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Barbosa-Méndez S, Matus-Ortega M, Hernandez-Miramontes R, Salazar-Juarez A. COT-TT vaccine attenuates cocaine-seeking and cocaine-conditioned place preference in rats. Hum Vaccin Immunother 2024; 20:2299068. [PMID: 38228468 DOI: 10.1080/21645515.2023.2299068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 12/21/2023] [Indexed: 01/18/2024] Open
Abstract
Vaccination active, promising alternative immunological strategy to treat of CUD. Various models of cocaine vaccines have been evaluated in animals and humans with relative success. In this sense, it is necessary to improve or optimize the cocaine vaccines already evaluated. Our laboratory previously reported the efficacy of the tetanus toxoid-conjugated morphine vaccine (M6-TT). The M6-TT vaccine can generate high titers of antibodies and reduce heroin-induced behavioral effects in rodents. So, it would be plausible to assume that if we modify the M6-TT vaccine by changing the hapten and maintaining the rest of the structural elements of the vaccine, we will maintain the properties of the M6-TT vaccine (high antibody titers). The objective of this study was to determine whether the antibodies generated by a tetanus toxoid-conjugated cocaine vaccine (COC-TT) can recognize and capture cocaine and decrease the cocaine-induced reinforcing effects. Male Wistar rats were immunized with the COC-TT. A solid-phase antibody-capture ELISA was used to monitor antibody titer responses after each booster dose in vaccinated animals. The study used cocaine self-administration and place-preference testing to evaluate the cocaine-reinforcing effects. The COC-TT vaccine could generate high levels of anti-cocaine antibodies. The antibodies reduced the cocaine self-administration and cocaine place preference. In addition, they decreased the cocaine-induced Fos protein expression. These findings suggest that the COC-TT vaccine generates a robust immunogenic response capable of reducing the reinforcing effects of cocaine, which supports its possible future use in clinical trials in patients with CUD.
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Affiliation(s)
- Susana Barbosa-Méndez
- Laboratorio de Neurofarmacología Conductual, Microcirugía y Terapéutica Experimental, Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría, Ciudad de México, México
| | - Maura Matus-Ortega
- Laboratorio de Neurobiología Molecular y Neuroquímica de las Adicciones, Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría, Ciudad de México, México
| | - Ricardo Hernandez-Miramontes
- Laboratorio de Neurofarmacología Conductual, Microcirugía y Terapéutica Experimental, Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría, Ciudad de México, México
| | - Alberto Salazar-Juarez
- Laboratorio de Neurofarmacología Conductual, Microcirugía y Terapéutica Experimental, Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría, Ciudad de México, México
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Hu J, Lian Z, Weng Z, Xu Z, Gao J, Liu Y, Luo T, Wang X. Intranasal Delivery of Near-Infrared and Magnetic Dual-Response Nanospheres to Rapidly Produce Antidepressant-Like and Cognitive Enhancement Effects. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2024:e2405547. [PMID: 38778461 DOI: 10.1002/adma.202405547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 05/18/2024] [Indexed: 05/25/2024]
Abstract
Restricted by synaptic plasticity, dopamine receptor (DR) upregulation takes a long time to work. Moreover, the impact of the blood-brain barrier (BBB) on delivery efficiency restricts the development of drugs. Taking inspiration from snuff bottles, a convenient, fast-acting, and nonaddictive nasal drug delivery system has been developed to rapidly reshape the balance of synaptic transmitters. This optical and magnetic response system called CFs@DP, comprised of carbonized MIL-100 (Fe) frameworks (CFs) and domperidone (DP), which can enter the brain via nasal administration. Under dual stimulation of near-infrared (NIR) irradiation and catecholamine-induced complexation, CFs@DP disintegrates to release iron ions and DP, causing upregulation of the dopamine type 1 (D1), type 2 (D2) receptors, and brain-derived neurotrophic factor (BDNF) to achieve a therapeutic effect. In vivo experiments demonstrate that the DR density of mice (postnatal day 50-60) increased in the prefrontal cortex (PFC) and the hippocampus (HPC) after 10 days of therapy, resulting in antidepressant-like and cognitive enhancement effects. Interestingly, the cognitive enhancement effect of CFs@DP is even working in noniron deficiency (normal fed) mice, making it a promising candidate for application in enhancing learning ability.
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Affiliation(s)
- Jiangnan Hu
- Institute of Biomedical Innovation, Jiangxi Medical College, School of Life Sciences, Nanchang University, Nanchang, 330088, P. R. China
| | - Zhenglong Lian
- The National Engineering Research Center for Bioengineering Drugs and Technologies, Institute of Translational Medicine, Nanchang University, Nanchang, 330088, P. R. China
| | - Zhenzhen Weng
- The National Engineering Research Center for Bioengineering Drugs and Technologies, Institute of Translational Medicine, Nanchang University, Nanchang, 330088, P. R. China
| | - Zihao Xu
- The National Engineering Research Center for Bioengineering Drugs and Technologies, Institute of Translational Medicine, Nanchang University, Nanchang, 330088, P. R. China
| | - Jie Gao
- The National Engineering Research Center for Bioengineering Drugs and Technologies, Institute of Translational Medicine, Nanchang University, Nanchang, 330088, P. R. China
| | - Yuanyuan Liu
- The National Engineering Research Center for Bioengineering Drugs and Technologies, Institute of Translational Medicine, Nanchang University, Nanchang, 330088, P. R. China
| | - Tao Luo
- Institute of Biomedical Innovation, Jiangxi Medical College, School of Life Sciences, Nanchang University, Nanchang, 330088, P. R. China
| | - Xiaolei Wang
- The National Engineering Research Center for Bioengineering Drugs and Technologies, Institute of Translational Medicine, Nanchang University, Nanchang, 330088, P. R. China
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Clergue-Duval V, Lyonnet A, Azuar J, Icick R, Poireau M, Rollet D, Taright N, Questel F, Gasquet I, Vorspan F. Hospitalized cocaine detoxification patients in Paris, France: Increased patient levels and changing population characteristics since 2011. Therapie 2024:S0040-5957(24)00038-6. [PMID: 38582619 DOI: 10.1016/j.therap.2024.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 02/08/2024] [Accepted: 03/18/2024] [Indexed: 04/08/2024]
Abstract
AIM OF THE STUDY The past twenty years have seen a rise in cocaine-related statistics in France, including cocaine use in the general population, emergency ward presentations of acute cocaine intoxication, cocaine use disorders related outpatient appointments and cocaine-related deaths. This study's objectives were to describe trends in patients' admission for specific cocaine detoxification as well as changes in patients' characteristics in the Assistance publique-Hôpitaux de Paris (AP-HP) hospitals group located in Paris region, France. METHODS We reviewed the international classification of diseases 10th edition (ICD-10) discharge codes of the AP-HP hospitals group between 2011 and 2021. In addition, medical reports of the largest addiction medicine ward were also analysed for changes across the years 2009, 2014, 2019 and 2022. RESULTS The regional database showed an almost 3-fold increase in cocaine-related disorders discharge codes between 2011 and 2019. This occurred due to a rise in hospital stays for cocaine dependence or cocaine acute intoxication prior to the fall in levels of inpatient stays associated with the coronavirus disease 2019 (COVID-19) pandemic. The in-depth analysis of inpatients' stays in the specialized addiction medicine ward also showed an increase in admissions for cocaine detoxification programs, with a prevalence of 1.19% in 2009 to 15.73% in 2022 (P=1.44×10-20). Inpatient characteristics showed significant changes, especially in 2022, namely: more daily users, less intravenous administration and less comorbid illicit substances use disorders, with heightened levels of cured hepatitis C patients (P<0.05). Inpatient prescriptions were primarily dopaminergic antagonists with sedatives properties (cyamemazine, loxapine and chlorpromazine), dopamine-receptors partial agonist (aripiprazole) and serotonin reuptake inhibitors. CONCLUSION The referral to hospital care for cocaine detoxification has increased in Paris region since 2011, coupled with changes in inpatients' characteristics. This trend has significant implications for the management of inpatient hospital services.
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Affiliation(s)
- Virgile Clergue-Duval
- Département de Psychiatrie et de Médecine Addictologique, site Lariboisière Fernand-Widal, APHP GHU Nord, Université Paris Cité, 75010 Paris, France; UMRS-1144 Optimisation Thérapeutique en Neuropsychopharmacologie, INSERM, Université Paris Cité, 75006 Paris, France; FHU Network of Research in Substance Use Disorders (NOR-SUD), 75006 Paris, France; UFR de Médecine, Université Paris Cité, 75006 Paris, France.
| | - Arthur Lyonnet
- Département de Psychiatrie et de Médecine Addictologique, site Lariboisière Fernand-Widal, APHP GHU Nord, Université Paris Cité, 75010 Paris, France; FHU Network of Research in Substance Use Disorders (NOR-SUD), 75006 Paris, France
| | - Julien Azuar
- Département de Psychiatrie et de Médecine Addictologique, site Lariboisière Fernand-Widal, APHP GHU Nord, Université Paris Cité, 75010 Paris, France; UMRS-1144 Optimisation Thérapeutique en Neuropsychopharmacologie, INSERM, Université Paris Cité, 75006 Paris, France; FHU Network of Research in Substance Use Disorders (NOR-SUD), 75006 Paris, France
| | - Romain Icick
- Département de Psychiatrie et de Médecine Addictologique, site Lariboisière Fernand-Widal, APHP GHU Nord, Université Paris Cité, 75010 Paris, France; UMRS-1144 Optimisation Thérapeutique en Neuropsychopharmacologie, INSERM, Université Paris Cité, 75006 Paris, France; FHU Network of Research in Substance Use Disorders (NOR-SUD), 75006 Paris, France
| | - Margaux Poireau
- UMRS-1144 Optimisation Thérapeutique en Neuropsychopharmacologie, INSERM, Université Paris Cité, 75006 Paris, France; FHU Network of Research in Substance Use Disorders (NOR-SUD), 75006 Paris, France
| | - Dorian Rollet
- Département de Psychiatrie et de Médecine Addictologique, site Lariboisière Fernand-Widal, APHP GHU Nord, Université Paris Cité, 75010 Paris, France; UMRS-1144 Optimisation Thérapeutique en Neuropsychopharmacologie, INSERM, Université Paris Cité, 75006 Paris, France; FHU Network of Research in Substance Use Disorders (NOR-SUD), 75006 Paris, France
| | - Namik Taright
- APHP, Department of Medical Information, 75012 Paris, France
| | - Frank Questel
- Département de Psychiatrie et de Médecine Addictologique, site Lariboisière Fernand-Widal, APHP GHU Nord, Université Paris Cité, 75010 Paris, France; UMRS-1144 Optimisation Thérapeutique en Neuropsychopharmacologie, INSERM, Université Paris Cité, 75006 Paris, France; FHU Network of Research in Substance Use Disorders (NOR-SUD), 75006 Paris, France
| | | | - Florence Vorspan
- Département de Psychiatrie et de Médecine Addictologique, site Lariboisière Fernand-Widal, APHP GHU Nord, Université Paris Cité, 75010 Paris, France; UMRS-1144 Optimisation Thérapeutique en Neuropsychopharmacologie, INSERM, Université Paris Cité, 75006 Paris, France; FHU Network of Research in Substance Use Disorders (NOR-SUD), 75006 Paris, France; UFR de Médecine, Université Paris Cité, 75006 Paris, France
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Montoya ID, Volkow ND. IUPHAR Review: New strategies for medications to treat substance use disorders. Pharmacol Res 2024; 200:107078. [PMID: 38246477 PMCID: PMC10922847 DOI: 10.1016/j.phrs.2024.107078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/11/2024] [Accepted: 01/15/2024] [Indexed: 01/23/2024]
Abstract
Substance use disorders (SUDs) and drug overdose are a public health emergency and safe and effective treatments are urgently needed. Developing new medications to treat them is expensive, time-consuming, and the probability of a compound progressing to clinical trials and obtaining FDA-approval is low. The small number of FDA-approved medications for SUDs reflects the low interest of pharmaceutical companies to invest in this area due to market forces, characteristics of the population (e.g., stigma, and socio-economic and legal disadvantages), and the high bar regulatory agencies set for new medication approval. In consequence, most research on medications is funded by government agencies, such as the National Institute on Drug Abuse (NIDA). Multiple scientific opportunities are emerging that can accelerate the discovery and development of new medications for SUDs. These include fast and efficient tools to screen new molecules, discover new medication targets, use of big data to explore large clinical data sets and artificial intelligence (AI) applications to make predictions, and precision medicine tools to individualize and optimize treatments. This review provides a general description of these new research strategies for the development of medications to treat SUDs with emphasis on the gaps and scientific opportunities. It includes a brief overview of the rising public health toll of SUDs; the justification, challenges, and opportunities to develop new medications; and a discussion of medications and treatment endpoints that are being evaluated with support from NIDA.
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Affiliation(s)
- Ivan D Montoya
- Division of Therapeutics and Medical Consequences, National Institute on Drug Abuse, 3 White Flint North, North Bethesda, MD 20852, United States.
| | - Nora D Volkow
- National Institute on Drug Abuse, 3 White Flint North, North Bethesda, MD 20852, United States
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Lombardozzi G, Trovini G, Amici E, Kotzalidis GD, Perrini F, Giovanetti V, Di Giovanni A, De Filippis S. Brexpiprazole in patients with schizophrenia with or without substance use disorder: an observational study. Front Psychiatry 2023; 14:1321233. [PMID: 38111619 PMCID: PMC10725927 DOI: 10.3389/fpsyt.2023.1321233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 11/13/2023] [Indexed: 12/20/2023] Open
Abstract
Background Partial dopamine D2 receptor agonists are used for psychotic symptoms in adults with schizophrenia spectrum disorders. Recently, interest surged for partial dopamine D2 receptor agonists in substance use disorders (SUDs). Since it is believed that SUDs decrease the efficacy of pharmacotherapy of underlying psychiatric disorders, we tested the efficacy of the partial D2 agonist brexpiprazole in patients with schizophrenia who were either comorbid with a SUD (SUD group) or not comorbid (non-SUD) to assess treatment response and the effect of brexpiprazole on substance craving in SUD. Methods We included patients with DSM-5/DSM-5-TR schizophrenia (using SCID-5-CV) aged 18-66 years with either comorbid SUD or non-SUD to treat with brexpiprazole 4 mg/day for 6 months during February-October 2022. Patients were assessed with the Clinical Global Impressions-Severity (CGI-S) scale, the 24-item Brief Psychiatric Rating Scale (BPRS), and the Positive And Negative Syndrome Scale (PANSS) at baseline, weekly for the first 2 months and monthly for the next four. Furthermore, we assessed substance craving in SUD with a visual analog scale for craving (VAScrav) at the same timepoints. Results The total sample was 86 (85 analysable) 18- to 64-year-old (mean 39.32 ± 14.09) patients with schizophrenia [51 men (59.3%) and 35 women (40.7%)], of whom 48 SUD (55.8%) (37 men and 11 women) and 38 non-SUD (44.2%) (14 men and 24 women). No serious or persistent adverse events developed over the study period, but one patient dropped out for subjective akathisia. Results indicated the main effects of time with improvements over the course of the study for CGI-S, BPRS, and PANSS in both SUD and non-SUD groups and the entire sample, and for VAScrav in SUD. Brexpiprazole was associated with similar significant improvements in both groups at the 6 month endpoint compared to baseline. Conclusion Treatment with brexpiprazole for 6 months improved psychotic symptoms in patients with schizophrenia, independently from whether they belonged to the SUD or the non-SUD group; hence, SUD comorbidity did not confer treatment resistance to brexpiprazole. Furthermore, in the SUD group, we observed reduced substance craving.
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Affiliation(s)
- Ginevra Lombardozzi
- Villa Von Siebenthal Neuropsychiatric Hospital and Clinic, Genzano di Roma, Italy
| | - Giada Trovini
- Villa Von Siebenthal Neuropsychiatric Hospital and Clinic, Genzano di Roma, Italy
| | - Emanuela Amici
- Villa Von Siebenthal Neuropsychiatric Hospital and Clinic, Genzano di Roma, Italy
| | - Georgios D. Kotzalidis
- Villa Von Siebenthal Neuropsychiatric Hospital and Clinic, Genzano di Roma, Italy
- NESMOS Department, Faculty of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University, Rome, Italy
- Department of Neuroscience, Section of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCSS, Rome, Italy
- Centro Lucio Bini, Rome, Italy
| | | | - Valeria Giovanetti
- Villa Von Siebenthal Neuropsychiatric Hospital and Clinic, Genzano di Roma, Italy
| | | | - Sergio De Filippis
- Villa Von Siebenthal Neuropsychiatric Hospital and Clinic, Genzano di Roma, Italy
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Amerio A, Baccino C, Breda GS, Cortesi D, Spiezio V, Magnani L, De Berardis D, Conio B, Costanza A, De Paola G, Rocca G, Arduino G, Aguglia A, Amore M, Serafini G. Effects of transcranial magnetic stimulation on cocaine addiction: A systematic review of randomized controlled trials. Psychiatry Res 2023; 329:115491. [PMID: 37783092 DOI: 10.1016/j.psychres.2023.115491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 09/17/2023] [Accepted: 09/21/2023] [Indexed: 10/04/2023]
Abstract
OBJECTIVE While pharmacological strategies appear to be ineffective in treating long-term addiction, repetitive transcranial magnetic stimulation (rTMS) is emerging as a promising new tool for the attenuation of craving among multiple substance dependent populations. METHOD A systematic review of randomized controlled trials (RCTs) was conducted on the efficacy and tolerability of rTMS in treating cocaine use disorder (CUD). Relevant papers published in English through November 30th 2022 were identified, searching the electronic databases MEDLINE, Embase, PsycINFO and the Cochrane Library. RESULTS Eight studies matched inclusion criteria. The best findings were reported by the RCTs conducted at high-frequency (≥5 Hz) multiple sessions of rTMS delivered over the left dorsolateral prefrontal cortex (DLPFC): a significant decrease in self-reported cue-induced cocaine craving and lower cocaine craving scores and a considerable amelioration in the tendency to act rashly under extreme negative emotions (impulsivity) were found in the active group compared to controls. CONCLUSION Although still scant and heterogeneous, the strongest evidence so far on the use of rTMS on individuals with CUD support the high frequency stimulation over the left DLPFC as a well tolerated treatment of cocaine craving and impulsivity.
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Affiliation(s)
- A Amerio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
| | - C Baccino
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - G S Breda
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - D Cortesi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
| | - V Spiezio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - L Magnani
- Department of Psychiatry, San Maurizio Hospital, Bolzano, Italy
| | - D De Berardis
- NHS, Department of Mental Health, Psychiatric Service for Diagnosis and Treatment, Hospital "G. Mazzini", ASL 4, Teramo, Italy.
| | - B Conio
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - A Costanza
- Department of Psychiatry, Faculty of Medicine, Geneva University (UNIGE), Geneva, Switzerland; Department of Psychiatry, Adult Psychiatry Service (SPA), University Hospitals of Geneva (HUG), Geneva, Switzerland; Department of Psychiatry, Faculty of Biomedical Sciences, University of Italian Switzerland (USI), Lugano, Switzerland.
| | - G De Paola
- Ospedale Maria Luigia, Monticelli Terme, Italy
| | - G Rocca
- R&R Neuromodulation Lab, Piacenza, Italy
| | - G Arduino
- Department of Mental Health and Pathological Addictions, Piacenza Local Health Authority, Piacenza, Italy
| | - A Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
| | - M Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
| | - G Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
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Wydra K, Witek K, Suder A, Filip M. Esketamine Inhibits Cocaine-Seeking Behaviour Subsequent to Various Abstinence Conditions in Rats. Biomolecules 2023; 13:1411. [PMID: 37759811 PMCID: PMC10527312 DOI: 10.3390/biom13091411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 09/11/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Cocaine use disorder (CUD) is a relapsing brain disease caused by a chronic drug intake that involves neural mechanisms and psychological processes, including depression. Preclinical and clinical studies have demonstrated the promise of pharmacological drugs in controlling the reinstatement of cocaine by targeting the N-methyl-D-aspartate (NMDA) receptor. Recent evidence has revealed that esketamine, a (S) enantiomer of ketamine, shows a high affinity to NMDA receptors and has been used in clinical trials to treat moderate-to-severe depression. METHODS In the present paper, we investigated the effects of esketamine in regulating cocaine-seeking behaviour induced through the use of cocaine (10 mg/kg) or the cocaine-associated conditioned cue after a short (10 days)-lasting period of drug abstinence with extinction training, home cage or enrichment environment conditions in male rats. Furthermore, we investigated the acute effects of esketamine on locomotor activity in drug-naïve animals. RESULTS Esketamine (2.5-10 mg/kg) administered peripherally attenuated the reinstatement induced with cocaine priming or the drug-associated conditioned cue after different conditions of abstinence. CONCLUSIONS These results seem to support esketamine as a candidate for the pharmacological management of cocaine-seeking and relapse prevention; however, further preclinical and clinical research is needed to better clarify esketamine's actions in CUD.
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Affiliation(s)
- Karolina Wydra
- Department of Drug Addiction Pharmacology, Maj Institute of Pharmacology, Polish Academy of Sciences, 12 Smętna Street, PL-31-343 Kraków, Poland; (K.W.); (A.S.)
| | | | | | - Małgorzata Filip
- Department of Drug Addiction Pharmacology, Maj Institute of Pharmacology, Polish Academy of Sciences, 12 Smętna Street, PL-31-343 Kraków, Poland; (K.W.); (A.S.)
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Preto MC, Kortas GT, Blaas IK, Lassi DLS, Waisman Campos M, Torales J, Ventriglio A, de Azevedo-Marques Périco C, de Andrade AG, Castaldelli-Maia JM. Unravelling the landscape of Cannabis craving pharmacological treatments: a PRISMA-guided review of evidence. Int Rev Psychiatry 2023; 35:434-449. [PMID: 38299652 DOI: 10.1080/09540261.2023.2231540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 06/27/2023] [Indexed: 02/02/2024]
Abstract
Currently, few treatments are available for craving in general, and none of them have received approval for cannabis craving. The objective of this review is to evaluate existing studies analysing treatments for cannabis craving and explore novel treatment possibilities for these patients. The study followed PRISMA guidelines and conducted an extensive database search. Inclusion criteria included human randomised controlled trials examining drug effects on craving symptoms. Exclusion criteria involved studies unrelated to craving, non-pharmacological treatments, duplicates, and non-English/Spanish/Portuguese articles. Our included 22 studies that investigated a wide range of compounds used for cravings related to other drugs, as well as interventions based on healthcare professionals' empirical knowledge. The current pharmacological treatments largely involve off-label drug use and the utilisation of cannabinoid-based medications, such as combinations of THC and lofexidine, oxytocin, progesterone, and N-acetylcysteine. These emerging treatments show promise and have the potential to revolutionise current clinical practices, but further investigation is needed to establish their efficacy. In this context, it is essential to consider non-pharmacological interventions, such as psychotherapy and behavioural treatments. These approaches play a crucial role in complementing pharmacological interventions and addressing the complex nature of the disorder.
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Affiliation(s)
- Mayra Cruz Preto
- Medical School, Universidade Cidade de São Paulo (UNICID), São Paulo, Brazil
| | - Guilherme Trevizan Kortas
- Perdizes Intitute (IPer), Clinics Hospital of Medical School (HCFMUSP), University of São Paulo, São Paulo, Brazil
- Department of Psychiatry, Medical School, University of São Paulo, São Paulo, Brazil
- Sirio-Libanês Hospital, São Paulo, Brazil
| | - Israel Kanaan Blaas
- Perdizes Intitute (IPer), Clinics Hospital of Medical School (HCFMUSP), University of São Paulo, São Paulo, Brazil
- Department of Neuroscience, Medical School, FMABC University Center, Santo André, Brazil
| | - Dangela Layne Silva Lassi
- Perdizes Intitute (IPer), Clinics Hospital of Medical School (HCFMUSP), University of São Paulo, São Paulo, Brazil
| | - Marcela Waisman Campos
- Department of Cognitive Neurology, Neuropsychiatry, and Neuropsychology, FLENI, Buenos Aires, Argentina
| | - Julio Torales
- Department of Medical Psychology, School of Medical Sciences, University of Asuncion, San Lorenzo, Paraguay
| | - Antonio Ventriglio
- Department of Experimental Medicine, Medical School, Medical School, University of Foggia, Foggia, Italy
| | | | - Arthur Guerra de Andrade
- Perdizes Intitute (IPer), Clinics Hospital of Medical School (HCFMUSP), University of São Paulo, São Paulo, Brazil
- Department of Psychiatry, Medical School, University of São Paulo, São Paulo, Brazil
- Sirio-Libanês Hospital, São Paulo, Brazil
- Department of Neuroscience, Medical School, FMABC University Center, Santo André, Brazil
| | - João Mauricio Castaldelli-Maia
- Department of Psychiatry, Medical School, University of São Paulo, São Paulo, Brazil
- Department of Neuroscience, Medical School, FMABC University Center, Santo André, Brazil
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Tschudi L, Fischer SKM, Perlov E, Baumgartner MR, Soyka M, Müller TJ, Seifritz E, Mutschler J. Concomitant Drug Use among Opioid-Dependent Patients with and without Attention Deficit Hyperactivity Disorder: Does Methylphenidate Merit a Trial? Eur Addict Res 2023; 29:305-312. [PMID: 37517394 DOI: 10.1159/000531008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 04/28/2023] [Indexed: 08/01/2023]
Abstract
INTRODUCTION Concomitant drug use is common among opioid-dependent patients in maintenance therapy. Attention deficit hyperactivity disorder (ADHD), a common comorbidity among opioid users, is associated with a higher risk of concomitant drug use. Earlier studies showed that methylphenidate (MPH) can reduce cocaine consumption among patients with ADHD. The use of MPH as an agonist-replacement or maintenance therapy in cocaine-dependent patients without ADHD is also common in Switzerland, despite a lack of supporting evidence. The aim of this study was to assess concomitant cocaine, amphetamine, MDMA, MPH, and heroin use among patients in opioid maintenance therapy either with or without comorbid ADHD. We expected stimulant consumption to be higher in patients with cocaine dependence and comorbid ADHD and that use of MPH would not lead to a reduction in cocaine consumption in patients without ADHD. We therefore evaluated correlations between use of MPH and cocaine consumption and between MPH consumption and cocaine craving within the two groups. METHODS This cross-sectional study included 94 opioid-dependent patients in maintenance therapy in an outpatient department of the Psychiatric Hospital of Zurich. The patients were divided into two groups based on comorbid ADHD; a group with ADHD (N = 27) and a group without ADHD (N = 67). Drug use was assessed using 3-month hair analysis. RESULTS We did not find significant differences in the number of patients using cocaine, amphetamine, MDMA, or heroin between groups with or without ADHD. With respect to cocaine use, 85.2 percent of patients in the ADHD group and 73.1 percent in the non-ADHD group were users. The non-ADHD group showed a significant positive correlation between the concentration of MPH and cocaine in hair samples (p < 0.05), and a positive correlation between cocaine craving and the concentration of MPH in hair samples (p = 0.065). These two trends were not evident in the ADHD group. CONCLUSION Among patients without ADHD, use of MPH correlates with higher cocaine consumption and craving. Conversely, no significant correlation was found between MPH and cocaine use in patients with ADHD. Our study adds to the evidence that MPH confers negative effects in cocaine users without ADHD and should thus have no place in the treatment of these patients.
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Affiliation(s)
- Letizia Tschudi
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Sebastian Karl Maximilian Fischer
- Psychiatric Services Lucerne, Lucerne, Switzerland
- Institute of General Practice and Family Medicine, University Hospital of the Ludwig-Maximilians University of Munich, Munich, Germany
| | | | - Markus R Baumgartner
- Zurich Institute of Forensic Medicine, Center for Forensic Hair Analysis, University of Zurich, Zurich, Switzerland
| | - Michael Soyka
- Department of Psychiatry and Psychotherapy, University Hospital of Ludwig-Maximilians-University Munich, Munich, Germany
| | | | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
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10
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Wardle MC, Hoots JK, Miloslavich K, Nunez C, Dios CD, Holden C, Ahluwahlia A, Green CE, Lane SD, Schmitz JM. Deficits in consummatory reward relate to severity of cocaine use. Drug Alcohol Depend 2023; 249:109950. [PMID: 37301068 PMCID: PMC10405525 DOI: 10.1016/j.drugalcdep.2023.109950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 04/26/2023] [Accepted: 05/27/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND AND AIMS Identifying modifiable neuropsychological factors associated with more severe CUD could improve CUD treatment. Impairments in processing of non-drug rewards may be one such factor. This study assessed the relationship between reward functioning and cocaine use severity using multi-modal measures of three distinct reward functions: consummatory reward (pleasure or "liking"); motivational reward ("wanting") and reward learning. METHODS Fifty-three adults with at least moderate CUD completed self-report and behavioral measures of consummatory reward, motivational reward and reward learning, and a composite cocaine use severity measure including quantity, frequency and life impacts of cocaine use. We conducted parallel Frequentist and Bayesian multiple regressions with measures of reward functioning as predictors of cocaine use severity. RESULTS Less self-reported ability to experience pleasure, a hypothesized measure of consummatory reward, significantly predicted greater severity after adjustment for covariates and multiple hypothesis testing, β = 0.39, t(38) = 2.86, p = 0.007. Bayesian analyses confirmed a highly likely association between severity and ability to experience pleasure, and provided moderate evidence for associations with willingness to exert effort and reward learning. CONCLUSIONS Our results suggest that less experience of subjective pleasure is related to greater cocaine use severity. This cross-sectional study cannot establish whether differences in consummatory reward are pre-existing, a result of CUD, or both. However, these results suggest interventions focused on increasing subjective pleasure, such as mindful "savoring", should be investigated for CUD.
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Affiliation(s)
- Margaret C Wardle
- Psychology Department, University of Illinois Chicago, 1007 W. Harrison St, Chicago, IL60607, United States.
| | - Jennifer K Hoots
- Psychology Department, University of Illinois Chicago, 1007 W. Harrison St, Chicago, IL60607, United States
| | - Krista Miloslavich
- Psychology Department, University of Illinois Chicago, 1007 W. Harrison St, Chicago, IL60607, United States
| | - Cecilia Nunez
- Psychology Department, University of Illinois Chicago, 1007 W. Harrison St, Chicago, IL60607, United States
| | - Constanza de Dios
- Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, 1941 East Rd, Houston, TX77054, United States
| | - Christopher Holden
- Department of Psychiatry, University of Illinois Hospital and Health Sciences System, 1740 W. Taylor St, Chicago, IL60612, United States
| | - Aneet Ahluwahlia
- Department of Psychiatry, University of Illinois Hospital and Health Sciences System, 1740 W. Taylor St, Chicago, IL60612, United States
| | - Charles E Green
- Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, 1941 East Rd, Houston, TX77054, United States
| | - Scott D Lane
- Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, 1941 East Rd, Houston, TX77054, United States
| | - Joy M Schmitz
- Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, 1941 East Rd, Houston, TX77054, United States
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