCIENCE AND BEHAVIORAL PHYSIOLOGY 2010; 40:761-6. [PMID: 20635213 DOI: 10.1007/s11055-010-9323-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2008] [Revised: 05/28/2009] [Indexed: 11/30/2022]
Abstract
Studies in rats (n = 6) in normal conditions addressed the morphometric parameters of neurons and macrogliocytes in the interconnected anteromedial regions of the mesoaccumbocingulate (MAC) dopaminergic system, which is important for diagnosing and identifying the morphogenesis of addiction states. A spatial model of the system was constructed which took into account the mean distance of frontal sections from the frontal pole; the densities of neurons and macrogliocytes were assessed in the central part of the paranigral nucleus of the ventral tegmental area (VTA) and the compact zone of the substantia nigra (SN) and in the interconnected anteromedial segments of these midbrain nuclei, the cingulate fields, the nucleus accumbens (NA), and layer VI of the pregenual (Cg3) and layer III of the supragenual (Cg2) cingulate fields. The anteromedial segments of the paranigral nucleus of the VTA and the compact zone of the SN, which are interconnected with these cingulate structures and the NA, contained larger numbers of neurons than the other segments, as they occupied a larger volume, while there were no differences in the volumes of neurons in the anterior and central parts of these segments. The anterior part of the compact zone of the SN also differed in having a greater neuron density. The anteromedial parts of the paranigral nucleus of the VTA and the compact zone of the SN (12.20 +/- 0.10 mm from the frontal pole) had the greatest diagnostic value in the morphological assessment of addiction because the lateral part of the paranigral nucleus of the VTA contained the largest number of non-dopaminergic neurons, while the neuron bodies of the other nuclear groups of the VTA were small in size. The medial part of the NA had its greatest volume (and, thus, number of neurons) in the central part of the nucleus (5.10 +/- 0.10 mm from the frontal pole) at the level of the anterior part of the supragenual cingulate field (Cg2). Layer VI of the pregenual cingulate field (Cg3) was most compact at the level of the base of the anterior forceps (2.40 +/- 0.10 mm from the frontal pole).
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Affiliation(s)
- A V Droblenkov
- St. Petersburg Bureau of Forensic Medicine, St. Petersburg, Russia
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Abstract
Addiction is increasingly understood as a neurobiological illness where repetitive substance abuse corrupts the normal circuitry of rewarding and adaptive behaviors causing drug-induced neuroplastic changes. The addictive process can be examined by looking at the biological basis of substance initiation to the progression of substance abuse to dependence to the enduring risk of relapse. Critical neurotransmitters and neurocircuits underlie the pathological changes at each of these stages. Enhanced dopamine transmission in the nucleus accumbens is part of the common pathway for the positively rewarding aspects of drugs of abuse and for initiation of the addictive process. F-Aminobutyric acid,opioid peptides, serotonin, acetylcholine, the endocannabinoids, and glutamate systems also play a role in the initial addictive process. Dopamine also plays a key role in conditioned responses to drugs of abuse, and addiction is now recognized as a disease of pathological learning and memory. In the path from substance abuse to addiction, the neurochemistry shifts from a dopamine-based behavioral system to a predominantly glutamate-based one marked by dysregulated glutamate transmission from the prefrontal cortex to the nucleus accumbens in relation to drug versus biologically oriented stimuli. This is a core part of the executive dysfunction now understood as one of the hallmark features of addiction that also includes impaired decision making and impulse dysregulation.Understanding the neurobiology of the addictive process allows for a theoretical psychopharmacological approach to treating addictive disorders,one that takes into account biological interventions aimed at particular stages of the illness.
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Affiliation(s)
- Stephen Ross
- Division of Alcoholism and Drug Abuse, Bellevue Hospital, NYU Langone Center of Excellence on Addiction, New York University School of Medicine, New York, NY 10016, USA.
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18
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De Sousa A. The pharmacotherapy of alcohol dependence: a state of the art review. Mens Sana Monogr 2010; 8:69-82. [PMID: 21327171 PMCID: PMC3031941 DOI: 10.4103/0973-1229.58820] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2009] [Revised: 07/17/2009] [Accepted: 07/18/2009] [Indexed: 12/20/2022] Open
Abstract
The psychopharmacology of alcohol dependence is today poised at interesting crossroads. Three major drugs Naltrexone, Disulfiram and Acamprosate have been tried and tested in various trials and have many meta-analyses each to support them. While Naltrexone may reduce craving, Acamprosate scores on cost effectiveness worldwide with Disulfiram being an alcohol deterrent drug. Studies support, refute and criticize the use of each of these drugs. Combining one or more of them is also a trend seen. The most important factor in efficacy has been the combination of psychosocial treatment with medication. Studies from the early 1970s to date have been reviewed and the findings presented in a manner useful for the busy clinician to judge the best pharmacological option in the management of alcohol dependence. The role of depot disulfiram, naltrexone, and medications like Topiramate and SSRIs under research for alcohol dependence, are also addressed.
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Barrett SP, Pihl RO, Benkelfat C, Brunelle C, Young SN, Leyton M. The role of dopamine in alcohol self-administration in humans: individual differences. Eur Neuropsychopharmacol 2008; 18:439-47. [PMID: 18367384 DOI: 10.1016/j.euroneuro.2008.01.008] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2007] [Revised: 01/08/2008] [Accepted: 01/22/2008] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To clarify dopamine's role in alcohol self-administration in a heterogeneous sample of drinkers using acute phenylalanine/tyrosine depletion (APTD). METHODS Sixteen men with variable drinking histories were characterized on their ethanol-induced cardiac response, a marker previously proposed to index dopamine system reactivity and vulnerability to alcohol abuse. During separate sessions participants were administered (i) a nutritionally balanced (BAL) amino acid (AA) mixture, (ii) a mixture lacking the dopamine precursors, phenylalanine and tyrosine, and (iii) APTD followed by the dopamine precursor, L-DOPA. Five hours after AA administration, participants could earn units of alcohol using a progressive ratio breakpoint task. RESULTS Alcohol self-administration was reduced in the APTD and APTD+L-DOPA conditions relative to the BAL condition. In both cases the changes were predicted by ethanol-induced cardiac change. CONCLUSIONS The motivation to drink is likely regulated by more than one neurobiological mechanism. Individual differences in cardiac responsivity to ethanol might provide a peripheral marker of responsiveness to pharmacological manipulations of dopamine.
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Affiliation(s)
- Sean P Barrett
- Psychology Department, McGill University, 1033 Pine Avenue West, Montreal, Quebec, Canada
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20
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Hanley MJ, Kenna GA. Quetiapine: Treatment for substance abuse and drug of abuse. Am J Health Syst Pharm 2008; 65:611-8. [DOI: 10.2146/ajhp070112] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Michael J. Hanley
- Tufts University, Boston, MA; at the time of writing he was Pharm.D. candidate, University College of Pharmacy, Kingston, RI
| | - George A. Kenna
- Center for Alcohol and Addiction Studies (CAAS), Brown University, Providence, RI; at the time of writing he was Postdoctoral Fellow in Community Health, CAAS, Brown University
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Kranzler HR, Covault J, Pierucci-Lagha A, Chan G, Douglas K, Arias AJ, Oncken C. Effects of aripiprazole on subjective and physiological responses to alcohol. Alcohol Clin Exp Res 2008; 32:573-9. [PMID: 18261195 PMCID: PMC3159685 DOI: 10.1111/j.1530-0277.2007.00608.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Aripiprazole is an atypical antipsychotic with partial agonist activity at D(2) receptors, which could reduce the reinforcing effects of alcohol. The present study examined whether aripiprazole modifies the behavioral and physiological effects of a moderate dose of alcohol in a group of social drinkers. METHODS Eighteen healthy subjects (9 men; mean age = 27.6 years) completed a double-blind, within-subject study with 3 experimental sessions in a randomized sequence, during which they received no medication, aripiprazole 2.5 mg, or aripiprazole 10 mg on the day prior to the laboratory session. During the session, subjects consumed alcohol that was served as three standardized drinks (i.e., a total of 0.8 g/kg for men and 0.7 g/kg for women). Breath alcohol concentration (BrAC), heart rate, blood pressure, static ataxia, and subjective effects were measured regularly throughout the laboratory sessions. RESULTS Alcohol consumption produced physiological and subjective responses that were consistent with the literature on its effects. Pre-treatment with aripiprazole was generally well tolerated, with tiredness being the most commonly reported adverse event. The medication was associated with modest physiological effects. It also significantly and dose-dependently increased the sedative effects of alcohol and, to a lesser degree, decreased the euphoric effects of alcohol. CONCLUSIONS These findings require replication in a larger subject sample that includes heavy drinkers and in a study that employs a placebo session. Based on its capacity to increase the sedative effects and decrease the euphoric effects of alcohol, aripiprazole could be of value in the treatment of heavy drinking.
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Affiliation(s)
- Henry R Kranzler
- Department of Psychiatry, Alcohol Research Center, University of Connecticut School of Medicine, Farmington, Connecticut 06030-2103, USA.
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22
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[Management of comorbid bipolar disorder and alcohol dependence]. Presse Med 2008; 37:1132-7. [PMID: 18296020 DOI: 10.1016/j.lpm.2007.09.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2007] [Revised: 09/18/2007] [Accepted: 09/18/2007] [Indexed: 11/24/2022] Open
Abstract
Recent studies confirm the clear association between bipolar disorders and alcohol abuse and dependence. Lifetime prevalence of disorders associated with alcohol abuse or dependence appears to be 3 to 4 times higher in patients with bipolar disorders than in the general population. Lifetime prevalence of mood disorders in alcohol-dependent subjects is approximately 10 times higher than in the general population. Despite the strength of this association, there is little information about specific management that takes into account both disorders and their interaction. One study shows that valproate may reduce excessive alcohol consumption in bipolar alcohol-dependent patients, especially because of its stabilizing and anticonvulsant effects. Based on this study, the American Psychiatry Association (APA) recently suggested the use of valproate in the treatment of patients with comorbid bipolar disorder and alcohol dependence.
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Bender S, Scherbaum N, Soyka M, Rüther E, Mann K, Gastpar M. The efficacy of the dopamine D2/D3 antagonist tiapride in maintaining abstinence: a randomized, double-blind, placebo-controlled trial in 299 alcohol-dependent patients. Int J Neuropsychopharmacol 2007; 10:653-60. [PMID: 17076934 DOI: 10.1017/s1461145706007164] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
In this investigation, the hypothesis was tested whether the selective dopamine D2/D3 receptor antagonist tiapride is effective in maintaining abstinence after detoxification in alcohol-dependent patients. The rationale of the study was based on the relevance of the dopaminergic system for addictive behaviour as well as some preliminary studies. A multi-centre, randomized, double-blind, placebo-controlled, parallel-group study was conducted. A total of 299 detoxified alcohol-dependent patients (ICD-10: F10.2) received either tiapride (300 mg/d) or placebo over a 24-wk study period. Subjects with severe comorbid psychiatric disorder such as schizophrenia or Wernicke-Korsakoff syndrome were excluded. Primary outcome variable was the time to first relapse with relapse defined as any alcohol consumption after detoxification. Data analysis was done with Kaplan-Meier estimates with log-rank test (one-sided, p<0.05). Tiapride was not superior to placebo in maintaining abstinence. The time to first relapse was 71 d in the tiapride group and 92 d in the placebo group (log-rank test, p=0.9895). Relapse rate was higher in the intervention group (54.4%) than in the control group (40.7%). Like the dopamine antagonist flupenthixol, tiapride was not effective in maintaining alcohol abstinence. Regarding the high success rate in the placebo group the influence of psychosocial treatment in studies investigating drug effects on the course of alcohol dependence has to be considered.
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Affiliation(s)
- Stefan Bender
- Department of Psychiatry and Psychotherapy, Rhine State Hospital, University Hospital Essen, Germany.
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24
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Kampman KM, Pettinati HM, Lynch KG, Whittingham T, Macfadden W, Dackis C, Tirado C, Oslin DW, Sparkman T, O'Brien CP. A double-blind, placebo-controlled pilot trial of quetiapine for the treatment of Type A and Type B alcoholism. J Clin Psychopharmacol 2007; 27:344-51. [PMID: 17632217 PMCID: PMC3193934 DOI: 10.1097/jcp.0b013e3180ca86e5] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Atypical antipsychotics may be useful in the treatment of alcohol dependence. Human trials suggest that atypical antipsychotics may reduce alcohol craving and consumption, especially among patients with comorbid psychopathology. Therefore, these medications may be more useful for treating more severely affected alcoholics, such as patients with Type B alcoholism. Type B alcoholics are characterized by an early age of onset of problem drinking, high severity of alcohol dependence, increased psychopathology, and treatment-resistance. Quetiapine is an atypical antipsychotic with a favorable side effect profile, and may be a promising medication for the treatment of alcohol dependence, particularly Type B alcoholism. METHODS Male and female alcoholics (33 Type A and 28 Type B) were included in a 12-week, double-blind, placebo-controlled trial. After detoxification, patients were randomized to receive quetiapine (n = 29), 400 mg/d at bedtime, or placebo (n = 32). The primary outcome measure was the quantity and frequency of alcohol consumption, measured by the timeline follow back. RESULTS Forty-seven patients (77%) completed the trial, with no significant between-group differences in treatment retention. Nine quetiapine-treated patients (31%) maintained complete abstinence compared with 2 placebo-treated patients (6%) (chi(2) = 6.3, P = 0.012). There was a significant interaction between quetiapine and alcoholic subtype. As predicted, quetiapine- versus placebo-treated Type B alcoholics had significantly fewer days of drinking and fewer days of heavy drinking. Alcohol craving was also significantly reduced in quetiapine-treated compared with placebo-treated Type B alcoholics. Among Type A alcoholics, quetiapine provided no advantage over placebo in improving drinking outcomes. CONCLUSIONS Quetiapine may be effective for the treatment of alcohol dependence, particularly in the more complicated Type B, early-onset alcoholics.
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Affiliation(s)
- Kyle M Kampman
- Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA.
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25
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van den Wildenberg E, Janssen RGJH, Hutchison KE, van Breukelen GJP, Wiers RW. Polymorphisms of the dopamine D4 receptor gene (DRD4 VNTR) and cannabinoid CB1 receptor gene (CNR1) are not strongly related to cue-reactivity after alcohol exposure. Addict Biol 2007; 12:210-20. [PMID: 17508995 DOI: 10.1111/j.1369-1600.2007.00064.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Polymorphisms in the D4 dopamine receptor gene (DRD4) and the CB1 cannabinoid receptor gene (CNR1) have been associated with a differential response to alcohol after consumption. The goal of the present study was to investigate whether heavy drinkers with these polymorphisms would respond with enhanced cue-reactivity after alcohol exposure. Eighty-eight male heavy drinkers were genotyped for the DRD4 variable number of tandem repeats (VNTR) [either DRD4 long (L) or short (S)] and the CNR1 rs2023239 polymorphism (either CT/CC or TT). Participants were exposed to water and beer in 3-minute trials. Dependent variables of main interest were subjective craving for alcohol, subjective arousal and salivary reactivity. Overall, no strong evidence was found for stronger cue-reactivity (= outcome difference between beer and water trial) in the DRD4 L and CNR1 C allele groups. The DRD4 VNTR polymorphism tended to moderate salivary reactivity such that DRD4 L participants showed a larger beverage effect than the DRD4 S participants. Unexpectedly, the DRD4 L participants reported, on average, less craving for alcohol and more subjective arousal during cue exposure, compared with the DRD4 S participants. As weekly alcohol consumption increased, the CNR1 C allele group tended to report more craving for alcohol during the alcohol exposure than the T allele group. The DRD4 and CNR1 polymorphisms do not appear to strongly moderate cue-reactivity after alcohol cue exposure, in male heavy drinkers.
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Affiliation(s)
- Esther van den Wildenberg
- Faculty of Psychology, Experimental Psychology, University of Maastricht, Maastricht, the Netherlands.
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26
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Croissant B, Klein O, Gehrlein L, Kniest A, Hermann D, Diehl A, Mann K. Quetiapine in relapse prevention in alcoholics suffering from craving and affective symptoms: a case series. Eur Psychiatry 2007; 21:570-3. [PMID: 17161284 DOI: 10.1016/j.eurpsy.2006.04.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Quetiapine is a novel antipsychotic, which is efficacious in the treatment of positive and negative symptoms in schizophrenia. Research has shown that atypical antipsychotic also reduce the craving and consumption for stimulants and alcohol. Due to Quetiapine's particulars and the promising receptor profile concerning addiction medicine, we set out to examine the tolerability and efficacy concerning relapse prevention of withdrawn alcoholics suffering from craving and affective symptoms. SUBJECTS AND METHODS Our case observations attempted to evaluate nine alcoholics after withdrawal suffering from persisting craving, sleep disorder, excitement, depressive symptoms or anxiety symptoms. The patients were treated with quetiapine as relapse prevention and we followed them up in our outpatient clinic. RESULTS Eight out of nine patients were abstinent under quetiapine over a period of 2-7 months. One of these patients relapsed after he stopped taking the preparation at his own initiative after 10 weeks. The ninth patient stopped taking the preparation immediately because of swollen nasal mucosae. All target symptoms disappeared in the patients after an average of (mean+/-S.D.) 24.5+/-18.1 days. The overall tolerability was considered to be very good; however, initial sleepiness appeared in four patients. CONCLUSION Although uncontrolled case observations can only be interpreted with caution quetiapine seems to deserve further investigation and may hold the potential for preventing alcohol relapse in alcoholics suffering from additional above-mentioned symptoms.
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Affiliation(s)
- B Croissant
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, University of Heidelberg, J 5, D-68159 Mannheim, Germany.
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Abstract
In recent years, advances in neuroscience led to the development of new medications to treat alcohol dependence and especially to prevent alcohol relapse after detoxification. Whereas the earliest medications against alcohol dependence were fortuitously discovered, recently developed drugs are increasingly based on alcohol's neurobiological mechanisms of action. This review discusses the most recent developments in alcohol pharmacotherapy and emphasizes the neurobiological basis of anti-alcohol medications. There are currently three approved drugs for the treatment of alcohol dependence with quite different mechanisms of action. Disulfiram is an inhibitor of the enzyme aldehyde dehydrogenase and acts as an alcohol-deterrent drug. Naltrexone, an opiate antagonist, reduces alcohol craving and relapse in heavy drinking, probably via a modulation of the mesolimbic dopamine activity. Finally, acamprosate helps maintaining alcohol abstinence, probably through a normalization of the chronic alcohol-induced hyperglutamatergic state. In addition to these approved medications, many other drugs have been suggested for preventing alcohol consumption on the basis of preclinical studies. Some of these drugs remain promising, whereas others have produced disappointing results in preliminary clinical studies. These new drugs in the field of alcohol pharmacotherapy are also discussed, together with their mechanisms of action.
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Affiliation(s)
- Sophie Tambour
- Unité de Recherche en Psychologie Expérimentale et Neurosciences Cognitives (URPENC), Université de Liège, Boulevard du Rectorat 5/B32, B-4000 Liège, Belgium
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Hutchison KE, Ray L, Sandman E, Rutter MC, Peters A, Davidson D, Swift R. The effect of olanzapine on craving and alcohol consumption. Neuropsychopharmacology 2006; 31:1310-7. [PMID: 16237394 DOI: 10.1038/sj.npp.1300917] [Citation(s) in RCA: 86] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Previous studies have indicated that olanzapine decreases craving after a priming dose of alcohol, that craving after a priming dose of alcohol is greater among individuals with the seven-repeat allele of the DRD4 variable number of tandem repeats (VNTR) polymorphism, and that the effect of olanzapine (a D2/D4 antagonist) is more pronounced among individuals with this allele. The present study tested the hypothesis that olanzapine may be differentially effective at reducing cue-elicited craving and differentially effective as a treatment for alcohol dependence over the course of a 12-week, randomized, placebo-controlled trial among individuals with and without the seven-repeat allele. Participants who met DSM IV criteria for alcohol dependence were randomly assigned to receive olanzapine (5 mg) or a placebo over the course of the trial. After 2 weeks of treatment, participants completed a cue reactivity assessment. The results suggested that participants who were homozygous or heterozygous for the seven (or longer)-repeat allele of the DRD4 VNTR responded to olanzapine with reductions in cue-elicited craving as well as reductions in alcohol consumption over the course of the 12-week trial, whereas individuals with the shorter alleles did not respond favorably to olanzapine.
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Affiliation(s)
- Kent E Hutchison
- Department of Psychology, University of Colorado at Boulder, Boulder, CO 80309-0345, USA.
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29
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Samson HH, Chappell AM. Effects of Raclopride in the Core of the Nucleus Accumbens on Ethanol Seeking and Consumption: The Use of Extinction Trials to Measure Seeking. Alcohol Clin Exp Res 2006; 28:544-9. [PMID: 15100604 DOI: 10.1097/01.alc.0000121649.81642.3f] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND A previous study using a sipper procedure of ethanol self-administration found that blockade of the D2 dopamine (DA) receptors in the nucleus accumbens resulted in a reduction in ethanol-seeking behavior with only slight effects on ethanol drinking. However, because of procedural matters in that study, it was unclear as to the extent of the reduction in seeking behavior that occurred. This study expanded that study to examine in more depth the role of DA transmission in the nucleus accumbens in ethanol-seeking and consummatory behaviors. METHODS Male Long-Evans rats were initiated to self-administer 10% ethanol with a sipper-tube procedure. Once initiated, in a once-a-day session, pressing a lever 30 times resulted in a sipper tube containing the ethanol solution being made available for 20 min. By using extinction trials in which no sipper was presented and responses were recorded for 20 min, a measure of ethanol seeking, with no effects of consumption, could be obtained. Bilateral microinjections of 1.0, 3.0, and 10.0 microg of raclopride into the nucleus accumbens were tested on both consummatory and extinction trials. RESULTS There were significant decreases in ethanol-seeking responses at both the 3.0- and 10.0-microg doses of raclopride, whereas no effects of those doses on consumption were observed. The effects on extinction responding were the same for the first run of responses as for total responding, without effecting rates of responding. CONCLUSIONS These findings replicate and expand the initial study with this model of ethanol self-administration and indicate that DA transmission at the D2 receptor in the nucleus accumbens is important for processing information related to stimulus control and goal-directed behavior. The results also suggest that DA has at most a minor role in controlling ethanol consumption once a drinking bout has begun.
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Affiliation(s)
- Herman H Samson
- Center for the Neurobehavioral Study of Alcohol, Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157-1083, USA.
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Guardia J, Segura L, Gonzalvo B, Iglesias L, Roncero C, Cardús M, Casas M. A Double-Blind, Placebo-Controlled Study of Olanzapine in the Treatment of Alcohol-Dependence Disorder. Alcohol Clin Exp Res 2006; 28:736-45. [PMID: 15166648 DOI: 10.1097/01.alc.0000125352.06688.f7] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND A 12-week, double-blind, randomized, parallel-group clinical trial, comparing olanzapine and placebo treatment together with cognitive-behavioral psychotherapy, was carried out to determine the efficacy, safety, and tolerability of olanzapine in the treatment of alcoholism. METHODS A total of 60 alcohol-dependent patients were assigned to 12 weeks' treatment with either olanzapine or placebo. The primary variable relapse to heavy drinking rate was evaluated by means of intention-to-treat analyses. Alcohol consumption, craving, adverse events, and changes in the biochemical markers of heavy drinking and possible toxicity were also evaluated. RESULTS We did not find significant differences in the survival analysis between placebo and olanzapine-treated patients (Kaplan-Meier log rank = 0.46, df = 1, p = 0.50). Eleven (37.9%) patients treated with olanzapine relapsed compared with 9 (29%) of those receiving placebo (chi = 0.53, df = 1, p = 0.5). Although some adverse events (weight gain, increased appetite, drowsiness, constipation, and dry mouth) were found more frequently in the olanzapine group, differences did not reach statistical significance in comparison with the placebo group. CONCLUSIONS Olanzapine was well tolerated, as the rate of adverse events was low, and it was safe, because it did not interfere with the normalization of biochemical markers of heavy drinking or alter liver function markers. Alcohol-dependent patients showed good adherence and compliance with the treatment protocol, but we found no differences in relapse rate or other drinking variables when comparing olanzapine with placebo-treated patients.
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Affiliation(s)
- José Guardia
- Addictive Behavior Unit, Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
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Barrett SP, Tichauer M, Leyton M, Pihl RO. Nicotine increases alcohol self-administration in non-dependent male smokers. Drug Alcohol Depend 2006; 81:197-204. [PMID: 16054779 DOI: 10.1016/j.drugalcdep.2005.06.009] [Citation(s) in RCA: 137] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2005] [Revised: 05/23/2005] [Accepted: 06/30/2005] [Indexed: 11/27/2022]
Abstract
BACKGROUND Alcohol and tobacco are commonly co-administered, yet little is known about the effects of acute nicotine administration on alcohol consumption in humans. This study sought to determine how nicotine delivered by tobacco smoke influences alcohol intake in humans using a double-blind placebo controlled repeated measures design. METHODS During two randomized 120 min sessions 15 male occasional smokers smoked four nicotine-containing or four de-nicotinized cigarettes at 30 min intervals. Throughout the session, subjects could earn units of their preferred alcoholic beverage and glasses of water using a progressive-ratio (PR) task. RESULTS Wilcoxon signed-rank tests indicated that nicotine increased alcohol self-administration in a significant proportion of participants (P<or=0.03) without affecting water consumption (P>or=0.16). A two-way ANOVA supported this observation further, and, compared to de-nicotinized cigarettes, the nicotine-containing cigarettes increased PR breakpoints for alcohol but not water, as reflected by a Cigarettex Beverage interaction (P<or=0.055). CONCLUSIONS The present data suggest that acute nicotine administration increases alcohol consumption in at least a subset of smokers.
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Affiliation(s)
- Sean P Barrett
- Department of Psychology, McGill University, Montreal, Que., Canada H3A 1B1.
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32
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Job MO, Ramachandra V, Anders S, Low MJ, Gonzales RA. Reduced basal and ethanol stimulation of striatal extracellular dopamine concentrations in dopamine D2 receptor knockout mice. Synapse 2006; 60:158-64. [PMID: 16715495 DOI: 10.1002/syn.20283] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The present study was undertaken to examine the role of the dopamine (DA) D2 receptor in the ethanol-evoked DA response in the ventral striatum. We performed microdialysis experiments using the D2 null mutant and wild-type controls and measured the effect of an intraperitoneal (i.p.) injection of either saline or ethanol (2 g/kg) on dialysate DA concentrations in the ventral striatum. Dialysate ethanol concentrations were also determined in the samples from the ventral striatum. In addition, the effects of quinpirole, a D2/D3 agonist, were examined in both the ventral and dorsal striatum. Basal dialysate concentrations of DA were significantly reduced in both the ventral and dorsal striatum of the D2 knockouts compared with wild-type controls. Ethanol administration significantly enhanced ventral striatal DA in both groups, but the increase in dialysate DA concentration was 3.5-fold higher in the wild-type controls. The time course of dialysate ethanol concentrations was similar in the two groups. Saline injection did not alter DA concentrations in either the ventral or dorsal striatum. However, quinpirole (0.3 mg/kg) administration significantly depressed striatal dialysate DA concentrations in the wild-type mice, but not in the D2 knockouts. The results suggest that the D2 receptor is necessary for normal development and regulation of striatal extracellular DA concentrations, but the mechanism for this alteration is unclear. In addition, the blunted ethanol-evoked DA response in the D2 knockouts may contribute, in part, to some of the behavioral deficits previously observed in response to ethanol.
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Affiliation(s)
- Martin O Job
- The University of Texas at Austin, PHAR-Pharmacology, Austin, Texas 78712, USA
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33
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Heidbreder C. Novel pharmacotherapeutic targets for the management of drug addiction. Eur J Pharmacol 2005; 526:101-12. [PMID: 16253234 DOI: 10.1016/j.ejphar.2005.09.038] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2005] [Revised: 07/12/2005] [Accepted: 09/23/2005] [Indexed: 11/20/2022]
Abstract
Despite individual variation in the liability to the abuse of psychoactive substances, there is substantial commonality shared by drugs of abuse. The knowledge of these common mechanisms together with the continued elucidation of the neurobiological underpinnings of withdrawal symptoms, drug intake, craving, relapse, and co-morbid psychiatric associations are critically important for the development of new therapeutic strategies. The present review will focus on recent advances in the development of innovative pharmacotherapeutic agents, which should promote higher efficacy (abstinence, prevention of relapse, long-term recovery) and patient compliance, as well as improved safety profiles.
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Affiliation(s)
- Christian Heidbreder
- Department of Neuropsychopharmacology, Centre of Excellence for Drug Discovery in Psychiatry, GlaxoSmithKline Pharmaceuticals, Via A. Fleming 4, 37135 Verona, Italy.
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Connor JP, Feeney GFX, Young RM. A comparison of the Yale-Brown Obsessive Compulsive Scale for "heavy drinking" with a single item craving measure: construct validity and clinical utility. Subst Use Misuse 2005; 40:551-61. [PMID: 15830736 DOI: 10.1081/ja-200030723] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The measurement of alcohol "craving" began with single-item scales. Multifactorial scales developed with the intention to capture more fully the phenomenon of craving. This study examines the construct validity of a multifactorial scale, the Yale-Brown Obsessive Compulsive Scale for heavy drinking (Y-BOCS-hd). The study compares its clinical utility with a single item visual-analogue craving scale. The study includes 212 alcohol dependent subjects (127 males, 75 females) undertaking an outpatient treatment program between 1999-2001. Subjects completed the Y-BOCS-hd and a single item visual-analogue scale, in addition to alcohol consumption and dependence severity measures. The Y-BOCS-hd had strong construct validity. Both the visual-analogue alcohol craving scale and Y-BOCS-hd were weakly associated with pretreatment dependence severity. There was a significant association between pretreatment alcohol consumption and the visual-analogue craving scale. Neither craving measure was able to predict total program abstinence or days abstinent. The relationship between obsessive-compulsive behavior in alcohol dependence and craving remains unclear.
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Affiliation(s)
- Jason P Connor
- Alcohol and Drug Assessment Unit, Division of Medicine, Princess Alexandra Hospital, Woolloongabba, Australia
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Abstract
BACKGROUND Dopamine D1 antagonist effects on behaviors related to obtaining and consuming ethanol remain unclear. The highly selective D1 antagonist ecopipam (SCH 39166), which has no effect on the serotonin system, was used to evaluate the role of D1 receptors in ethanol reward and its potential for treating alcohol abuse by determining its effect on several measures of ethanol reward in C57BL/6 (B6) mice. METHODS Ecopipam (0.025-0.2 mg/kg) effects on instrumental and contingent consummatory responses and on noncontingent consummatory responses for ethanol and water reward were determined in food-restricted male mice trained to lever-respond for 12% ethanol delivered on a fixed ratio-4 reinforcement schedule. The mice were tested for 15-min sessions under preprandial (high-hunger and low-thirst) and postprandial (low-hunger and high-thirst) test conditions. RESULTS Ecopipam dose-dependently reduced instrumental and consummatory responses for ethanol and ethanol intake when tested under hunger- or thirst-motivated conditions with free access to water. Under thirst motivation with no access to an alternate fluid source, lever responses for ethanol and water were similar; however, ecopipam reduced responding for ethanol more than responding for water reward. When given concurrent free access to the same fluid delivered for lever pressing, animals made more contacts for ethanol than for water; ecopipam reduced free ethanol but not water contacts. CONCLUSIONS Ecopipam attenuated ethanol reward at doses that did not affect water reward, indicating an effect independent of reductions in motor system function or general motivation and arousal. Ecopipam also reduced ethanol reward to the same degree under hunger, thirst, or sated conditions, again indicating that it affected ethanol reward at doses that did not grossly affect general motivational states. These data suggest that ecopipam may reduce ethanol reward with few side effects and that it warrants further investigation as a pharmacological tool for treating alcohol abuse.
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Affiliation(s)
- Kimber L Price
- Center for Drug and Alcohol Programs, Department of Psychiatry and Behavioral Sciences, and Department of Physiology and Neurosciences, Medical University of South Carolina, 67 President St., Charleston, SC 29425, USA
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Abstract
Research on the biological basis of borderline personality disorder (BPD) has focused primarily on the serotonin model of impulsive aggression. However, there is evidence that dopamine (DA) dysfunction may also be associated with BPD. Pertinent research and review articles, identified by Medline searches of relevant topics, books, references from bibliographies, and conference proceedings from 1975 to 2003, were reviewed. Evidence of DA dysfunction in BPD derives from the efficacy of traditional and atypical antipsychotic agents in BPD, and from provocative challenges with amphetamine and methylphenidate of subjects with the disorder. In addition, human and animal studies indicate that DA activity plays an important role in emotion information processing, impulse control, and cognition. The results of this review suggest that DA dysfunction is associated with three dimensions of BPD, that is, emotional dysregulation, impulsivity, and cognitive-perceptual impairment. The main limitation of this hypothesis is that the evidence reviewed is circumstantial. There is no study that directly demonstrates DA dysfunction in BPD. In addition, the therapeutic effects of antipsychotic agents observed in BPD may be mediated by non-DA mechanisms of action. If the stated hypothesis is correct, DA dysfunction in BPD may result from genetic, developmental, or environmental factors directly affecting specific DA pathways. Alternatively, DA dysfunction in BPD may be a compensatory response to alterations in the primary neural systems that control emotion, impulse control, and cognition, and that are mediated by the brain's main neurotransmitters, glutamate, and GABA, or in one or more other neuromodulatory pathways such as serotonin, acetylcholine, and norepinephrine.
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Affiliation(s)
- Robert O Friedel
- Department of Psychiatry, Medical College of Virginia/Virginia Commonwealth University, Richmond, VA 23298, USA.
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Hutchison KE, Wooden A, Swift RM, Smolen A, McGeary J, Adler L, Paris L. Olanzapine reduces craving for alcohol: a DRD4 VNTR polymorphism by pharmacotherapy interaction. Neuropsychopharmacology 2003; 28:1882-8. [PMID: 12888781 DOI: 10.1038/sj.npp.1300264] [Citation(s) in RCA: 93] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Separate investigations have suggested that olanzapine, a D4 antagonist, decreases craving after a priming dose of alcohol and that the DRD4 variable number of tandem repeats (VNTR) polymorphism influences the expression of craving after a priming dose of alcohol. The present study tested the hypothesis that olanzapine may be differentially effective at reducing cue-elicited craving based on individual differences in DRD4 VNTR in a sample of heavy social drinkers. Participants were randomly assigned to receive olanzapine (5 mg) or a control medication (cyproheptadine, 4 mg) prior to consuming three alcoholic drinks. Participants completed subjective measures of craving and euphoria after each drink. Participants who were homozygous or heterozygous for the 7 (or longer) repeat allele of the DRD4 VNTR were classified as DRD4 L, while the other participants were classified as DRD4 S. The findings indicated that olanzapine reduces craving for alcohol at baseline for both DRD4 S and DRD4 L individuals, but only reduces craving after exposure to alcohol cues and after a priming dose of alcohol for DRD4 L individuals.
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Affiliation(s)
- Kent E Hutchison
- Department of Psychology, University of Colorado at Boulder, Boulder, CO 80309-0345, USA.
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Sher L, Oquendo MA, Li S, Huang YY, Grunebaum MF, Burke AK, Malone KM, Mann JJ. Lower CSF homovanillic acid levels in depressed patients with a history of alcoholism. Neuropsychopharmacology 2003; 28:1712-9. [PMID: 12825091 DOI: 10.1038/sj.npp.1300231] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Major depression and alcoholism are often comorbid, resulting in more impairment and more suicidal behavior compared with either diagnosis alone. This study compared clinical features and cerebrospinal fluid (CSF) monoamine metabolites in depressed subjects with and without a history of alcoholism and healthy volunteers. We hypothesized that depressed subjects with a history of alcoholism would be more aggressive, impulsive, and suicidal than depressed subjects without a history of alcoholism, and would have lower CSF monoamine metabolite levels. We compared 63 subjects with a current major depressive episode (MDE) and a history of alcoholism, 72 subjects with a current MDE but without a history of alcoholism, and 22 healthy volunteers. Participants with a history of alcoholism were in remission for at least 6 months. All subjects were free from prescribed medications known to affect brain serotonin, dopamine, or norepinephrine systems for a minimum of 14 days. Depressive symptoms, lifetime aggression, impulsivity, Axis II disorders, and suicidal behavior were assessed. CSF was sampled and homovanillic acid (HVA), 5-hydroxyindolacetic acid (5-HIAA), and 3-methoxy-4-hydroxyphenylglycol (MHPG) were assayed by high-performance lipid chromatography with electrochemical detection. Depressed subjects with a history of alcoholism did not differ from depressed subjects without a history of alcoholism in current severity of depressive symptoms, or in past suicidal behavior. Depressed subjects with a history of alcoholism had lower CSF HVA levels, and higher lifetime aggression and current suicide ideation scale scores and were more likely to be tobacco smokers compared with depressed subjects without a history of alcoholism. Low HVA was present after adjustment for sex, aggression and depression scores, cigarette smoking, antisocial and borderline personality disorders, psychomotor retardation, and delusions. Controls had CSF HVA levels intermediate between the two depressed groups. We found no group difference in CSF 5-HIAA and MHPG levels. In individuals with current MDE, those with a history of comorbid alcoholism had lower CSF HVA levels compared with those without a history of alcoholism. Low CSF HVA suggests that impaired dopaminergic activity is associated with a history of alcoholism in persons with current MDE.
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Affiliation(s)
- Leo Sher
- Division of Neuroscience, Department of Psychiatry, Columbia University, New York, NY 10032, USA.
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Chi H, de Wit H. Mecamylamine attenuates the subjective stimulant-like effects of alcohol in social drinkers. Alcohol Clin Exp Res 2003; 27:780-6. [PMID: 12766622 DOI: 10.1097/01.alc.0000065435.12068.24] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Recent studies have implicated central nicotinic cholinergic receptor systems in the reinforcing properties of alcohol. In laboratory animals, mecamylamine, a central nicotinic receptor antagonist, reduces the consumption of and preference for alcohol. This study investigated the effect of mecamylamine on the subjective responses to alcohol in humans. It was hypothesized that mecamylamine (7.5 and 15 mg) would attenuate the stimulant-like subjective effects of alcohol (0.8 g/kg) and decrease the self-reported desire to consume additional alcohol beverages. METHODS Fourteen male and 13 female nonsmokers participated in 6 laboratory sessions. During each session, subjects received, in randomized order under double-blinded conditions, a capsule containing mecamylamine (7.5 or 15 mg) or placebo followed by a beverage containing alcohol (0.8 g/kg) or placebo. Physiologic and subjective-effect measures were taken at 30-min intervals for 2 hr after beverage consumption. RESULTS Mecamylamine attenuated the stimulant and euphoric effects of alcohol and reduced the self-reported desire to consume additional alcohol beverages. This effect was most pronounced in men, even though women exhibited greater physiologic reactions to mecamylamine. CONCLUSIONS These findings suggest that nicotinic cholinergic receptors are involved in mediating some of the stimulant-like effects of alcohol.
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Affiliation(s)
- Henry Chi
- Department of Psychiatry, University of Chicago, 5841 S. Maryland Avenue, Chicago, IL 60637, USA
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Czachowski CL, Santini LA, Legg BH, Samson HH. Separate measures of ethanol seeking and drinking in the rat: effects of remoxipride. Alcohol 2002; 28:39-46. [PMID: 12377359 DOI: 10.1016/s0741-8329(02)00236-7] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Remoxipride, a dopamine D(2) antagonist, decreases responding that results in the presentation of small amounts (approximately 0.1 ml) of ethanol in limited-access paradigms. This type of operant response is a combined appetitive/consummatory response that is differentially affected by changing stimulus properties of consumed ethanol (i.e., taste, pharmacology) over the course of the session. In the present experimental design, ethanol-directed appetitive and consummatory responses were procedurally separated to investigate the specific effects of remoxipride on these distinct behaviors. Male Long-Evans rats were trained to make a series of lever-press responses once each day that resulted in access to a sipper tube spout containing 10% ethanol for 20 min. Three doses of remoxipride were tested: 5.0, 10.0, and 15.0 mg/kg (-30 min, i.p.). In Experiment 1, a response requirement of 20 was used, and both reinforced and nonreinforced sessions were examined. In nonreinforced sessions, subjects were permitted to lever press for 20 min, after which the session ended without sipper tube presentation. These sessions were conducted to remove the possibility that limiting responding might obscure a drug effect on the seeking response. In Experiment 2, a low response requirement (4) was used to investigate the effects of remoxipride on ethanol intake. Average baseline ethanol intake (Experiment 1) was 0.69 g/kg, with blood ethanol concentrations at the end of the session at 64 mg%. At all doses tested, remoxipride had no effect on the measures of ethanol consumption (e.g., total intake, lick latency, lick rate) in either experiment. However, remoxipride dose dependently decreased the number of appetitive responses made, while having no effect on response latency or rate, during both reinforced and nonreinforced sessions in Experiment 1. In these experiments, the systemic antagonism of the dopamine D(2) receptor decreased ethanol seeking without causing a general impairment of motor function. The procedural separation of seeking and intake responses revealed that appetitive responding was more sensitive than consummatory responding to remoxipride treatment.
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Affiliation(s)
- Cristine L Czachowski
- Department of Physiology and Pharmacology, Center for the Neurobehavioral Study of Alcohol, Wake Forest University School of Medicine, Winston-Salem, NC 27157-1083, USA.
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King AC, Houle T, Wit H, Holdstock L, Schuster A. Biphasic Alcohol Response Differs in Heavy Versus Light Drinkers. Alcohol Clin Exp Res 2002. [DOI: 10.1111/j.1530-0277.2002.tb02611.x] [Citation(s) in RCA: 161] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Hutchison KE, LaChance H, Niaura R, Bryan A, Smolen A. The DRD4 VNTR polymorphism influences reactivity to smoking cues. JOURNAL OF ABNORMAL PSYCHOLOGY 2002; 111:134-43. [PMID: 11866166 DOI: 10.1037/0021-843x.111.1.134] [Citation(s) in RCA: 105] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Recent research has indicated that craving for tobacco can be reliably elicited by exposure to smoking cues, suggesting that cue-elicited craving for tobacco may be a useful phenotype for research on genetic factors related to nicotine dependence. Given the potential role of dopamine in cue-elicited craving, the authors examined whether the DRD4 VNTR polymorphism is associated with cue-elicited craving for tobacco. Participants who were homozygous or heterozygous for the 7 repeat (or longer) allele were classified as DRD4 L, and all other participants were classified as DRD4 S. Participants were exposed to smoking cues before smoking either high-nicotine cigarettes or control cigarettes. Analyses suggested that participants in the L group demonstrated significantly greater craving, more arousal, less positive affect, and more attention to the smoking cues than did the participants in the S group.
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Affiliation(s)
- Kent E Hutchison
- Department of Psychology, University of Colorado at Boulder, 80309-0345, USA.
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Hutchinson KE, McGeary J, Smolen A, Bryan A, Swift RM. The DRD4 VNTR polymorphism moderates craving after alcohol consumption. Health Psychol 2002. [DOI: 10.1037/0278-6133.21.2.139] [Citation(s) in RCA: 110] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Enggasser JL, Wit H. Haloperidol Reduces Stimulant and Reinforcing Effects of Ethanol in Social Drinkers. Alcohol Clin Exp Res 2001. [DOI: 10.1111/j.1530-0277.2001.tb02146.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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46
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Holdstock L, Wit H. Individual Differences in Responses to Ethanol and d-Amphetamine: A Within-Subject Study. Alcohol Clin Exp Res 2001. [DOI: 10.1111/j.1530-0277.2001.tb02248.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Flannery BA, Roberts AJ, Cooney N, Swift RM, Anton RF, Rohsenow DJ. The Role of Craving in Alcohol Use, Dependence, and Treatment. Alcohol Clin Exp Res 2001. [DOI: 10.1111/j.1530-0277.2001.tb02213.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Leyton M, Young SN, Blier P, Baker GB, Pihl RO, Benkelfat C. Acute Tyrosine Depletion and Alcohol Ingestion in Healthy Women. Alcohol Clin Exp Res 2000. [DOI: 10.1111/j.1530-0277.2000.tb02012.x] [Citation(s) in RCA: 67] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Wood MD, Sher KJ. Risks of alcohol consumption in laboratory studies involving human research participants. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2000. [DOI: 10.1037/0893-164x.14.4.328] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Abstract
Mesolimbic dopaminergic neurons are thought to serve as a final common neural pathway for mediating reinforcement processes. However, several recent findings have challenged the view that mesolimbic dopamine has a crucial role in the maintenance of reinforcement processes, or the subjective rewarding actions of natural rewards and drugs of abuse. Instead, there is growing evidence that dopamine is involved in the formation of associations between salient contextual stimuli and internal rewarding or aversive events. This evidence suggests that dopaminergic-neuron activation aids the organism in learning to recognize stimuli associated with such events. Thus, mesolimbic dopaminergic neurons have an important function in the acquisition of behavior reinforced by natural reward and drug stimuli. Furthermore, long-lasting neuroadaptive changes in mesolimbic dopamine-mediated transmission that develop during chronic drug use might contribute to compulsive drug-seeking behavior and relapse.
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Affiliation(s)
- R Spanagel
- Max Planck Institute of Psychiatry, 80804 Munich, Germany
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