1
|
Kerr PL, Gregg JM. The Roles of Endogenous Opioids in Placebo and Nocebo Effects: From Pain to Performance to Prozac. ADVANCES IN NEUROBIOLOGY 2024; 35:183-220. [PMID: 38874724 DOI: 10.1007/978-3-031-45493-6_10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2024]
Abstract
Placebo and nocebo effects have been well documented for nearly two centuries. However, research has only relatively recently begun to explicate the neurobiological underpinnings of these phenomena. Similarly, research on the broader social implications of placebo/nocebo effects, especially within healthcare delivery settings, is in a nascent stage. Biological and psychosocial outcomes of placebo/nocebo effects are of equal relevance. A common pathway for such outcomes is the endogenous opioid system. This chapter describes the history of placebo/nocebo in medicine; delineates the current state of the literature related to placebo/nocebo in relation to pain modulation; summarizes research findings related to human performance in sports and exercise; discusses the implications of placebo/nocebo effects among diverse patient populations; and describes placebo/nocebo influences in research related to psychopharmacology, including the relevance of endogenous opioids to new lines of research on antidepressant pharmacotherapies.
Collapse
Affiliation(s)
- Patrick L Kerr
- West Virginia University School of Medicine-Charleston, Charleston, WV, USA.
| | - John M Gregg
- Department of Surgery, VTCSOM, Blacksburg, VA, USA
| |
Collapse
|
2
|
Widelski J, Kasica N, Maciąg M, Luca SV, Budzyńska B, Fondai D, Podlasz P, Skalicka-Woźniak K. Simple Coumarins from Peucedanum luxurians Fruits: Evaluation of Anxiolytic Activity and Influence on Gene Expression Related to Anxiety in Zebrafish Model. Int J Mol Sci 2023; 24:ijms24108693. [PMID: 37240050 DOI: 10.3390/ijms24108693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 04/30/2023] [Accepted: 05/08/2023] [Indexed: 05/28/2023] Open
Abstract
Anxiety is one of the most common central nervous system disorders, affecting at least one-quarter of the worldwide population. The medications routinely used for the treatment of anxiety (mainly benzodiazepines) are a cause of addiction and are characterized by many undesirable side effects. Thus, there is an important and urgent need for screening and finding novel drug candidates that can be used in the prevention or treatment of anxiety. Simple coumarins usually do not show side effects, or these effects are much lower than in the case of synthetic drugs acting on the central nervous system (CNS). This study aimed to evaluate the anxiolytic activity of three simple coumarins from Peucedanum luxurians Tamamsch, namely officinalin, stenocarpin isobutyrate, and officinalin isobutyrate, in a 5 dpf larval zebrafish model. Moreover, the influence of the tested coumarins on the expression of genes involved in the neural activity (c-fos, bdnf) or dopaminergic (th1), serotoninergic (htr1Aa, htr1b, htr2b), GABA-ergic (gabarapa, gabarapb), enkephalinergic (penka, penkb), and galaninergic (galn) neurotransmission was assessed by quantitative PCR. All tested coumarins showed significant anxiolytic activity, with officinalin as the most potent compound. The presence of a free hydroxyl group at position C-7 and the lack of methoxy moiety at position C-8 might be key structural features responsible for the observed effects. In addition, officinalin and its isobutyrate upregulated the expression of genes involved in neurotransmission and decreased the expression of genes connected with neural activity. Therefore, the coumarins from P. luxurians might be considered as promising drug candidates for the therapy of anxiety and related disorders.
Collapse
Affiliation(s)
- Jarosław Widelski
- Medicinal Plant Unit, Department of Pharmacognosy, Medical University of Lublin, 20-093 Lublin, Poland
| | - Natalia Kasica
- Department of Animal Anatomy, Faculty of Veterinary Medicine, University of Warmia and Mazury in Olsztyn, 10-719 Olsztyn, Poland
| | - Monika Maciąg
- Independent Laboratory of Behavioral Studies, Medical University of Lublin, 20-093 Lublin, Poland
| | - Simon Vlad Luca
- Biothermodynamics, TUM School of Life Sciences, Technical University of Munich, 85354 Freising, Germany
- Department of Pharmacognosy, Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
| | - Barbara Budzyńska
- Independent Laboratory of Behavioral Studies, Medical University of Lublin, 20-093 Lublin, Poland
| | - Dafina Fondai
- Department of Pharmacy, Faculty of Medicine, University of Prishtina, 10000 Prishtina, Kosovo
| | - Piotr Podlasz
- Department of Pathophysiology, Forensic Veterinary Medicine and Administration, Faculty of Veterinary Medicine, University of Warmia and Mazury in Olsztyn, 10-719 Olsztyn, Poland
| | | |
Collapse
|
3
|
VanIderstine C, Johnston E. Risk Factors for Prolonged Opioid Use Following Total Hip Arthroplasty and Total Knee Arthroplasty: A Narrative Review of Recent Literature. Ann Pharmacother 2022:10600280221133078. [DOI: 10.1177/10600280221133078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Objective: To provide pharmacists and other health care professionals with the knowledge required to minimize the risk of prolonged opioid use following total hip arthroplasty (THA) and total knee arthroplasty (TKA). Data Sources: A literature search of PubMed and Embase was performed, and included the search terms: (opioid OR opiate OR opium) AND (risk factor OR predict*) AND (arthroplasty OR replacement) NOT shoulder. Study Selection and Data Extraction: Randomized control trials, cohort studies (both prospective and retrospective), systematic reviews, and meta-analyses were included if risk ratios (RRs) or odds ratios (ORs) were reported and published within the last 5 years. Data Synthesis: ]Twenty studies met inclusion criteria, including 2 meta-analyses and 2 prospective studies. There were several risk factors that overlapped between studies and presented clinically significant risks for prolonged opioid use following THA and TKA surgery. Of these, age < 65 (RRs: 1.15-9.36), preoperative opioid use (RRs: 1.09-7.81), larger quantities of opioids prescribed at discharge (RRs: 1.26-8.81), and TKA surgery (RRs: 1.73-6.07) were the most significant. Several risk factors were recently described, including migraines (RRs: 1.14-5.11) and fibromyalgia (RRs: 1.1-2.3) that may be of interest for further research. Relevance to Patient Care and Clinical Practice: This review presents a discussion of the factors associated with prolonged opioid use following THA and TKA surgeries, which are among the most common orthopedic surgeries. Conclusions: Prescribers should carefully consider patient-specific factors when prescribing opioids as there are several factors, including age, surgery type, and medical conditions that can predispose patients to prolonged opioid use.
Collapse
Affiliation(s)
- Carter VanIderstine
- College of Pharmacy, Dalhousie University, Halifax, Nova Scotia, Canada
- Pharmacy Department Halifax Infirmary, Nova Scotia Health, Halifax, Nova Scotia, Canada
| | - Emily Johnston
- Pharmacy Department Halifax Infirmary, Nova Scotia Health, Halifax, Nova Scotia, Canada
| |
Collapse
|
4
|
Grau AS, Xie H, Redfern RE, Moussa M, Wang X, Shih CH. Effects of acute pain medications on posttraumatic stress symptoms in early aftermath of trauma. Int Clin Psychopharmacol 2022; 37:201-205. [PMID: 35503040 PMCID: PMC9357097 DOI: 10.1097/yic.0000000000000413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Posttraumatic stress symptoms (PTSS) develop as sequelae from traumatic injuries. Limited studies suggest that using opioids to reduce acute pain immediately after trauma may also reduce subsequent PTSS, but other pain medications rarely have been examined for preventing acute PTSS. The current study examined the effects of commonly used pain medications, opioid and nonsteroidal anti-inflammatory drugs (NSAIDs), on PTSS after acute traumatic injuries. Participants ( n = 71) were categorized into opioid or NSAID group according to their medical records and self-reported medication use. Their PTSS were assessed using posttraumatic stress disorder checklist twice within 2 weeks after trauma. Participants' pain levels reduced from pretreatment to follow-up in both groups, F (1, 55) = 6.696, P = 0.012, partial η 2 = 0.109. Interestingly, a significant interaction between time and medication group on PTSS reached statistical significance, F (1, 69) = 6.014, P = 0.017, partial η 2 = 0.080. Follow-up analyses revealed that this interaction was driven by a significant PTSS reduction only in opioid but not in NSAID group. These findings suggested that pain reduction alone is not sufficient to reduce acute PTSS in the NSAID group, highlighting the need to continue further investigations into the mechanisms by which opioids reduce PTSS in the early posttrauma period.
Collapse
Affiliation(s)
- Aaron S. Grau
- Department of Psychiatry, University of Toledo, OH 43614
| | - Hong Xie
- Department of Psychiatry, University of Toledo, OH 43614
| | | | - Mohamad Moussa
- Department of Psychiatry, University of Toledo, OH 43614
| | - Xin Wang
- Department of Psychiatry, University of Toledo, OH 43614
| | - Chia-Hao Shih
- Department of Psychiatry, University of Toledo, OH 43614
| |
Collapse
|
5
|
Abstract
Psychiatric illness is associated with both chronic pain syndromes and opioid use disorder, further complicating how we care for patients with psychiatric issues. We report a unique case of a de novo and persistent psychotic disorder after complicated opioid withdrawal in a patient without any psychiatric history. The patient developed persistent auditory hallucinations after discontinuation of chronic opioid therapy that responded only to atypical antipsychotic (olanzapine) treatment. This case illustrates the neuropsychiatric effects of chronic opioid exposure, as well as layered clinical management dimensions related to opioid detoxification and psychosis treatment. Long-term opioid therapy may have lasting neuropsychiatric effects, including playing a role in the development and/or expression of psychotic disorders. Here we review the limited literature on the effects of opioids on psychosis. This complex case also demonstrates a clinical approach for effectively co-managing psychiatric symptoms in the context of chronic pain and chronic opioid therapy.
Collapse
|
6
|
Kupcova I, Danisovic L, Grgac I, Harsanyi S. Anxiety and Depression: What Do We Know of Neuropeptides? Behav Sci (Basel) 2022; 12:bs12080262. [PMID: 36004833 PMCID: PMC9405013 DOI: 10.3390/bs12080262] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 07/11/2022] [Accepted: 07/27/2022] [Indexed: 12/04/2022] Open
Abstract
In modern society, there has been a rising trend of depression and anxiety. This trend heavily impacts the population’s mental health and thus contributes significantly to morbidity and, in the worst case, to suicides. Modern medicine, with many antidepressants and anxiolytics at hand, is still unable to achieve remission in many patients. The pathophysiology of depression and anxiety is still only marginally understood, which encouraged researchers to focus on neuropeptides, as they are a vast group of signaling molecules in the nervous system. Neuropeptides are involved in the regulation of many physiological functions. Some act as neuromodulators and are often co-released with neurotransmitters that allow for reciprocal communication between the brain and the body. Most studied in the past were the antidepressant and anxiolytic effects of oxytocin, vasopressin or neuropeptide Y and S, or Substance P. However, in recent years, more and more novel neuropeptides have been added to the list, with implications for the research and development of new targets, diagnostic elements, and even therapies to treat anxiety and depressive disorders. In this review, we take a close look at all currently studied neuropeptides, their related pathways, their roles in stress adaptation, and the etiology of anxiety and depression in humans and animal models. We will focus on the latest research and information regarding these associated neuropeptides and thus picture their potential uses in the future.
Collapse
Affiliation(s)
- Ida Kupcova
- Institute of Medical Biology, Genetics and Clinical Genetics, Faculty of Medicine, Comenius University in Bratislava, Sasinkova 4, 811 08 Bratislava, Slovakia; (I.K.); (L.D.)
| | - Lubos Danisovic
- Institute of Medical Biology, Genetics and Clinical Genetics, Faculty of Medicine, Comenius University in Bratislava, Sasinkova 4, 811 08 Bratislava, Slovakia; (I.K.); (L.D.)
| | - Ivan Grgac
- Institute of Anatomy, Faculty of Medicine, Comenius University in Bratislava, Sasinkova 4, 811 08 Bratislava, Slovakia;
| | - Stefan Harsanyi
- Institute of Medical Biology, Genetics and Clinical Genetics, Faculty of Medicine, Comenius University in Bratislava, Sasinkova 4, 811 08 Bratislava, Slovakia; (I.K.); (L.D.)
- Correspondence: ; Tel.: +421-2-59357-299
| |
Collapse
|
7
|
Barbee BR, Gourley SL. Brain systems in cocaine abstinence-induced anxiety-like behavior in rodents: A review. ADDICTION NEUROSCIENCE 2022; 2:100012. [PMID: 37485439 PMCID: PMC10361393 DOI: 10.1016/j.addicn.2022.100012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
Cocaine use disorder (CUD) is a significant public health issue that generates substantial personal, familial, and economic burdens. Still, there are no FDA-approved pharmacotherapies for CUD. Cocaine-dependent individuals report anxiety during withdrawal, and alleviation of anxiety and other negative affective states may be critical for maintaining drug abstinence. However, the neurobiological mechanisms underlying abstinence-related anxiety in humans or anxiety-like behavior in rodents are not fully understood. This review summarizes investigations regarding anxiety-like behavior in mice and rats undergoing cocaine abstinence, as assessed using four of the most common anxiety-related assays: the elevated plus (or its derivative, the elevated zero) maze, open field test, light-dark transition test, and defensive burying task. We first summarize available evidence that cocaine abstinence generates anxiety-like behavior that persists throughout protracted abstinence. Then, we examine investigations concerning neuropeptide, neurotransmitter, and neuromodulator systems in cocaine abstinence-induced anxiety-like behavior. Throughout, we discuss how differences in sex, rodent strain, cocaine dose and dosing strategy and abstinence duration interact to generate anxiety-like behavior.
Collapse
Affiliation(s)
- Britton R. Barbee
- Graduate Program in Molecular and Systems Pharmacology,
Emory University
- Department of Pediatrics, Emory University School of
Medicine; Yerkes National Primate Research Center
| | - Shannon L. Gourley
- Graduate Program in Molecular and Systems Pharmacology,
Emory University
- Department of Pediatrics, Emory University School of
Medicine; Yerkes National Primate Research Center
| |
Collapse
|
8
|
Hazani HM, Naina Mohamed I, Muzaimi M, Mohamed W, Yahaya MF, Teoh SL, Pakri Mohamed RM, Mohamad Isa MF, Abdulrahman SM, Ramadah R, Kamaluddin MR, Kumar J. Goofballing of Opioid and Methamphetamine: The Science Behind the Deadly Cocktail. Front Pharmacol 2022; 13:859563. [PMID: 35462918 PMCID: PMC9021401 DOI: 10.3389/fphar.2022.859563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 03/18/2022] [Indexed: 11/23/2022] Open
Abstract
Globally, millions of people suffer from various substance use disorders (SUD), including mono-and polydrug use of opioids and methamphetamine. Brain regions such as the cingulate cortex, infralimbic cortex, dorsal striatum, nucleus accumbens, basolateral and central amygdala have been shown to play important roles in addiction-related behavioral changes. Clinical and pre-clinical studies have characterized these brain regions and their corresponding neurochemical changes in numerous phases of drug dependence such as acute drug use, intoxication, craving, withdrawal, and relapse. At present, many studies have reported the individual effects of opioids and methamphetamine. However, little is known about their combined effects. Co-use of these drugs produces effects greater than either drug alone, where one decreases the side effects of the other, and the combination produces a prolonged intoxication period or a more desirable intoxication effect. An increasing number of studies have associated polydrug abuse with poorer treatment outcomes, drug-related deaths, and more severe psychopathologies. To date, the pharmacological treatment efficacy for polydrug abuse is vague, and still at the experimental stage. This present review discusses the human and animal behavioral, neuroanatomical, and neurochemical changes underlying both morphine and methamphetamine dependence separately, as well as its combination. This narrative review also delineates the recent advances in the pharmacotherapy of mono- and poly drug-use of opioids and methamphetamine at clinical and preclinical stages.
Collapse
Affiliation(s)
- Hanis Mohammad Hazani
- Department of Physiology, Faculty of Medicine, The National University of Malaysia, Cheras, Malaysia
| | - Isa Naina Mohamed
- Department of Pharmacology, Faculty of Medicine, The National University of Malaysia, Cheras, Malaysia
| | - Mustapha Muzaimi
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Wael Mohamed
- Basic Medical Science Department, Kulliyyah of Medicine, International Islamic University Malaysia, Kuantan, Malaysia
- Faculty of Medicine, Department of Clinical Pharmacology, Menoufia University, Shebin El-Kom, Egypt
| | - Mohamad Fairuz Yahaya
- Department of Anatomy, Faculty of Medicine, National University of Malaysia, Cheras, Malaysia
| | - Seong Lin Teoh
- Department of Anatomy, Faculty of Medicine, National University of Malaysia, Cheras, Malaysia
| | | | | | | | - Ravi Ramadah
- National Anti-Drugs Agency Malaysia, Selangor, Malaysia
| | - Mohammad Rahim Kamaluddin
- Centre for Research in Psychology and Human Well-Being, Faculty of Social Sciences and Humanities, The National University of Malaysia, Bangi, Malaysia
| | - Jaya Kumar
- Department of Physiology, Faculty of Medicine, The National University of Malaysia, Cheras, Malaysia
- *Correspondence: Jaya Kumar,
| |
Collapse
|
9
|
de Abreu MS, Giacomini ACVV, Demin KA, Galstyan DS, Zabegalov KN, Kolesnikova TO, Amstislavskaya TG, Strekalova T, Petersen EV, Kalueff AV. Unconventional anxiety pharmacology in zebrafish: Drugs beyond traditional anxiogenic and anxiolytic spectra. Pharmacol Biochem Behav 2021; 207:173205. [PMID: 33991579 DOI: 10.1016/j.pbb.2021.173205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 05/06/2021] [Accepted: 05/07/2021] [Indexed: 12/14/2022]
Abstract
Anxiety is the most prevalent brain disorder and a common cause of human disability. Animal models are critical for understanding anxiety pathogenesis and its pharmacotherapy. The zebrafish (Danio rerio) is increasingly utilized as a powerful model organism in anxiety research and anxiolytic drug screening. High similarity between human, rodent and zebrafish molecular targets implies shared signaling pathways involved in anxiety pathogenesis. However, mounting evidence shows that zebrafish behavior can be modulated by drugs beyond conventional anxiolytics or anxiogenics. Furthermore, these effects may differ from human and/or rodent responses, as such 'unconventional' drugs may affect zebrafish behavior despite having no such profiles (or exerting opposite effects) in humans or rodents. Here, we discuss the effects of several putative unconventional anxiotropic drugs (aspirin, lysergic acid diethylamide (LSD), nicotine, naloxone and naltrexone) and their potential mechanisms of action in zebrafish. Emphasizing the growing utility of zebrafish models in CNS drug discovery, such unconventional anxiety pharmacology may provide important, evolutionarily relevant insights into complex regulation of anxiety in biological systems. Albeit seemingly complicating direct translation from zebrafish into clinical phenotypes, this knowledge may instead foster the development of novel CNS drugs, eventually facilitating innovative treatment of patients based on novel 'unconventional' targets identified in fish models.
Collapse
Affiliation(s)
- Murilo S de Abreu
- Bioscience Institute, University of Passo Fundo, Passo Fundo, Brazil; Laboratory of Cell and Molecular Biology and Neurobiology, Moscow Institute of Physics and Technology, Moscow, Russia; The International Zebrafish Neuroscience Research Consortium (ZNRC), Slidell, LA, USA.
| | - Ana C V V Giacomini
- Bioscience Institute, University of Passo Fundo, Passo Fundo, Brazil; Postgraduate Program in Environmental Sciences, University of Passo Fundo, Passo Fundo, Brazil
| | - Konstantin A Demin
- Institute of Experimental Medicine, Almazov Medical Research Center, Ministry of Healthcare of Russian Federation, St. Petersburg, Russia; Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg, Russia
| | - David S Galstyan
- Institute of Experimental Medicine, Almazov Medical Research Center, Ministry of Healthcare of Russian Federation, St. Petersburg, Russia; Granov Scientific Research Center of Radiology and Surgical Technologies, Ministry of Healthcare of Russian Federation, St. Petersburg, Russia
| | - Konstantin N Zabegalov
- Ural Federal University, Ekaterinburg, Russia; Neurobiology Program, Sirius University, Sochi, Russia
| | - Tatyana O Kolesnikova
- Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg, Russia; School of Chemistry, Ural Federal University, Ekaterinburg, Russia; Neurobiology Program, Sirius University, Sochi, Russia
| | - Tamara G Amstislavskaya
- Scientific Research Institute of Neuroscience and Medicine, Novosibirsk, Russia; Novosibirsk State University, Novosibirsk, Russia
| | - Tatyana Strekalova
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands; Laboratory of Psychiatric Neurobiology, Institute of Molecular Medicine and Department of Normal Physiology, Sechenov 1st Moscow State Medical University, Moscow, Russia; Institute of General Pathology and Pathophysiology, Moscow, Russia; Department of Preventive Medicine, Maastricht Medical Center Annadal, Maastricht, Netherlands
| | - Elena V Petersen
- Laboratory of Cell and Molecular Biology and Neurobiology, Moscow Institute of Physics and Technology, Moscow, Russia
| | - Allan V Kalueff
- School of Pharmacy, Southwest University, Chongqing, China; School of Chemistry, Ural Federal University, Ekaterinburg, Russia; Neurobiology Program, Sirius University, Sochi, Russia.
| |
Collapse
|
10
|
Elison-Davies S, Märtens K, Yau C, Davies G, Ward J. Associations between baseline opioid use disorder severity, mental health and biopsychosocial functioning, with clinical responses to computer-assisted therapy treatment. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2021; 47:360-372. [PMID: 33428458 DOI: 10.1080/00952990.2020.1861618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Background: Increasing rates of opioid-related overdose have been identified globally. Treatment for opioid use disorders (OUD) includes medications for opioid use disorder (MOUD) alongside behavioral support. Novel approaches to behavioral support should be explored, including computer-assisted therapy (CAT) programs.Objectives: Examine differences between baseline and post-treatment measures of opioid use and biopsychosocial functioning for individuals with OUD engaging with the CAT program 'Breaking Free Online,' and the extent to which participant characteristics may be associated with post-treatment measures.Methods: 1107 individuals engaged with CAT and provided baseline and post-treatment data - 724 (65.4%) were male, 383 (34.6%) were female.Results: Significant differences between baseline and post-treatment measures were identified (all p <.0001, effect sizes range:15 -.50). Participant characteristics were associated with post-treatment measures of opioid use, opioid dependence, mental health issues, quality of life, and biopsychosocial impairment (all p <.0001). An aggregated consensus measure of clinical impairment was found to be associated with changes in opioid use and post-treatment biopsychosocial functioning measures, with those participants with greater baseline clinical impairment demonstrating a greater magnitude of improvement from baseline to post-treatment than those with lower clinical impairment.Conclusion: CAT may reduce opioid use and improve biopsychosocial functioning in individuals with OUD. CAT could therefore provide a solution to the global opioid crisis if delivered as combination behavioral support alongside MOUD. Findings also indicate that it may be important for treatment systems to identify individuals with psychosocial complexity who might require behavioral support and MOUD.
Collapse
Affiliation(s)
| | - Kaspar Märtens
- Department of Statistics, University of Oxford, Oxford, UK
| | - Christopher Yau
- Division of Informatics, Imaging and Data Sciences, University of Manchester, Manchester, UK
| | - Glyn Davies
- Breaking Free Online, Manchester Science Park, Manchester, UK
| | - Jonathan Ward
- Breaking Free Online, Manchester Science Park, Manchester, UK
| |
Collapse
|
11
|
Shi Y, Wang Y, Zeng Y, Zhan H, Huang S, Cai G, Yang J, Wu W. Personality differences in brain network mechanisms for placebo analgesia and nocebo hyperalgesia in experimental pain: a functional magnetic resonance imaging study. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:371. [PMID: 33842592 PMCID: PMC8033354 DOI: 10.21037/atm-20-5123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Placebo and nocebo responses have been increasingly gaining the attention of clinical and scientific researchers. Inconsistent conclusions from current studies indicate that different factors potentially affect both placebo and nocebo responses. Increasing evidence suggests that personality differences may affect the mechanisms of both two responses. In the present work, we explored the characteristics of neural signals of placebo and nocebo responses based on functional connectivity (FC) analysis and Granger causality analysis (GCA). Methods A total of 34 healthy participants received conditional induction training to establish placebo and nocebo responses. Every participant completed the following experimental workflow, including scanning of baseline, experimental low back pain model establishment, scanning of acute pain status, and scanning of placebo response or nocebo response. We collect visual analogue scale (VAS) data after each scanning. Functional magnetic resonance imaging (fMRI) data from different personality groups were subjected to FC analysis and multivariate GCA (mGCA). Results Pain scores for placebo and nocebo responses were statistically different across different personality. There are also statistically differences in the neural signals of two responses across different personality. Conclusions The findings of the present study indicated that extroverted and introverted participants are likely to experience placebo analgesic effects and nocebo hyperalgesia effects, respectively. Both extroverted and introverted participants showed significant changes in brain networks under placebo response. Variation in emotional control and ventromedial prefrontal cortex inactivity may constitute the bulk of the personality differences in placebo analgesia. Differences in the regulation of the sensory conduction system (SCS) and release of the emotional circuit could be important factors affecting personality differences in nocebo hyperalgesia.
Collapse
Affiliation(s)
- Yu Shi
- Department of Rehabilitation, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Yaping Wang
- Department of Rehabilitation, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Yanyan Zeng
- Department of Rehabilitation, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Hongrui Zhan
- Department of Rehabilitation, Zhujiang Hospital, Southern Medical University, Guangzhou, China.,Department of Physical Medicine and Rehabilitation, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Shimin Huang
- Department of Rehabilitation, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Guiyuan Cai
- Department of Rehabilitation, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Jianming Yang
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Wen Wu
- Department of Rehabilitation, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| |
Collapse
|
12
|
An Argument for Reconsidering the Role of Social Support in Treating Anxiety Disorders. JOURNAL OF PSYCHIATRY AND BRAIN SCIENCE 2021; 6. [PMID: 34307897 PMCID: PMC8298022 DOI: 10.20900/jpbs.20210010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Reminders of loved ones have long been avoided during extinction-based treatments because of their assumed status as safety signals, which, by inhibiting fear in the moment, impair the long-term outcomes of fear extinction. Yet, recent work has demonstrated that in contrast to standard safety signals, social support reminders actually enhance fear extinction and lead to lasting reduction of fear, suggesting that they may have beneficial effects during exposure therapy that have before-now been overlooked. Here, we argue for a revision of the assumption that social support is detrimental to fear extinction processes and propose that future work should focus on the potential of social support reminders to improve treatment outcomes in those with anxiety disorders.
Collapse
|
13
|
CRH CeA→VTA inputs inhibit the positive ensembles to induce negative effect of opiate withdrawal. Mol Psychiatry 2021; 26:6170-6186. [PMID: 34642456 PMCID: PMC8760059 DOI: 10.1038/s41380-021-01321-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 08/26/2021] [Accepted: 09/24/2021] [Indexed: 01/23/2023]
Abstract
Plasticity of neurons in the ventral tegmental area (VTA) is critical for establishment of drug dependence. However, the remodeling of the circuits mediating the transition between positive and negative effect remains unclear. Here, we used neuronal activity-dependent labeling technique to characterize and temporarily control the VTA neuronal ensembles recruited by the initial morphine exposure (morphine-positive ensembles, Mor-Ens). Mor-Ens preferentially projected to NAc, and induced dopamine-dependent positive reinforcement. Electrophysiology and rabies viral tracing revealed the preferential connections between the VTA-projective corticotrophin-releasing hormone (CRH) neurons of central amygdala (CRHCeA→VTA) and Mor-Ens, which was enhanced after escalating morphine exposure and mediated the negative effect during opiate withdrawal. Pharmacologic intervention or CRISPR-mediated repression of CRHR1 in Mor-Ens weakened the inhibitory CRHCeA→VTA inputs, and alleviated the negative effect during opiate withdrawal. These data suggest that neurons encoding opioid reward experience are inhibited by enhanced CRHCeA→VTA inputs induced by chronic morphine exposure, leading to negative effect during opiate withdrawal, and provide new insight into the pathological changes in VTA plasticity after drug abuse and mechanism of opiate dependence.
Collapse
|
14
|
A mu-opioid feedback model of human social behavior. Neurosci Biobehav Rev 2020; 121:250-258. [PMID: 33359094 DOI: 10.1016/j.neubiorev.2020.12.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 11/26/2020] [Accepted: 12/12/2020] [Indexed: 12/16/2022]
Abstract
Since the discovery of pain relieving and rewarding properties of opiates such as morphine or heroin, the human mu-opioid system has been a target for medical research on pain processing and addiction. Indeed, pain and pleasure act mutually inhibitory on each other and the mu-opioid system has been suggested as an underlying common neurobiological mechanism. Recently, research interest extended the role of the endogenous mu-opioid system beyond the hedonic value of pain and pleasure towards human social-emotional behavior. Here we propose a mu-opioid feedback model of social behavior. This model is based upon recent findings of opioid modulation of human social learning, bonding and empathy in relation to affiliative and protective tendencies. Fundamental to the model is that the mu-opioid system reinforces socially affiliative or protective behavior in response to positive and negative social experiences with long-term consequences for social behavior and health. The functional implications for stress, anxiety, depression and attachment behaviors are discussed.
Collapse
|
15
|
Bengoetxea X, Goedecke L, Blaesse P, Pape HC, Jüngling K. The µ-opioid system in midline thalamic nuclei modulates defence strategies towards a conditioned fear stimulus in male mice. J Psychopharmacol 2020; 34:1280-1288. [PMID: 32684084 PMCID: PMC7604929 DOI: 10.1177/0269881120940919] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
BACKGROUND Nuclei located in the dorsal midline thalamus, such as the paraventricular nucleus of the thalamus (PVT), are crucial to modulate fear and aversive behaviour. In addition, the PVT shows a dense expression of µ-opioid receptors (MORs) and could mediate the anxiolytic effects of opioids. METHODS We analysed the contribution of MORs in the dorsal midline thalamus (i.e. the PVT) to the performance of mice in a classical fear conditioning paradigm. We locally injected a specific agonist (DAMGO), an antagonist (CTAP) of MOR or saline as a control into the dorsal midline thalamus of male mice, prior to fear extinction training. We assessed freezing as a typical measure of fear and extended our analysis by evaluation of aversive, non-aversive and neutral behavioural features using compositional data analysis. RESULTS Pharmacological blockade of MORs through CTAP in the dorsal midline thalamus induced a fear memory extinction deficit, as evidenced by maintained freezing during extinction sessions. Stimulation of MORs by DAMGO resulted in an overall increase in locomotor activity, associated with decreased freezing during recall of extinction. Compositional data analysis confirmed the freezing-related pharmacological effects and revealed specific differences in basic behavioural states. CTAP-treated mice remained in an aversive state, whereas DAMGO-treated mice displayed predominantly neutral behaviour. CONCLUSIONS Fear extinction requires the integrity of the µ-opioid system in the dorsal midline thalamus. Pharmacological stimulation of MOR and associated facilitation of fear extinction recall suggest a potential therapeutic avenue for stress-related or anxiety disorders.
Collapse
Affiliation(s)
- Xabier Bengoetxea
- Xabier Bengoetxea, Institute of Physiology I, University of Münster, Robert-Koch-Str. 27a, Münster, 48149, Germany.
| | | | | | | | | |
Collapse
|
16
|
Caspi O, Aronson D. Morphine in the Setting of Acute Heart Failure: Do the Risks Outweigh the Benefits? Card Fail Rev 2020; 6:e20. [PMID: 32774891 PMCID: PMC7407569 DOI: 10.15420/cfr.2019.22] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 03/08/2020] [Indexed: 12/12/2022] Open
Abstract
The use of opioids in acute pulmonary oedema is considered standard therapy by many physicians. The immediate relieving effect of morphine on the key symptomatic discomfort associated with acute heart failure, dyspnoea, facilitated the categorisation of morphine as a beneficial treatment in this setting. During the last decade, several retrospective studies raised concerns regarding the safety and efficacy of morphine in the setting of acute heart failure. In this article, the physiological effects of morphine on the cardiovascular and respiratory systems are summarised, as well as the potential clinical benefits and risks associated with morphine therapy. Finally, the reported clinical outcomes and adverse event profiles from recent observational studies are discussed, as well as future perspectives and potential alternatives to morphine in the setting of acute heart failure.
Collapse
Affiliation(s)
- Oren Caspi
- Departments of Cardiology, Rambam Medical Centre and B Rappaport Faculty of Medicine, Technion Medical School Haifa, Israel
| | - Doron Aronson
- Departments of Cardiology, Rambam Medical Centre and B Rappaport Faculty of Medicine, Technion Medical School Haifa, Israel
| |
Collapse
|
17
|
Anxiety, depression, and opioid misuse among adults with chronic pain: the role of emotion dysregulation. J Behav Med 2020; 44:66-73. [PMID: 32594288 DOI: 10.1007/s10865-020-00169-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 06/19/2020] [Indexed: 12/31/2022]
Abstract
The opioid epidemic is a significant public health concern in the United States, particularly among adults with chronic pain. Considerable research suggests that people with mental health problems, including anxiety and depression, may experience more opioid-related problems in the context of chronic pain. Yet, little work has examined potential mechanisms underyling these relations. Emotion dysregulation is one mechanistic factor that may link anxiety and depression and opioid-related problems among persons with chronic pain. Therefore, the current study examined the explanatory role of emotion dysregulation in the cross-sectional relationship between anxiety and depression problems and current opioid misuse and severity of opioid dependence among 431 adults with chronic pain who reported currently using opioid medications (74% female, Mage=38.32 years, SD = 11.11). Results indicated that emotion dysregulation explained, in part, the relationship between anxiety and depression symptoms and opioid-related problems. These findings highlight the need to further consider the role of emotion dysregulation among adults with chronic pain who use prescription opioids and experience symptoms of anxiety or depression. Future prospective research will be needed to further establish emotion dysregulation as a mechanism in anxiety/depression-opioid misuse/dependence processes.
Collapse
|
18
|
Holmstedt A, Olsson M, Håkansson A. Clinical characteristics distinguishing tramadol-using adolescents from other substance-using adolescents in an out-patient treatment setting. Addict Behav Rep 2020; 11:100272. [PMID: 32322659 PMCID: PMC7160423 DOI: 10.1016/j.abrep.2020.100272] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 03/27/2020] [Accepted: 03/27/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Non-medical Prescription Opioid Use (NMPOU) has increased worldwide during the last decades, and specifically, tramadol misuse may represent a novel pattern of substance use among adolescents. The present study aims to analyze characteristics distinguishing tramadol-using adolescents from other substance-using adolescents seeking out-patient treatment. METHODS This is a cross-sectional study of treatment-seeking patients between 13 and 24 years of age in an out-patient facility for substance use problems in Malmö, Sweden. A total of 526 treatment-seeking adolescents at an out-patient treatment center were included. Data on substance use, treatment history and socio-demographic variables were extracted through a semi-structured interview method aimed specifically for adolescents with alcohol or drug problems (Ung-DOK). Lifetime tramadol users were compared to non-users, and also, primary tramadol users were compared to remaining subjects. RESULTS Thirty-one percent (n = 162) were tramadol users (lifetime prevalence). In logistic regression, the tramadol group showed a significantly increased risk of tobacco use, problematic lifetime cocaine, benzodiazepine and amphetamine use, and were more likely to report contacts with the judicial system, and less likely to report contacts with child or adult psychiatry, and more likely to have parents born outside the Scandinavian countries. In logistic regression, primary tramadol use was negatively associated with frequent cannabis use. CONCLUSIONS Tramadol use appears to be a novel pattern among treatment-seeking adolescents. They showed a significantly increased risk of initiation of other illicit drugs and criminal behaviour, despite less contact with psychiatric care. More attention may be needed to this relatively novel pattern of opioid use.
Collapse
Affiliation(s)
- A. Holmstedt
- Lund University, Faculty of Medicine, Dept of Clinical Sciences Lund, Psychiatry, Lund, Sweden
- Malmö Addiction Center, Region Skåne, Malmö, Sweden
| | - M.O. Olsson
- Stockholm Center for Dependency Disorders, Region Stockholm, Centre for Psychiatric Research, Karolinska Institute, Stockholm, Sweden
| | - A. Håkansson
- Lund University, Faculty of Medicine, Dept of Clinical Sciences Lund, Psychiatry, Lund, Sweden
- Malmö Addiction Center, Region Skåne, Malmö, Sweden
| |
Collapse
|
19
|
Tchalova K, MacDonald G. Opioid receptor blockade inhibits self-disclosure during a closeness-building social interaction. Psychoneuroendocrinology 2020; 113:104559. [PMID: 31911348 DOI: 10.1016/j.psyneuen.2019.104559] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 12/16/2019] [Accepted: 12/17/2019] [Indexed: 12/29/2022]
Abstract
Social ties are critical to human health and well-being; thus, it is important to gain a better understanding of the neurobiological mechanisms involved in the development of interpersonal closeness. Prior research indicates that endogenous opioids may play a role in social affiliation by elaborating feelings of social connection and warmth; however, it is not currently known whether opioids mediate affiliative behavior and emerging feelings of closeness in humans at the relationship initiation stage. This randomized, double-blind study examined opioidergic processes in the context of a naturalistic, face-to-face social interaction. Eighty pairs of unacquainted participants (final N = 159 due to removal of one dyad member from analysis) received either 50 mg of the opioid receptor antagonist naltrexone or placebo prior to completing a closeness-building exercise centered on escalating self-disclosure (sharing of personal information about the self). Compared to the placebo group, naltrexone participants held lower social reward expectations prior to the interaction, engaged in less intimacy-fostering behavior (self-disclosure) during the interaction, and reported wanting less closeness with their partner. Feelings of social connection were not significantly lower in the naltrexone group. However, placebo participants experienced improvements in mood after the closeness-building task whereas naltrexone participants did not. These findings suggest that endogenous opioids may contribute to behavioral, affective, and motivational processes related to the development of initial closeness.
Collapse
Affiliation(s)
- Kristina Tchalova
- Department of Psychology, University of Toronto, 100 St. George Street, Toronto, ON M5S 3G3, Canada; Department of Psychology, McGill University, 2001 McGill College Avenue, Montréal, QC H3A 1G1, Canada.
| | - Geoff MacDonald
- Department of Psychology, University of Toronto, 100 St. George Street, Toronto, ON M5S 3G3, Canada
| |
Collapse
|
20
|
Synergistic effect between citalopram and citicoline on anxiolytic effect in non-sensitized and morphine-sensitized mice: An isobologram analysis. Brain Res 2020; 1734:146701. [PMID: 32070686 DOI: 10.1016/j.brainres.2020.146701] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 01/14/2020] [Accepted: 02/03/2020] [Indexed: 11/21/2022]
Abstract
In the present study, the effects of intraperitoneal (i.p.) injections of citalopram and citicoline on morphine-induced anxiolytic effects were investigated in non-sensitized and morphine-sensitized mice using elevated plus-maze (EPM). Subcutaneous (s.c.) administration morphine (5 mg/kg) increased the percentage of open arm time (%OAT, in morphine-sensitized mice), and open arm entries (%OAE, in non-sensitized mice), but not a locomotor activity, indicating an anxiolytic response to morphine. On the other hand, i.p. administration of naloxone decreased %OAT (morphine-sensitized mice), and %OAE (non-sensitized and morphine-sensitized mice), but not a locomotor activity, showing an anxiogenic effect to naloxone. Moreover, i.p.co-administration of citalopram (5 and 10 mg/kg) and citicoline (75 mg/kg) induced the anxiolytic effect. Interestingly, i.p. co-administration of low doses of citalopram (0.5, 1 and 2.5 mg/kg) and citicoline (25 mg/kg) significantly increased %OAT and %OAE in non-sensitized as well as %OAT in morphine-sensitized mice, indicating an anxiolytic effect. An isobolographic analysis of data was performed, presenting a synergistic interaction between citalopram and citicoline upon the production of anxiolytic effect in non-sensitized and morphine-sensitized mice. In conclusion, it seems that (1) morphine sensitization affects the anxiety behavior in the EPM, (2) μ-opioid receptors play an important role in morphine anxiolytic effect, (3) citalopram and citicoline induced anti-anxiety effect, (4) a synergistic effect of citalopram and citicoline upon induction of anti-anxiety behavior in non-sensitized and morphine-sensitized mice.
Collapse
|
21
|
Gilam G, Sturgeon JA, You DS, Wasan AD, Darnall BD, Mackey SC. Negative Affect-Related Factors Have the Strongest Association with Prescription Opioid Misuse in a Cross-Sectional Cohort of Patients with Chronic Pain. PAIN MEDICINE (MALDEN, MASS.) 2020; 21:e127-e138. [PMID: 31617916 PMCID: PMC7049262 DOI: 10.1093/pm/pnz249] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Increased opioid prescription to relieve pain among patients with chronic pain is associated with increased risk for misuse, potentially leading to substance use disorders and overdose death. We aimed to characterize the relative importance and identify the most significant of several potential risk factors for the severity of self-reported prescribed opioid misuse behaviors. METHODS A sample of 1,193 patients (mean age ± SD = 50.72 ± 14.97 years, 64.04% female) with various chronic pain conditions completed a multidimensional registry assessing four pain severity measures and 14 physical, mental, and social health status factors using the National Institutes of Health's Patient-Reported Outcomes Measurement Information System (PROMIS). A validated PROMIS measure of medication misuse was completed by 692 patients who endorsed currently taking opioid medication. Patients taking opioid medications were compared across all measures with those who do not take opioid medications. Subsequently, a data-driven regression analysis was used to determine which measures best explained variability in severity of misuse. We hypothesized that negative affect-related factors, namely anxiety, anger, and/or depression, would be key predictors of misuse severity due to their crucial role in chronic pain and substance use disorders. RESULTS Patients taking opioid medications had significantly greater impairment across most measures. Above and beyond demographic variables, the only and most significant predictors of prescribed opioid misuse severity were as follows: anxiety (β = 0.15, P = 0.01), anger (β = 0.13, P = 0.02), Pain Intensity-worst (β = 0.09, P = 0.02), and depression (β = 0.13, P = 0.04). CONCLUSIONS Findings suggest that anxiety, anger, and depression are key factors associated with prescribed opioid misuse tendencies in patients with chronic pain and that they are potential targets for therapeutic intervention.
Collapse
Affiliation(s)
- Gadi Gilam
- Division of Pain Medicine, Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, California
| | - John A Sturgeon
- Center for Pain Relief, Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, Washington
| | - Dokyoung S You
- Division of Pain Medicine, Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, California
| | - Ajay D Wasan
- Division of Chronic Pain, Department of Anesthesiology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Beth D Darnall
- Division of Pain Medicine, Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, California
| | - Sean C Mackey
- Division of Pain Medicine, Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, California
| |
Collapse
|
22
|
Abstract
Given the aging Baby Boomer generation, changes in cannabis legislation, and the growing acknowledgment of cannabis for its therapeutic potential, it is predicted that cannabis use in the older population will escalate. It is, therefore, important to determine the interaction between the effects of cannabis and aging. The aim of this report is to describe the link between cannabis use and the aging brain. Our review of the literature found few and inconsistent empirical studies that directly address the impact of cannabis use on the aging brain. However, research focused on long-term cannabis use points toward cumulative effects on multimodal systems in the brain that are similarly affected during aging. Specifically, the effects of cannabis and aging converge on overlapping networks in the endocannabinoid, opioid, and dopamine systems that may affect functional decline particularly in the hippocampus and prefrontal cortex, which are critical areas for memory and executive functioning. To conclude, despite the limited current knowledge on the potential interactive effects between cannabis and aging, evidence from the literature suggests that cannabis and aging effects are concurrently present across several neurotransmitter systems. There is a great need for future research to directly test the interactions between cannabis and aging.
Collapse
Affiliation(s)
- Hye Bin Yoo
- Center for BrainHealth, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, Texas, USA
| | - Jennifer DiMuzio
- Center for BrainHealth, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, Texas, USA
| | - Francesca M Filbey
- Center for BrainHealth, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, Texas, USA
| |
Collapse
|
23
|
Review: Exteroceptive Sensory Abnormalities in Childhood and Adolescent Anxiety and Obsessive-Compulsive Disorder: A Critical Review. J Am Acad Child Adolesc Psychiatry 2020; 59:78-87. [PMID: 31265873 DOI: 10.1016/j.jaac.2019.06.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 05/20/2019] [Accepted: 06/24/2019] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Childhood anxiety and obsessive-compulsive disorder (OCD) are defined by fear, worry, and uncertainty, but there is also evidence that affected children possess exteroceptive sensory abnormalities. These sensory features may often instigate symptoms and cause significant distress and functional impairment. In addition, a purported class of conditions known as "sensory processing disorders" may significantly overlap with childhood anxiety and OCD, which provides further support for a connection between abnormal sensation and fear-based psychopathology. METHOD The current review was conducted to synthesize and to critically evaluate the existing research on exteroceptive sensory abnormalities in childhood anxiety and OCD. Because of the paucity of research in this area, studies with adult populations were also briefly reviewed. RESULTS The review found significant support for the notion that sensory abnormalities are common in children with anxiety disorders and OCD, but there are significant limitations to research in this area that prevent firm conclusions. CONCLUSION Potential avenues for future research on sensory features of pediatric anxiety and OCD are discussed.
Collapse
|
24
|
Kim DJ, Blossom SJ, Delgado PL, Carbajal JM, Cáceda R. Examination of pain threshold and neuropeptides in patients with acute suicide risk. Prog Neuropsychopharmacol Biol Psychiatry 2019; 95:109705. [PMID: 31326514 PMCID: PMC7309511 DOI: 10.1016/j.pnpbp.2019.109705] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 07/08/2019] [Accepted: 07/17/2019] [Indexed: 01/01/2023]
Abstract
INTRODUCTION One of the main challenges in suicide prevention is the limited understanding of the biological mechanisms underlying suicide. Recent findings suggest impairments in pain processing in acutely suicidal patients. However, little is known about the biological factors that may drive these discrete physiological abnormalities. In this study, we examined plasma peptides involved in analgesic and inflammatory responses and physical pain threshold in acutely suicidal patients. METHODS Thirty-seven depressed patients of both sexes hospitalized for severe suicidal ideation or a recent suicide attempt were characterized clinically including history of suicidal ideation and behavior. Psychological and physical pain, and pressure pain threshold was also measured. Plasma levels of β-endorphin, neurotensin, agouti-related protein (AgRP), C-reactive protein (CRP), adrenocorticotropic hormone (ACTH), and brain-derived neurotrophic factor (BDNF) were run in Milliplex multiplex assays. RESULTS The number of lifetime suicide attempts was positively correlated with β-endorphin (r = 0.702; p = 0.007), and neurotensin (r = 0.728, p = 0.007) plasma levels. Higher pain threshold was measured in the suicide attempt group as compared to the suicidal ideation group. Pain threshold was strongly and negatively associated with CRP plasma levels (r = -0.548; p < 0.001). In patients reporting chronic pain, lower AgRP levels and lower pain threshold were observed (t = 4.472; p = 0.001). CONCLUSION Our results suggest that abnormalities in the opioid and neurotensin systems may underlie the increase in pain threshold found in suicide attempters, and possibly risk for suicidal behavior. Targeting pain circuits and systems may provide therapeutic mechanisms for suicide prevention.
Collapse
Affiliation(s)
- Diane J. Kim
- Department of Psychiatry and Behavioral Health, Stony Brook University, Stony Brook, New York, USA
| | - Sarah J. Blossom
- Department of Pediatrics and Microbiology/Immunology, University of Arkansas for Medical Sciences and Arkansas Children’s Research Institute, Little Rock, Arkansas, USA
| | - Pedro L. Delgado
- Psychiatric Research Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Jessica M. Carbajal
- Department of Psychiatry and Behavioral Health, Stony Brook University, Stony Brook, New York, USA
| | - Ricardo Cáceda
- Department of Psychiatry and Behavioral Health, Stony Brook University, Stony Brook, New York, USA.
| |
Collapse
|
25
|
Goodlev ER, Discala S, Darnall BD, Hanson M, Petok A, Silverman M. Managing Cancer Pain, Monitoring for Cancer Recurrence, and Mitigating Risk of Opioid Use Disorders: A Team-Based, Interdisciplinary Approach to Cancer Survivorship. J Palliat Med 2019; 22:1308-1317. [PMID: 31329500 DOI: 10.1089/jpm.2019.0171] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Affiliation(s)
- Eric R. Goodlev
- Division of Geriatrics and Palliative Care, Department of Family and Community Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania
- Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Sandra Discala
- West Palm Beach Veterans Affairs Medical Center, West Palm Beach, Florida
| | - Beth D. Darnall
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, California
| | - Molly Hanson
- Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Alison Petok
- Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Michael Silverman
- West Palm Beach Veterans Affairs Medical Center, West Palm Beach, Florida
| |
Collapse
|
26
|
Abstract
Anxiety occurs in about one third of people over 65 years of age. However, its identification in this age has significant difficulties. The clinical manifestations, pathogenetic mechanisms, approaches to the diagnosis and treatment of various types of anxiety are described in the article. Particular attention is paid to the comorbidity of anxiety disorders in elderly patients. A comprehensive approach to the treatment of elderly patients with anxiety includes psychotherapeutic and pharmacotherapeutic approaches. Special attention should be paid to the efficacy and safety of the drugs, which is especially important in this category of patients.
Collapse
Affiliation(s)
- O S Levin
- Russian Medical Academy for Continuing Professional Education, Moscow, Russia
| | - A S Chimagomedova
- Russian Medical Academy for Continuing Professional Education, Moscow, Russia
| | - A P Arefieva
- Russian Medical Academy for Continuing Professional Education, Moscow, Russia
| |
Collapse
|
27
|
Calvo F, Almada RC, Dos Anjos-Garcia T, Falconi-Sobrinho LL, Paschoalin-Maurin T, Bazaglia-de-Sousa G, Medeiros P, Silva JAD, Lobão-Soares B, Coimbra NC. Panicolytic-like effect of µ 1-opioid receptor blockade in the inferior colliculus of prey threatened by Crotalus durissus terrificus pit vipers. J Psychopharmacol 2019; 33:577-588. [PMID: 30663473 DOI: 10.1177/0269881118822078] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND The endogenous opioid peptide system has been implicated in the neural modulation of fear and anxiety organised by the dorsal midbrain. Furthermore, previous results indicate a fundamental role played by inferior colliculus (IC) opioid mechanisms during the expression of defensive behaviours, but the involvement of the IC µ1-opioid receptor in the modulation of anxiety- and panic attack-related behaviours remains unclear. Using a prey-versus-snake confrontation paradigm, we sought to investigate the effects of µ1-opioid receptor blockade in the IC on the defensive behaviour displayed by rats in a dangerous situation. METHODS Specific pathogen-free Wistar rats were treated with microinjection of the selective µ1-opioid receptor antagonist naloxonazine into the IC at different concentrations (1.0, 3.0 and 5.0 µg/0.2 µL) and then confronted with rattlesnakes ( Crotalus durissus terrificus). The defensive behavioural repertoire, such as defensive attention, flat back approach (FBA), startle, defensive immobility, escape or active avoidance, displayed by rats either during the confrontations with wild snakes or during re-exposure to the experimental context without the predator was analysed. RESULTS The blockade of µ1-opioid receptors in the IC decreased the expression of both anxiety-related behaviours (defensive attention, FBA) and panic attack-related responses (startle, defensive immobility and escape) during the confrontation with rattlesnakes. A significant decrease in defensive attention was also recorded during re-exposure of the prey to the experimental apparatus context without the predator. CONCLUSION Taken together, these results suggest that a decrease in µ1-opioid receptor signalling activity within the IC modulates anxiety- and panic attack-related behaviours in dangerous environments.
Collapse
Affiliation(s)
- Fabrício Calvo
- 1 Department of Pharmacology, University of São Paulo (FMRP-USP), Ribeirão Preto (SP), Brazil.,2 Department of Pharmacology, São Lucas College, Porto Velho (RO), Brazil.,3 Aparício Carvalho Integrative College (FIMCA), Porto Velho (RO), Brazil.,4 Ophidiarium LNN-FMRP-USP/INeC, University of São Paulo (FMRP-USP), Ribeirão Preto (SP), Brasil
| | - Rafael Carvalho Almada
- 1 Department of Pharmacology, University of São Paulo (FMRP-USP), Ribeirão Preto (SP), Brazil.,4 Ophidiarium LNN-FMRP-USP/INeC, University of São Paulo (FMRP-USP), Ribeirão Preto (SP), Brasil.,5 Behavioural Neurosciences Institute (INeC), Ribeirão Preto (SP), Brazil
| | - Tayllon Dos Anjos-Garcia
- 1 Department of Pharmacology, University of São Paulo (FMRP-USP), Ribeirão Preto (SP), Brazil.,4 Ophidiarium LNN-FMRP-USP/INeC, University of São Paulo (FMRP-USP), Ribeirão Preto (SP), Brasil.,6 NAP-USP-Neurobiology of Emotions Research Centre (NuPNE), University of São Paulo (FMRP-USP), Ribeirão Preto (SP), Brazil
| | - Luiz Luciano Falconi-Sobrinho
- 1 Department of Pharmacology, University of São Paulo (FMRP-USP), Ribeirão Preto (SP), Brazil.,4 Ophidiarium LNN-FMRP-USP/INeC, University of São Paulo (FMRP-USP), Ribeirão Preto (SP), Brasil.,5 Behavioural Neurosciences Institute (INeC), Ribeirão Preto (SP), Brazil.,6 NAP-USP-Neurobiology of Emotions Research Centre (NuPNE), University of São Paulo (FMRP-USP), Ribeirão Preto (SP), Brazil
| | - Tatiana Paschoalin-Maurin
- 1 Department of Pharmacology, University of São Paulo (FMRP-USP), Ribeirão Preto (SP), Brazil.,4 Ophidiarium LNN-FMRP-USP/INeC, University of São Paulo (FMRP-USP), Ribeirão Preto (SP), Brasil.,5 Behavioural Neurosciences Institute (INeC), Ribeirão Preto (SP), Brazil
| | - Guilherme Bazaglia-de-Sousa
- 1 Department of Pharmacology, University of São Paulo (FMRP-USP), Ribeirão Preto (SP), Brazil.,4 Ophidiarium LNN-FMRP-USP/INeC, University of São Paulo (FMRP-USP), Ribeirão Preto (SP), Brasil.,5 Behavioural Neurosciences Institute (INeC), Ribeirão Preto (SP), Brazil.,6 NAP-USP-Neurobiology of Emotions Research Centre (NuPNE), University of São Paulo (FMRP-USP), Ribeirão Preto (SP), Brazil
| | - Priscila Medeiros
- 1 Department of Pharmacology, University of São Paulo (FMRP-USP), Ribeirão Preto (SP), Brazil.,4 Ophidiarium LNN-FMRP-USP/INeC, University of São Paulo (FMRP-USP), Ribeirão Preto (SP), Brasil.,5 Behavioural Neurosciences Institute (INeC), Ribeirão Preto (SP), Brazil
| | - Juliana Almeida da Silva
- 1 Department of Pharmacology, University of São Paulo (FMRP-USP), Ribeirão Preto (SP), Brazil.,4 Ophidiarium LNN-FMRP-USP/INeC, University of São Paulo (FMRP-USP), Ribeirão Preto (SP), Brasil.,5 Behavioural Neurosciences Institute (INeC), Ribeirão Preto (SP), Brazil.,6 NAP-USP-Neurobiology of Emotions Research Centre (NuPNE), University of São Paulo (FMRP-USP), Ribeirão Preto (SP), Brazil
| | - Bruno Lobão-Soares
- 1 Department of Pharmacology, University of São Paulo (FMRP-USP), Ribeirão Preto (SP), Brazil.,4 Ophidiarium LNN-FMRP-USP/INeC, University of São Paulo (FMRP-USP), Ribeirão Preto (SP), Brasil.,5 Behavioural Neurosciences Institute (INeC), Ribeirão Preto (SP), Brazil.,7 Department of Biophysics and Pharmacology, Federal University of Rio Grande do Norte (UFRN), Natal (RN), Brazil
| | - Norberto Cysne Coimbra
- 1 Department of Pharmacology, University of São Paulo (FMRP-USP), Ribeirão Preto (SP), Brazil.,4 Ophidiarium LNN-FMRP-USP/INeC, University of São Paulo (FMRP-USP), Ribeirão Preto (SP), Brasil.,5 Behavioural Neurosciences Institute (INeC), Ribeirão Preto (SP), Brazil.,6 NAP-USP-Neurobiology of Emotions Research Centre (NuPNE), University of São Paulo (FMRP-USP), Ribeirão Preto (SP), Brazil
| |
Collapse
|
28
|
Szymaszkiewicz A, Storr M, Fichna J, Zielinska M. Enkephalinase inhibitors, potential therapeutics for the future treatment of diarrhea predominant functional gastrointestinal disorders. Neurogastroenterol Motil 2019; 31:e13526. [PMID: 30549162 DOI: 10.1111/nmo.13526] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 10/20/2018] [Accepted: 11/12/2018] [Indexed: 02/08/2023]
Abstract
The endogenous opioid system (EOS) is considered being a crucial element involved in the pathophysiology of irritable bowel syndrome (IBS) as it regulates gastrointestinal (GI) homeostasis through modulation of motility and water and ion secretion/absorption. Along with opioid receptors (ORs), the following components of EOS can be distinguished: 1. endogenous opioid peptides (EOPs), namely enkephalins, endorphins, endomorphins and dynorphins, and 2. peptidases, which regulate the metabolism (synthesis and degradation) of EOPs. Enkephalins, which are δ-opioid receptors agonists, induce significant effects in the GI tract as they act as potent pro-absorptive neurotransmitters. The action of enkephalins and other EOPs is limited, since EOPs are easily and rapidly inactivated by a natural metalloendopeptidase (enkephalinase/neprilysin) and aminopeptidase N. Studies show that the activity of EOPs can be enhanced by inhibition of these enzymes. In this review, we discuss the antidiarrheal and antinociceptive potential of enkephalinase inhibitors. Furthermore, our review is to answer the question whether enkephalinase inhibitors may be helpful in the future treatment of diarrhea predominant functional GI disorders.
Collapse
Affiliation(s)
- Agata Szymaszkiewicz
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Lodz, Poland
| | - Martin Storr
- Department of Medicine, Ludwig Maximilians University Munich, Munich, Germany.,Center of Endoscopy, Starnberg, Germany
| | - Jakub Fichna
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Lodz, Poland
| | - Marta Zielinska
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Lodz, Poland
| |
Collapse
|
29
|
Fujii K, Koshidaka Y, Adachi M, Takao K. Effects of chronic fentanyl administration on behavioral characteristics of mice. Neuropsychopharmacol Rep 2018; 39:17-35. [PMID: 30506634 PMCID: PMC7292323 DOI: 10.1002/npr2.12040] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 10/10/2018] [Accepted: 10/19/2018] [Indexed: 01/16/2023] Open
Abstract
Background Fentanyl, a synthetic opioid categorized as a narcotic analgesic, has a 100‐ to 200‐fold stronger effect than most opioids, such as morphine. Fatal accidents due to chronic use and abuse of fentanyl are a worldwide social problem. One reason for the abuse of fentanyl is its psychostimulant effects that could induce behavioral changes. The effects of chronic fentanyl administration on behavior, however, are unclear. Methods Adult male C57BL/6J mice were chronically administered fentanyl (0.03 or 0.3 mg/kg/d i.p.), and various behaviors were assessed using a behavioral test battery. Results Mice chronically administered a high dose of fentanyl (0.3 mg/kg/d) exhibited decreased anxiety‐like behavior as assessed by the open field and elevated plus maze tests. On the other hand, interruption of fentanyl administration led to increased anxiety‐like behavior as observed in the light and dark transition test. The hot plate test revealed that chronic administration of fentanyl reduced pain sensitivity. High‐dose chronic fentanyl administration reduced the locomotor stimulatory effects of cocaine. The results, however, failed to reach the threshold for study‐wide statistical significance. Conclusion Chronic fentanyl administration induces some behavioral changes in mice. Although further studies are needed to clarify the underlying mechanisms of the behavioral effects of chronic fentanyl administration, our findings suggest that fentanyl is safe under properly controlled conditions. To investigate the effects of long‐term fentanyl use on brain function, adult male C57BL/6J mice were chronically administered fentanyl (0.03 or 0.3 mg/kg/d ip) and analyzed in a behavioral test battery. Chronic fentanyl administration reduced anxiety‐like behavior, pain sensitivity, and the locomotor stimulatory effects of cocaine in mice. The results, however, failed to reach the threshold for study‐wide statistical significance.![]()
Collapse
Affiliation(s)
- Kazuki Fujii
- Department of Behavioral Physiology, Graduate School of Innovative Life Science, University of Toyama, Toyama, Japan.,Life Science Research Center, University of Toyama, Toyama, Japan
| | - Yumie Koshidaka
- Life Science Research Center, University of Toyama, Toyama, Japan
| | - Mayumi Adachi
- Life Science Research Center, University of Toyama, Toyama, Japan
| | - Keizo Takao
- Department of Behavioral Physiology, Graduate School of Innovative Life Science, University of Toyama, Toyama, Japan.,Life Science Research Center, University of Toyama, Toyama, Japan
| |
Collapse
|
30
|
Karjalainen T, Seppälä K, Glerean E, Karlsson HK, Lahnakoski JM, Nuutila P, Jääskeläinen IP, Hari R, Sams M, Nummenmaa L. Opioidergic Regulation of Emotional Arousal: A Combined PET–fMRI Study. Cereb Cortex 2018; 29:4006-4016. [DOI: 10.1093/cercor/bhy281] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 10/11/2018] [Indexed: 01/17/2023] Open
Abstract
Abstract
Emotions can be characterized by dimensions of arousal and valence (pleasantness). While the functional brain bases of emotional arousal and valence have been actively investigated, the neuromolecular underpinnings remain poorly understood. We tested whether the opioid and dopamine systems involved in reward and motivational processes would be associated with emotional arousal and valence. We used in vivo positron emission tomography to quantify μ-opioid receptor and type 2 dopamine receptor (MOR and D2R, respectively) availability in brains of 35 healthy adult females. During subsequent functional magnetic resonance imaging carried out to monitor hemodynamic activity, the subjects viewed movie scenes of varying emotional content. Arousal and valence were associated with hemodynamic activity in brain regions involved in emotional processing, including amygdala, thalamus, and superior temporal sulcus. Cerebral MOR availability correlated negatively with the hemodynamic responses to arousing scenes in amygdala, hippocampus, thalamus, and hypothalamus, whereas no positive correlations were observed in any brain region. D2R availability—here reliably quantified only in striatum—was not associated with either arousal or valence. These results suggest that emotional arousal is regulated by the MOR system, and that cerebral MOR availability influences brain activity elicited by arousing stimuli.
Collapse
Affiliation(s)
| | | | - Enrico Glerean
- Brain and Mind Laboratory, Department of Neuroscience and Biomedical Engineering (NBE), Aalto University, Aalto, Espoo, Finland
- Department of Computer Science, Aalto University, Aalto, Espoo, Finland
- Helsinki Institute for Information Technology, Aalto, Espoo, Finland
| | | | - Juha M Lahnakoski
- Brain and Mind Laboratory, Department of Neuroscience and Biomedical Engineering (NBE), Aalto University, Aalto, Espoo, Finland
- Independent Max Planck Research Group for Social Neuroscience, Max Planck Institute of Psychiatry, Munich, Germany
| | - Pirjo Nuutila
- Turku PET Centre, University of Turku, Turku, Finland
- Department of Endocrinology, Turku University Hospital, Turku, Finland
| | - Iiro P Jääskeläinen
- Brain and Mind Laboratory, Department of Neuroscience and Biomedical Engineering (NBE), Aalto University, Aalto, Espoo, Finland
| | - Riitta Hari
- Department of Art, Aalto University, Aalto, Espoo, Finland
| | - Mikko Sams
- Brain and Mind Laboratory, Department of Neuroscience and Biomedical Engineering (NBE), Aalto University, Aalto, Espoo, Finland
- Department of Computer Science, Aalto University, Aalto, Espoo, Finland
| | - Lauri Nummenmaa
- Turku PET Centre, University of Turku, Turku, Finland
- Department of Psychology, University of Turku, Turku, Finland
| |
Collapse
|
31
|
Barnett LA, Pritchard MG, Edwards JJ, Afolabi EK, Jordan KP, Healey EL, Finney AG, Chew-Graham CA, Mallen CD, Dziedzic KS. Relationship of anxiety with joint pain and its management: A population survey. Musculoskeletal Care 2018; 16:353-362. [PMID: 29675943 DOI: 10.1002/msc.1243] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 03/11/2018] [Accepted: 03/11/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVES The aims of the present study was to examine the associations between the severity of pain and anxiety in a community population reporting joint pain, and to investigate the management of joint pain in the presence of comorbid anxiety. METHODS A population survey was carried out of people aged ≥45 years, registered with eight general practices in Cheshire, Shropshire and Staffordshire, UK. Respondents were asked to report pain intensity in their hands, hips, knees and feet (on a numerical rating scale), anxiety symptoms (Generalized Anxiety Disorder seven-item [GAD-7] scale) and guideline-recommended treatments used to manage pain. Clinical anxiety was defined by a GAD-7 score of 10 or more. RESULTS A total of 11,222 respondents with joint pain were included in the analysis, with 1,802 (16.1%) reporting clinical anxiety. Respondents reporting more severe pain were more likely to report clinical anxiety (severe versus mild pain, odds ratio [OR] 5.36, 95% confidence interval [CI] 4.56 to 6.31). The number of pain sites was also positively associated with clinical anxiety (four versus one site; OR 3.64, 95% CI 3.09 to 4.30). Those with clinical anxiety were less likely to undertake general fitness exercises (OR 0.60, 95% CI 0.52 to 0.70), but more likely to diet (OR 1.43, 95% CI 1.21 to 1.69), use walking aids (OR 1.53, 95% CI 1.32 to 1.77) and assistive devices (OR 1.24, 95% CI 1.04 to 1.49), and more likely to use opioids (OR 1.34, 95% CI 1.18 to1.52). CONCLUSIONS Anxiety is common among patients presenting to primary care with joint pain. Patients with anxiety are likely to manage their joint pain differently to those without. Case-finding to identify and treat anxiety would be appropriate in this population, with caution about opioid prescribing and consideration of exercise as an intervention.
Collapse
Affiliation(s)
- Lauren A Barnett
- Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire, ST5 5BG, UK
| | - Mark G Pritchard
- Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire, ST5 5BG, UK
- Royal Stoke University Hospital, Stoke-on-Trent, Staffordshire
| | - John J Edwards
- Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire, ST5 5BG, UK
| | - Ebenezer K Afolabi
- Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire, ST5 5BG, UK
| | - Kelvin P Jordan
- Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire, ST5 5BG, UK
| | - Emma L Healey
- Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire, ST5 5BG, UK
| | - Andrew G Finney
- Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire, ST5 5BG, UK
| | - Carolyn A Chew-Graham
- Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire, ST5 5BG, UK
- Collaboration for Leadership in Applied Health Research and Care, West Midlands
| | - Christian D Mallen
- Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire, ST5 5BG, UK
- Collaboration for Leadership in Applied Health Research and Care, West Midlands
| | - Krysia S Dziedzic
- Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire, ST5 5BG, UK
| |
Collapse
|
32
|
Demin KA, Meshalkina DA, Kysil EV, Antonova KA, Volgin AD, Yakovlev OA, Alekseeva PA, Firuleva MM, Lakstygal AM, de Abreu MS, Barcellos LJG, Bao W, Friend AJ, Amstislavskaya TG, Rosemberg DB, Musienko PE, Song C, Kalueff AV. Zebrafish models relevant to studying central opioid and endocannabinoid systems. Prog Neuropsychopharmacol Biol Psychiatry 2018; 86:301-312. [PMID: 29604314 DOI: 10.1016/j.pnpbp.2018.03.024] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 03/26/2018] [Accepted: 03/26/2018] [Indexed: 12/19/2022]
Abstract
The endocannabinoid and opioid systems are two interplaying neurotransmitter systems that modulate drug abuse, anxiety, pain, cognition, neurogenesis and immune activity. Although they are involved in such critical functions, our understanding of endocannabinoid and opioid physiology remains limited, necessitating further studies, novel models and new model organisms in this field. Zebrafish (Danio rerio) is rapidly emerging as one of the most effective translational models in neuroscience and biological psychiatry. Due to their high physiological and genetic homology to humans, zebrafish may be effectively used to study the endocannabinoid and opioid systems. Here, we discuss current models used to target the endocannabinoid and opioid systems in zebrafish, and their potential use in future translational research and high-throughput drug screening. Emphasizing the high degree of conservation of the endocannabinoid and opioid systems in zebrafish and mammals, we suggest zebrafish as an excellent model organism to study these systems and to search for the new drugs and therapies targeting their evolutionarily conserved mechanisms.
Collapse
Affiliation(s)
- Konstantin A Demin
- Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg, Russia; Institute of Experimental Medicine, Almazov National Medical Research Centre, St. Petersburg, Russia; Laboratory of Preclinical Bioscreening, Russian Research Center for Radiology and Surgical Technologies, Ministry of Health, St. Petersburg, Russia
| | - Darya A Meshalkina
- Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg, Russia; Institute of Experimental Medicine, Almazov National Medical Research Centre, St. Petersburg, Russia; Laboratory of Preclinical Bioscreening, Russian Research Center for Radiology and Surgical Technologies, Ministry of Health, St. Petersburg, Russia
| | - Elana V Kysil
- Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg, Russia
| | - Kristina A Antonova
- Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg, Russia
| | - Andrey D Volgin
- Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg, Russia; Medical Military Academy, St. Petersburg, Russia
| | - Oleg A Yakovlev
- Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg, Russia; Medical Military Academy, St. Petersburg, Russia
| | - Polina A Alekseeva
- Institute of Experimental Medicine, Almazov National Medical Research Centre, St. Petersburg, Russia
| | - Maria M Firuleva
- Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg, Russia
| | - Anton M Lakstygal
- Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg, Russia
| | - Murilo S de Abreu
- Bioscience Institute, University of Passo Fundo (UPF), Passo Fundo, RS, Brazil; Graduate Program in Pharmacology, Federal University of Santa Maria, Santa Maria, Brazil
| | - Leonardo J G Barcellos
- Graduate Program in Pharmacology, Federal University of Santa Maria, Santa Maria, Brazil; Graduate Programs in Environmental Sciences, and Bio-Experimentation, University of Passo Fundo (UPF), Passo Fundo, Brazil; The International Zebrafish Neuroscience Research Consortium (ZNRC), Slidell, LA, USA
| | - Wandong Bao
- School of Pharmacy, Southwest University, Chongqing, China
| | - Ashton J Friend
- The International Zebrafish Neuroscience Research Consortium (ZNRC), Slidell, LA, USA; Tulane University School of Science and Engineering, New Orleans, LA, USA
| | - Tamara G Amstislavskaya
- The International Zebrafish Neuroscience Research Consortium (ZNRC), Slidell, LA, USA; Laboratory of Translational Biopsychiatry, Research Institute of Physiology and Basic Medicine, Novosibirsk, Russia; Neuroscience Department, Novosibirsk State University, Novosibirsk, Russia
| | - Denis B Rosemberg
- The International Zebrafish Neuroscience Research Consortium (ZNRC), Slidell, LA, USA; Department of Biochemistry and Molecular Biology, Federal University of Santa Maria, Santa Maria, Brazil
| | - Pavel E Musienko
- Laboratory of Neuroprosthetics, Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg, Russia; Laboratory of Motor Physiology, Pavlov Institute of Physiology RAS, St. Petersburg, Russia; Laboratory of Neurophysiology and Experimental Neurorehabilitation, St. Petersburg State Research Institute of Phthysiopulmonology, Ministry of Health, St. Petersburg, Russia; Russian Research Center of Radiology and Surgical Technologies, Ministry of Health, St. Petersburg, Russia
| | - Cai Song
- Research Institute for Marine Drugs and Nutrition, Guangdong Ocean University, Zhanjiang, China; Marine Medicine Research and Development Center, Shenzhen Institute of Guangdong Ocean University, Shenzhen, China
| | - Allan V Kalueff
- School of Pharmacy, Southwest University, Chongqing, China; Laboratory of Translational Biopsychiatry, Research Institute of Physiology and Basic Medicine, Novosibirsk, Russia; Neuroscience Department, Novosibirsk State University, Novosibirsk, Russia; ZENEREI Research Center, Slidell, LA, USA; Russian Research Center of Radiology and Surgical Technologies, Ministry of Health, St. Petersburg, Russia; Ural Federal University, Ekaterinburg, Russia; Aquatic Laboratory, Institute of Experimental Medicine, Almazov National Medical Research Centre, St. Petersburg, Russia.
| |
Collapse
|
33
|
Darnall BD, Colloca L. Optimizing Placebo and Minimizing Nocebo to Reduce Pain, Catastrophizing, and Opioid Use: A Review of the Science and an Evidence-Informed Clinical Toolkit. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2018; 139:129-157. [PMID: 30146045 PMCID: PMC6175287 DOI: 10.1016/bs.irn.2018.07.022] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Pain, a noxious psychosensory experience, motivates escape behavior to assure protection and survival. Psychological factors alter the experience and trajectory of pain, as well as behavior and treatment response. In the context of pain, the placebo effect (expectation for pain relief) releases endogenous opioids and facilitates analgesia from exogenously administered opioids. Nocebo hyperalgesia (expectation for persistent or worsening pain) opposes endogenous opioid analgesia and patient engagement in prescription opioid tapering. Reductions in nocebo hyperalgesia and pain catastrophizing may enhance descending modulation of pain, mediate adaptive structural brain changes and promote patient engagement in opioid tapering. Interventions that minimize nocebo and optimize placebo may adaptively shape the central nervous system toward pain relief and potentially opioid reduction. Here we provide a critical description of catastrophizing and its impact on pain, placebo and nocebo effects. We also consider the importance of minimizing nocebo and optimizing placebo effects during prescription opioid tapering, and offer a clinical toolkit of resources to accomplish these goals clinically.
Collapse
Affiliation(s)
- Beth D Darnall
- School of Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Division of Pain Medicine, Psychiatry and Behavioral Sciences (by courtesy), Stanford University, Palo Alto, CA, United States.
| | - Luana Colloca
- Department of Pain Translational Symptom Science, School of Nursing, University of Maryland, Baltimore, MD, United States; Departments of Anesthesiology and Psychiatry, School of Medicine, University of Maryland, Baltimore, MD, United States; Center to Advance Chronic Pain Research, University of Maryland, Baltimore, MD, United States
| |
Collapse
|
34
|
Nummenmaa L, Tuominen L. Opioid system and human emotions. Br J Pharmacol 2018; 175:2737-2749. [PMID: 28394427 PMCID: PMC6016642 DOI: 10.1111/bph.13812] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 03/07/2017] [Accepted: 03/24/2017] [Indexed: 12/31/2022] Open
Abstract
Emotions are states of vigilant readiness that guide human and animal behaviour during survival-salient situations. Categorical models of emotions posit neurally and physiologically distinct basic human emotions (anger, fear, disgust, happiness, sadness and surprise) that govern different survival functions. Opioid receptors are expressed abundantly in the mammalian emotion circuit, and the opioid system modulates a variety of functions related to arousal and motivation. Yet, its specific contribution to different basic emotions has remained poorly understood. Here, we review how the endogenous opioid system and particularly the μ receptor contribute to emotional processing in humans. Activation of the endogenous opioid system is consistently associated with both pleasant and unpleasant emotions. In general, exogenous opioid agonists facilitate approach-oriented emotions (anger, pleasure) and inhibit avoidance-oriented emotions (fear, sadness). Opioids also modulate social bonding and affiliative behaviour, and prolonged opioid abuse may render both social bonding and emotion recognition circuits dysfunctional. However, there is no clear evidence that the opioid system is able to affect the emotions associated with surprise and disgust. Taken together, the opioid systems contribute to a wide array of positive and negative emotions through their general ability to modulate the approach versus avoidance motivation associated with specific emotions. Because of the protective effects of opioid system-mediated prosociality and positive mood, the opioid system may constitute an important factor contributing to psychological and psychosomatic resilience. LINKED ARTICLES This article is part of a themed section on Emerging Areas of Opioid Pharmacology. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v175.14/issuetoc.
Collapse
Affiliation(s)
- Lauri Nummenmaa
- Turku PET Centre and Department of PsychologyUniversity of TurkuTurkuFinland
| | - Lauri Tuominen
- Department of PsychiatryMassachusetts General Hospital and Harvard Medical SchoolBostonMAUSA
| |
Collapse
|
35
|
Pecina M, Zubieta JK. Expectancy Modulation of Opioid Neurotransmission. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2018; 138:17-37. [PMID: 29681324 PMCID: PMC6314670 DOI: 10.1016/bs.irn.2018.02.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Expectancies are powerful modulators of cognitive and emotional experiences, as well as the neurobiological responses linked to these processes. In medicine, placebo effects are a clear example of how expectancies activate opioid neurotransmission in a treatment context, leading to the experience of analgesia and the improvement of emotional states, among other symptoms. Molecular neuroimaging techniques using positron emission tomography (PET) and the selective μ-opioid receptor tracer [11C]carfentanil have significantly contributed to our understanding of the neurobiological systems involved in the formation of placebo effects. This line of research has described neural and neurotransmitter networks implicated in placebo effects and provided the technical tools to examine inter-individual differences in the function of placebo responsive mechanisms. As a consequence, the capacity to activate endogenous opioid networks during the administration of placebos has been linked to the concept of resiliency mechanisms, partially determined by genetic factors, and uncovered by the cognitive emotional integration of the expectations created by the therapeutic environment and its maintenance through learning mechanisms. This evidence has contributed to the understanding of the biological bases of the cognitive and psychological mechanisms implicated in the response to treatments, and opened up new opportunities for drug development and the enhancement of treatment responses. Further, delineation of these processes within and across diseases is critical to understand neural systems that could be enhanced to promote symptomatic improvement and modify disease progression.
Collapse
MESH Headings
- Analgesia/psychology
- Brain/diagnostic imaging
- Brain/metabolism
- Brain/physiology
- Depressive Disorder, Major/diagnostic imaging
- Depressive Disorder, Major/metabolism
- Depressive Disorder, Major/physiopathology
- Health Knowledge, Attitudes, Practice
- Humans
- Nociception/physiology
- Personality/physiology
- Placebo Effect
- Receptors, Opioid, mu/genetics
- Receptors, Opioid, mu/metabolism
- Receptors, Opioid, mu/physiology
- Synaptic Transmission/physiology
Collapse
Affiliation(s)
- Marta Pecina
- University of Pittsburgh, Pittsburgh, PA, United States.
| | - Jon-Kar Zubieta
- University Neuropsychiatric Institute, University of Utah Health Sciences Center, Salt Lake City, UT, United States
| |
Collapse
|
36
|
Nicolini C, Fahnestock M. The valproic acid-induced rodent model of autism. Exp Neurol 2018; 299:217-227. [DOI: 10.1016/j.expneurol.2017.04.017] [Citation(s) in RCA: 235] [Impact Index Per Article: 39.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 04/26/2017] [Accepted: 04/28/2017] [Indexed: 01/12/2023]
|
37
|
Knight KR. Women on the Edge: Opioids, Benzodiazepines, and the Social Anxieties Surrounding Women's Reproduction in the U.S. "Opioid Epidemic". CONTEMPORARY DRUG PROBLEMS 2017; 44:301-320. [PMID: 31537950 PMCID: PMC6752216 DOI: 10.1177/0091450917740359] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The current "opioid epidemic" provides an opportunity to identify age-old social anxieties about drug use while opening up new lines of inquiry about how and why drug use epidemics become gendered. This paper reflects on the intertwined phenomena of opioid and benzodiazepine prescribing to U.S. women to examine how gender, race, and class inform social anxieties about reproduction and parenting. Multiple discourses abound about the relationship between women and the "opioid epidemic." Epidemiological reports attribute premature death among White women to the deadly combination of opioids and antianxiety medications. The National Institute on Drug Abuse reports that "every 25 minutes a baby is born suffering from opioid withdrawal," leading to costly hospital stays for infants and the potential for mother-child separation and other forms of family adjudication postpartum. Primary care providers are reluctant to distinguish diagnoses of chronic noncancer pain from anxiety among their female patients. Taken together, these discourses beg the question: What exactly are we worried about? I compare and contrast the narratives of two anxious women on opioids to raise larger structural questions about pregnancy, parenting, and drug use and to interrogate the public narrative that women on opioids threaten the American family and thwart the American Dream.
Collapse
Affiliation(s)
- Kelly R. Knight
- Department of Anthropology, History, and Social Medicine (DAHSM), University of California–San Francisco, San Francisco, CA, USA
| |
Collapse
|
38
|
Potentiation of morphine-induced antinociception and locomotion by citalopram is accompanied by anxiolytic-like effects. Pharmacol Biochem Behav 2017; 163:83-89. [DOI: 10.1016/j.pbb.2017.10.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 10/04/2017] [Accepted: 10/06/2017] [Indexed: 11/30/2022]
|
39
|
Macleod AD(S. Fear in palliative care. PROGRESS IN PALLIATIVE CARE 2017. [DOI: 10.1080/09699260.2017.1395980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
40
|
Hassan AN, Le Foll B, Imtiaz S, Rehm J. The effect of post-traumatic stress disorder on the risk of developing prescription opioid use disorder: Results from the National Epidemiologic Survey on Alcohol and Related Conditions III. Drug Alcohol Depend 2017; 179:260-266. [PMID: 28818717 DOI: 10.1016/j.drugalcdep.2017.07.012] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Revised: 06/24/2017] [Accepted: 07/11/2017] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To evaluate the effect of baseline post-traumatic stress disorder (PTSD) and each symptoms cluster on the risk of developing opioid use disorder (OUD) in those exposed to opioid painkillers and to assess the effect of comorbid PTSD and OUD on functioning, OUD severity, and treatment seeking compared with individuals with OUD only. METHODS We obtained data from 4025 individuals exposed to opioid painkillers from the National Epidemiologic Survey on Alcohol and Related Conditions III. We matched individuals with baseline PTSD with individuals without PTSD on demographics, developmental background, family history, personalities, and exposure to stressful life events with propensity score methodology. We controlled for clinical diagnoses and other risk factors that may have occurred after PTSD onset. Quality of life was assessed with the SF-12; the number of diagnostic criteria met indicated OUD severity. RESULTS Baseline PTSD predicted OUD after controlling for matching variables and other risk factors, including baseline mood/anxiety disorders and other substance use disorders (odds ratio[OR]: 1.58; 95% confidence interval[CI]: 1.14-2.17; p=0.02). Among individuals with PTSD, arousal/reactivity cluster predicted OUD. Individuals with comorbid PTSD and OUD had lower mean scores on the SF-12 scale and greater severity of OUD than individuals with OUD. There were no differences in help-seeking. CONCLUSION Baseline PTSD increases the risk of developing OUD after exposure to opioid painkillers. Clinicians should screen for PTSD diagnosis and arousal/reactivity symptoms prior to prescribing painkillers. Integrated treatments are strongly recommended for patients with this dual diagnosis.
Collapse
Affiliation(s)
- Ahmed N Hassan
- Addictions Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada.
| | - Bernard Le Foll
- Addictions Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Departments of Family and Community Medicine, Pharmacology and Toxicology, and Psychiatry, Institute of Medical Sciences, University of Toronto, Toronto, Canada; Campbell Family Mental Health Research Institute, CAMH, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Sameer Imtiaz
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada; Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Jürgen Rehm
- Department of Psychiatry, University of Toronto, Toronto, Canada; Campbell Family Mental Health Research Institute, CAMH, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada; Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto,155 College Street, Toronto, Ontario, Canada
| |
Collapse
|
41
|
Fedotova J, Kubatka P, Büsselberg D, Shleikin AG, Caprnda M, Dragasek J, Rodrigo L, Pohanka M, Gasparova I, Nosal V, Opatrilova R, Qaradakhi T, Zulli A, Kruzliak P. Therapeutical strategies for anxiety and anxiety-like disorders using plant-derived natural compounds and plant extracts. Biomed Pharmacother 2017; 95:437-446. [PMID: 28863384 DOI: 10.1016/j.biopha.2017.08.107] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 08/13/2017] [Accepted: 08/23/2017] [Indexed: 01/20/2023] Open
Abstract
Anxiety and anxiety-like disorders describe many mental disorders, yet fear is a common overwhelming symptom often leading to depression. Currently two basic strategies are discussed to treat anxiety: pharmacotherapy or psychotherapy. In the pharmacotherapeutical clinical approach, several conventional synthetic anxiolytic drugs are being used with several adverse effects. Therefore, studies to find suitable safe medicines from natural sources are being sought by researchers. The results of a plethora experimental studies demonstrated that dietary phytochemicals like alkaloids, terpenes, flavonoids, phenolic acids, lignans, cinnamates, and saponins or various plant extracts with the mixture of different phytochemicals possess anxiolytic effects in a wide range of animal models of anxiety. The involved mechanisms of anxiolytics action include interaction with γ-aminobutyric acid A receptors at benzodiazepine (BZD) and non-BZD sites with various affinity to different subunits, serotonergic 5-hydrodytryptamine receptors, noradrenergic and dopaminergic systems, glutamate receptors, and cannabinoid receptors. This review focuses on the use of both plant-derived natural compounds and plant extracts with anxiolytic effects, describing their biological effects and clinical application.
Collapse
Affiliation(s)
- Julia Fedotova
- Laboratory of Neuroendocrinology, I.P. Pavlov Institute of Physiology, Russian Academy of Sciences, St. Petersburg, Russia; Laboratory of Comparative Somnology and Neuroendocrinology, I.M. Sechenov Institute of Evolutionary Physiology and Biochemistry, Russian Academy of Sciences, St. Petersburg, Russia; Department of Chemistry and Molecular Biology, ITMO University, St. Petersburg, Russia
| | - Peter Kubatka
- Department of Medical Biology, Jessenius Faculty of Medicine, Comenius University in Bratislava, Martin, Slovakia; Division of Oncology, Biomedical Center Martin, Jessenius Faculty of Medicine, Comenius University in Bratislava, Martin, Slovakia
| | | | - Alexander G Shleikin
- Department of Chemistry and Molecular Biology, ITMO University, St. Petersburg, Russia
| | - Martin Caprnda
- 2nd Department of Internal Medicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Jozef Dragasek
- Department of Psychiatry, Faculty of Medicine, Pavol Jozef Safarik University and University Hospital, Kosice, Slovakia
| | - Luis Rodrigo
- Faculty of Medicine, University of Oviedo, Central University Hospital of Asturia (HUCA), Oviedo, Spain
| | - Miroslav Pohanka
- Facultpy of Military Health Sciences, University of Defence, Hradec Kralove, Czech Republic
| | - Iveta Gasparova
- Institute of Biology, Genetics and Medical Genetics, Faculty of Medicine, Comenius University and University Hospital, Bratislava, Slovakia
| | - Vladimir Nosal
- Clinic of Neurology, Jessenius Faculty of Medicine, Comenius University and University Hospital in Martin, Martin, Slovakia
| | - Radka Opatrilova
- Department of Chemical Drugs, Faculty of Pharmacy, University of Veterinary and Pharmaceutical Sciences, Brno, Czech Republic
| | - Tawar Qaradakhi
- The Centre for Chronic Disease, College of Health & Biomedicine, Victoria University, Melbourne, Werribee Campus, Victoria, Australia
| | - Anthony Zulli
- The Centre for Chronic Disease, College of Health & Biomedicine, Victoria University, Melbourne, Werribee Campus, Victoria, Australia
| | - Peter Kruzliak
- Department of Chemical Drugs, Faculty of Pharmacy, University of Veterinary and Pharmaceutical Sciences, Brno, Czech Republic.
| |
Collapse
|
42
|
Kang J, Scholp A, Jiang JJ. A Review of the Physiological Effects and Mechanisms of Singing. J Voice 2017; 32:390-395. [PMID: 28826978 DOI: 10.1016/j.jvoice.2017.07.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 07/13/2017] [Accepted: 07/17/2017] [Indexed: 01/26/2023]
Abstract
Daily experience suggests that singing can energize us and even provide a physical workout. A growing amount of evidence has been presented to support anecdotal claims of the benefits of singing on health and well-being. Singing has been shown to be related to numerous physiological changes. The cardiorespiratory system is utilized during persistent singing training, resulting in enhanced respiratory muscles and an optimized breathing mode. In addition, singing can also cause changes in neurotransmitters and hormones, including the upregulation of oxytocin, immunoglobulin A, and endorphins, which improves immune function and increases feelings of happiness. This review is organized by respiratory, circulatory, and hormonal changes that are collectively a part of singing in a healthy population. The various studies are discussed with the intention of helping researchers and clinicians realize the potential benefit of singing and provide a clinical option as an adjunct therapy for a given situation. Better understanding of physiological mechanisms will lay a solid theoretical foundation for singing activities and will present important implications for further study. Evaluations of existing research and recommendations for future research are given to promote the scale and duration to better demonstrate the effectiveness of singing before it can be recommended in clinical guidelines and satisfy criteria for funding by commissioners of health and social care.
Collapse
Affiliation(s)
- Jing Kang
- EENT Hospital of Fudan University, Department of Otolaryngology-Head and Neck Surgery, Shanghai, China
| | - Austin Scholp
- University of Wisconsin-Madison, School of Medicine and Public Health, Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, Madison, Wisconsin
| | - Jack J Jiang
- EENT Hospital of Fudan University, Department of Otolaryngology-Head and Neck Surgery, Shanghai, China; University of Wisconsin-Madison, School of Medicine and Public Health, Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, Madison, Wisconsin.
| |
Collapse
|
43
|
Feingold D, Brill S, Goor-Aryeh I, Delayahu Y, Lev-Ran S. Depression and anxiety among chronic pain patients receiving prescription opioids and medical marijuana. J Affect Disord 2017; 218:1-7. [PMID: 28453948 DOI: 10.1016/j.jad.2017.04.026] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 04/17/2017] [Indexed: 01/11/2023]
Abstract
BACKGROUND High rates of depression and anxiety have been consistently reported among patients suffering from chronic pain. Prescription opioids are one of the most common modalities for pharmacological treatment of pain, however in recent years medical marijuana(MM) has been increasingly used for pain control in the US and in several countries worldwide. The aim of this study was to compare levels of depression and anxiety among pain patients receiving prescription opioids and MM. METHODS Participants were patients suffering from chronic pain treated with prescription opioids (OP,N=474), MM (N=329) or both (OPMM,N=77). Depression and anxiety were assessed using the depression module of the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder scale (GAD-7). RESULTS Prevalence of depression among patients in the OP, MM and OPMM groups was 57.1%, 22.3% and 51.4%, respectively and rates of anxiety were 48.4%, 21.5% and 38.7%, respectively. After controlling for confounders, patients in the OP group were significantly more likely to screen positive for depression (Adjusted Odds Ratio(AOR)=6.18;95%CI=4.12-9.338) and anxiety(AOR=4.12;CI=3.84-5.71)) compared to those in the MM group. Individuals in the OPMM group were more prone for depression (AOR for depression=3.34;CI=1.52-7.34)) compared to those in the MM group. LIMITATIONS Cross-sectional study, restricting inference of causality. CONCLUSIONS Levels of depression and anxiety are higher among chronic pain patients receiving prescription opioids compared to those receiving MM. Findings should be taken into consideration when deciding on the most appropriate treatment modality for chronic pain, particularly among those at risk for depression and anxiety.
Collapse
Affiliation(s)
- Daniel Feingold
- Ariel University, Ariel, Israel; Dual Diagnosis Clinic, Lev-Hasharon Medical Center, Pardesiya, Israel.
| | - Silviu Brill
- Pain Center, Sourasky Medical Center, Tel Aviv, Israel
| | | | - Yael Delayahu
- Department of Dual Diagnosis, Abarbanel Mental Health Center, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shaul Lev-Ran
- Dual Diagnosis Clinic, Lev-Hasharon Medical Center, Pardesiya, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
44
|
Misuse of prescription opioids among chronic pain patients suffering from anxiety: A cross-sectional analysis. Gen Hosp Psychiatry 2017; 47:36-42. [PMID: 28807136 DOI: 10.1016/j.genhosppsych.2017.04.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 04/17/2017] [Accepted: 04/21/2017] [Indexed: 11/23/2022]
Abstract
OBJECTIVE In the past two decades, chronic pain has been increasingly treated with prescription opioids, particularly in developed countries. This has drawn public concern of possible risks associated with the potential misuse of prescriptions opioids. Previous research has indicated that this may be particularly true among individuals suffering from co-occurring psychiatric disorders. The present study sought to explore rates of misuse among chronic pain patients prescribed opioids, comparing individuals with and without anxiety. METHODS Chronic pain patients receiving prescription opioids (N=554) were screened for anxiety using the Generalized Anxiety Disorder (GAD-7) scale and for opioid misuse using the Current Opioid Misuse Measure (COMM). RESULTS Among patients who screened positive for anxiety (GAD-7≥10), 50% also screened positive for opioid misuse, compared to 10% among those without anxiety. After controlling for possible confounding sociodemographic and clinical variables, patients with anxiety were significantly more prone to screen positive for opioid misuse (Adjusted Odds Ratio (AOR)=2.18; 95% Confidence Interval (CI)=1.37-4.17) compared to those without anxiety. This was maintained when conducting separate comparisons for severe, but not mild or moderate, level of anxiety. CONCLUSIONS These findings highlight the importance of detecting and addressing co-occurring anxiety when treating patients with chronic pain who receive prescription opioids.
Collapse
|
45
|
Ye Y, Bernabé DG, Salvo E, Viet CT, Ono K, Dolan JC, Janal M, Aouizerat BE, Miaskowski C, Schmidt BL. Alterations in opioid inhibition cause widespread nociception but do not affect anxiety-like behavior in oral cancer mice. Neuroscience 2017; 363:50-61. [PMID: 28673713 DOI: 10.1016/j.neuroscience.2017.06.038] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 06/12/2017] [Accepted: 06/21/2017] [Indexed: 01/06/2023]
Abstract
Widespread pain and anxiety are commonly reported in cancer patients. We hypothesize that cancer is accompanied by attenuation of endogenous opioid-mediated inhibition, which subsequently causes widespread pain and anxiety. To test this hypothesis we used a mouse model of oral squamous cell carcinoma (SCC) in the tongue. We found that mice with tongue SCC exhibited widespread nociceptive behaviors in addition to behaviors associated with local nociception that we reported previously. Tongue SCC mice exhibited a pattern of reduced opioid receptor expression in the spinal cord; intrathecal administration of respective mu (MOR), delta (DOR), and kappa (KOR) opioid receptor agonists reduced widespread nociception in mice, except for the fail flick assay following administration of the MOR agonist. We infer from these findings that opioid receptors contribute to widespread nociception in oral cancer mice. Despite significant nociception, mice with tongue SCC did not differ from sham mice in anxiety-like behaviors as measured by the open field assay and elevated maze. No significant differences in c-Fos staining were found in anxiety-associated brain regions in cancer relative to control mice. No correlation was found between nociceptive and anxiety-like behaviors. Moreover, opioid receptor agonists did not yield a statistically significant effect on behaviors measured in the open field and elevated maze in cancer mice. Lastly, we used an acute cancer pain model (injection of cancer supernatant into the mouse tongue) to test whether adaptation to chronic pain is responsible for the absence of greater anxiety-like behavior in cancer mice. No changes in anxiety-like behavior were observed in mice with acute cancer pain.
Collapse
Affiliation(s)
- Yi Ye
- Bluestone Center for Clinical Research, College of Dentistry, New York University, United States
| | - Daniel G Bernabé
- Bluestone Center for Clinical Research, College of Dentistry, New York University, United States
| | - Elizabeth Salvo
- Bluestone Center for Clinical Research, College of Dentistry, New York University, United States
| | - Chi T Viet
- Bluestone Center for Clinical Research, College of Dentistry, New York University, United States; Department of Oral Maxillofacial Surgery, College of Dentistry, New York University, United States
| | - Kentaro Ono
- Bluestone Center for Clinical Research, College of Dentistry, New York University, United States
| | - John C Dolan
- Bluestone Center for Clinical Research, College of Dentistry, New York University, United States; Department of Oral Maxillofacial Surgery, College of Dentistry, New York University, United States
| | - Malvin Janal
- Epidemiology and Health Promotion, College of Dentistry, New York University, United States
| | - Brad E Aouizerat
- Bluestone Center for Clinical Research, College of Dentistry, New York University, United States; Department of Oral Maxillofacial Surgery, College of Dentistry, New York University, United States
| | - Christine Miaskowski
- Department of Physiological Nursing, School of Nursing, University of California at San Francisco, San Francisco, CA, United States
| | - Brian L Schmidt
- Bluestone Center for Clinical Research, College of Dentistry, New York University, United States; Department of Oral Maxillofacial Surgery, College of Dentistry, New York University, United States.
| |
Collapse
|
46
|
Manninen S, Tuominen L, Dunbar RI, Karjalainen T, Hirvonen J, Arponen E, Hari R, Jääskeläinen IP, Sams M, Nummenmaa L. Social Laughter Triggers Endogenous Opioid Release in Humans. J Neurosci 2017; 37:6125-6131. [PMID: 28536272 PMCID: PMC6596504 DOI: 10.1523/jneurosci.0688-16.2017] [Citation(s) in RCA: 109] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 03/13/2017] [Accepted: 04/10/2017] [Indexed: 12/16/2022] Open
Abstract
The size of human social networks significantly exceeds the network that can be maintained by social grooming or touching in other primates. It has been proposed that endogenous opioid release after social laughter would provide a neurochemical pathway supporting long-term relationships in humans (Dunbar, 2012), yet this hypothesis currently lacks direct neurophysiological support. We used PET and the μ-opioid-receptor (MOR)-specific ligand [11C]carfentanil to quantify laughter-induced endogenous opioid release in 12 healthy males. Before the social laughter scan, the subjects watched laughter-inducing comedy clips with their close friends for 30 min. Before the baseline scan, subjects spent 30 min alone in the testing room. Social laughter increased pleasurable sensations and triggered endogenous opioid release in thalamus, caudate nucleus, and anterior insula. In addition, baseline MOR availability in the cingulate and orbitofrontal cortices was associated with the rate of social laughter. In a behavioral control experiment, pain threshold-a proxy of endogenous opioidergic activation-was elevated significantly more in both male and female volunteers after watching laughter-inducing comedy versus non-laughter-inducing drama in groups. Modulation of the opioidergic activity by social laughter may be an important neurochemical pathway that supports the formation, reinforcement, and maintenance of human social bonds.SIGNIFICANCE STATEMENT Social contacts are vital to humans. The size of human social networks significantly exceeds the network that can be maintained by social grooming in other primates. Here, we used PET to show that endogenous opioid release after social laughter may provide a neurochemical mechanism supporting long-term relationships in humans. Participants were scanned twice: after a 30 min social laughter session and after spending 30 min alone in the testing room (baseline). Endogenous opioid release was stronger after laughter versus the baseline scan. Opioid receptor density in the frontal cortex predicted social laughter rates. Modulation of the opioidergic activity by social laughter may be an important neurochemical mechanism reinforcing and maintaining social bonds between humans.
Collapse
Affiliation(s)
| | - Lauri Tuominen
- Turku PET Centre, University of Turku, 20520 Turku, Finland
| | - Robin I Dunbar
- Department of Neuroscience and Biomedical Engineering, School of Science, Aalto University, 00076 Aalto, Finland
- Department of Experimental Psychology, University of Oxford, OX1 3UD Oxford, United Kingdom
| | | | - Jussi Hirvonen
- Turku PET Centre, University of Turku, 20520 Turku, Finland
| | | | - Riitta Hari
- Department of Neuroscience and Biomedical Engineering, School of Science, Aalto University, 00076 Aalto, Finland
- Department of Art, School of Arts, Design and Architecture, Aalto University, 00076 Aalto, Finland, and
| | - Iiro P Jääskeläinen
- Department of Neuroscience and Biomedical Engineering, School of Science, Aalto University, 00076 Aalto, Finland
| | - Mikko Sams
- Department of Neuroscience and Biomedical Engineering, School of Science, Aalto University, 00076 Aalto, Finland
| | - Lauri Nummenmaa
- Turku PET Centre, University of Turku, 20520 Turku, Finland,
- Department of Psychology, University of Turku, 20014 Turku, Finland
| |
Collapse
|
47
|
Coimbra NC, Calvo F, Almada RC, Freitas RL, Paschoalin-Maurin T, dos Anjos-Garcia T, Elias-Filho DH, Ubiali WA, Lobão-Soares B, Tracey I. Opioid neurotransmission modulates defensive behavior and fear-induced antinociception in dangerous environments. Neuroscience 2017; 354:178-195. [DOI: 10.1016/j.neuroscience.2017.04.032] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 04/18/2017] [Accepted: 04/19/2017] [Indexed: 10/19/2022]
|
48
|
Montes GC, da Silva BNM, Rezende B, Sudo RT, Ferreira VF, de Carvalho da Silva F, da Cunha Pinto A, da Silva BV, Zapata-Sudo G. The Hypnotic, Anxiolytic, and Antinociceptive Profile of a Novel µ-Opioid Agonist. Molecules 2017; 22:molecules22050800. [PMID: 28509855 PMCID: PMC6154531 DOI: 10.3390/molecules22050800] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 04/17/2017] [Accepted: 04/26/2017] [Indexed: 01/09/2023] Open
Abstract
5'-4-Alkyl/aryl-1H-1,2,3-triazole derivatives PILAB 1-12 were synthesized and a pharmacological screening of these derivatives was performed to identify a possible effect on the Central Nervous System (CNS) and to explore the associated mechanisms of action. The mice received a peritoneal injection (100 µmol/kg) of each of the 12 PILAB derivatives 10 min prior to the injection of pentobarbital and the mean hypnosis times were recorded. The mean hypnosis time increased for the mice treated with PILAB 8, which was prevented when mice were administered CTOP, a µ-opioid antagonist. Locomotor and motor activities were not affected by PILAB 8. The anxiolytic effect of PILAB 8 was evaluated next in an elevated-plus maze apparatus. PILAB 8 and midazolam increased a percentage of entries and spent time in the open arms of the apparatus compared with the control group. Conversely, a decrease in the percentages of entries and time spent in the closed arms were observed. Pretreatment with naloxone, a non-specific opioid antagonist, prior to administration of PILAB 8 exhibited a reverted anxiolytic effect. PILAB 8 exhibited antinociceptive activity in the hot plate test, and reduced reactivity to formalin in the neurogenic and the inflammatory phases. These data suggest that PILAB 8 can activate µ-opioid receptors to provoke antinociceptive and anti-inflammatory effects in mice.
Collapse
Affiliation(s)
- Guilherme Carneiro Montes
- Programa de Pesquisa em Desenvolvimento de Fármacos, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro RJ 21941-902, Brazil.
| | | | - Bismarck Rezende
- Programa de Pesquisa em Desenvolvimento de Fármacos, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro RJ 21941-902, Brazil.
| | - Roberto Takashi Sudo
- Programa de Pesquisa em Desenvolvimento de Fármacos, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro RJ 21941-902, Brazil.
- Instituto Nacional de Ciência e Tecnologia de Fármacos e Medicamentos (INCT-INOFAR), Rio de Janeiro RJ 21941-971, Brazil.
| | | | | | - Angelo da Cunha Pinto
- Instituto de Química, Universidade Federal do Rio de Janeiro, Rio de Janeiro RJ 21941-909, Brazil.
- Instituto Nacional de Ciência e Tecnologia de Fármacos e Medicamentos (INCT-INOFAR), Rio de Janeiro RJ 21941-971, Brazil.
| | | | - Gisele Zapata-Sudo
- Programa de Pesquisa em Desenvolvimento de Fármacos, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro RJ 21941-902, Brazil.
- Instituto Nacional de Ciência e Tecnologia de Fármacos e Medicamentos (INCT-INOFAR), Rio de Janeiro RJ 21941-971, Brazil.
| |
Collapse
|
49
|
Peng B, Wu X, Shi X, Liu J, Zhang F. The effect of preoperative anxiety on the pain and opioid consumption of children after tonsillectomy and adenoidectomy. Minerva Pediatr 2017; 70:498-500. [PMID: 28353325 DOI: 10.23736/s0026-4946.17.04904-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Bei Peng
- Department of Anesthesiology, Xuzhou Children's Hospital, Xuzhou, China
| | - Xiaole Wu
- Department of Anesthesiology, Xuzhou Children's Hospital, Xuzhou, China
| | - Xuxu Shi
- Department of Anesthesiology, Xuzhou Children's Hospital, Xuzhou, China
| | - Jingjing Liu
- Department of Anesthesiology, Xuzhou Children's Hospital, Xuzhou, China
| | - Fengchao Zhang
- Department of Anesthesiology, Xuzhou Children's Hospital, Xuzhou, China -
| |
Collapse
|
50
|
Just JM, Bleckwenn M, Schnakenberg R, Skatulla P, Weckbecker K. Drug-related celebrity deaths: A cross-sectional study. Subst Abuse Treat Prev Policy 2016; 11:40. [PMID: 27938383 PMCID: PMC5148833 DOI: 10.1186/s13011-016-0084-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 12/06/2016] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Celebrities are at risk for premature mortality as well as drug-related death. Despite being a vulnerable patient group, celebrities influence people's health behaviours through biological, psychological and social processes. Therefore, celebrity endorsement of the topic could be one way to challenge the current "opioid endemic". Our aim was to better understand the factors surrounding drug-related celebrity deaths by investigating the incidence as well as substances used between 1970 and 2015 using a cross-sectional study design. METHOD We searched public databases for drug-related celebrity deaths between 1970 and 2015. They were categorized for sex, profession, age at death, year of death and substances involved. The main outcome measures are descriptive values including number of drug deaths per year and substances involved. Secondary outcome measures are analytical questions to examine whether and which factors influence age at death and year of death (e.g. type of substance use disorder). RESULTS We identified 220 celebrities who died a drug-related death with a clear indication of involved substances between 1970 and 2015. The average age at death was 38.6 years; 75% were male. Most celebrities died between the age of 25 and 40. The number of drug-related deaths increased in the 21st century, with a significant increase in the use of prescription opioids. Deaths involving prescription opioids and heroin were associated with a significantly lower mean age at death compared to deaths where these substances were not involved. CONCLUSIONS Compared to the 20th century, the total number of celebrities who died from a drug-related death in the 21st century increased, possibly due to an increased involvement of prescription opioids. Negative effects on individual health decisions of celebrity's followers could be the result.
Collapse
Affiliation(s)
- Johannes M. Just
- Bonn University Clinic, Institute of General Practice and Family Medicine, Sigmund-Freud-Street 25, 53127 Bonn, Germany
| | - Markus Bleckwenn
- Bonn University Clinic, Institute of General Practice and Family Medicine, Sigmund-Freud-Street 25, 53127 Bonn, Germany
| | - Rieke Schnakenberg
- Bonn University Clinic, Institute of General Practice and Family Medicine, Sigmund-Freud-Street 25, 53127 Bonn, Germany
| | - Philipp Skatulla
- Bonn University Clinic, Institute of General Practice and Family Medicine, Sigmund-Freud-Street 25, 53127 Bonn, Germany
| | - Klaus Weckbecker
- Bonn University Clinic, Institute of General Practice and Family Medicine, Sigmund-Freud-Street 25, 53127 Bonn, Germany
| |
Collapse
|