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Ceccanti M, Blum K, Bowirrat A, Dennen CA, Braverman ER, Baron D, Mclaughlin T, Giordano J, Gupta A, Downs BW, Bagchi D, Barh D, Elman I, Thanos PK, Badgaiyan RD, Edwards D, Gold MS. Future Newborns with Opioid-Induced Neonatal Abstinence Syndrome (NAS) Could Be Assessed with the Genetic Addiction Risk Severity (GARS) Test and Potentially Treated Using Precision Amino-Acid Enkephalinase Inhibition Therapy (KB220) as a Frontline Modality Instead of Potent Opioids. J Pers Med 2022; 12:2015. [PMID: 36556236 PMCID: PMC9782293 DOI: 10.3390/jpm12122015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/14/2022] [Accepted: 11/25/2022] [Indexed: 12/12/2022] Open
Abstract
In this nonsystematic review and opinion, including articles primarily selected from PubMed, we examine the pharmacological and nonpharmacological treatments of neonatal abstinence syndrome (NAS) in order to craft a reasonable opinion to help forge a paradigm shift in the treatment and prevention of primarily opioid-induced NAS. Newborns of individuals who use illicit and licit substances during pregnancy are at risk for withdrawal, also known as NAS. In the US, the reported prevalence of NAS has increased from 4.0 per 1000 hospital births in 2010 to 7.3 per 1000 hospital births in 2017, which is an 82% increase. The management of NAS is varied and involves a combination of nonpharmacologic and pharmacologic therapy. The preferred first-line pharmacological treatment for NAS is opioid therapy, specifically morphine, and the goal is the short-term improvement in NAS symptomatology. Nonpharmacological therapies are individualized and typically focus on general care measures, the newborn-parent/caregiver relationship, the environment, and feeding. When used appropriately, nonpharmacologic therapies can help newborns with NAS avoid or reduce the amount of pharmacologic therapy required and the length of hospitalization. In addition, genetic polymorphisms of the catechol-o-methyltransferase (COMT) and mu-opioid receptor (OPRM1) genes appear to affect the length of stay and the need for pharmacotherapy in newborns with prenatal opioid exposure. Therefore, based on this extensive literature and additional research, this team of coauthors suggests that, in the future, in addition to the current nonpharmacological therapies, patients with opioid-induced NAS should undergo genetic assessment (i.e., the genetic addiction risk severity (GARS) test), which can subsequently be used to guide DNA-directed precision amino-acid enkephalinase inhibition (KB220) therapy as a frontline modality instead of potent opioids.
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Affiliation(s)
- Mauro Ceccanti
- Società Italiana per il Trattamento dell’Alcolismo e le sue Complicanze (SITAC), ASL Roma1, Sapienza University of Rome, 00185 Rome, Italy
| | - Kenneth Blum
- The Kenneth Blum Behavioral & Neurogenetic Institute, Austin, TX 78701, USA
- Division of Addiction Research & Education, Center for Mental Health & Sports, Exercise and Global Mental Health, Western University Health Sciences, Pomona, CA 91766, USA
- Institute of Psychology, ELTE Eötvös Loránd University, Egyetem tér 1-3, H-1053 Budapest, Hungary
- Department of Psychiatry, School of Medicine, University of Vermont, Burlington, VT 05405, USA
- Department of Psychiatry, Wright State University Boonshoft School of Medicine and Dayton VA Medical Centre, Dayton, OH 45324, USA
- Reward Deficiency Clinics of America, Austin, TX 78701, USA
- Center for Genomics and Applied Gene Technology, Institute of Integrative Omics and applied Biotechnology (IIOAB), Nonakuri, Purba Medinipur, West Bengal 721172, India
- Department of Precision Behavioral Management, Transplicegen Therapeutics, Inc., LLC., Austin, TX 78701, USA
- Department of Molecular Biology and Adelson School of Medicine, Ariel University, Ariel 40700, Israel
| | - Abdalla Bowirrat
- Department of Molecular Biology and Adelson School of Medicine, Ariel University, Ariel 40700, Israel
| | - Catherine A. Dennen
- Department of Family Medicine, Jefferson Health Northeast, Philadelphia, PA 19107, USA
| | - Eric R. Braverman
- The Kenneth Blum Behavioral & Neurogenetic Institute, Austin, TX 78701, USA
| | - David Baron
- Division of Addiction Research & Education, Center for Mental Health & Sports, Exercise and Global Mental Health, Western University Health Sciences, Pomona, CA 91766, USA
| | | | - John Giordano
- The Kenneth Blum Behavioral & Neurogenetic Institute, Austin, TX 78701, USA
- Ketamine Infusion Clinic of South Florida, Pompano Beach, FL 33062, USA
| | - Ashim Gupta
- Future Biologics, Lawrenceville, GA 30043, USA
| | - Bernard W. Downs
- The Kenneth Blum Behavioral & Neurogenetic Institute, Austin, TX 78701, USA
| | - Debasis Bagchi
- The Kenneth Blum Behavioral & Neurogenetic Institute, Austin, TX 78701, USA
- Department of Pharmaceutical Sciences, Southern University College of Pharmacy, Houston, TX 77004, USA
| | - Debmalya Barh
- Center for Genomics and Applied Gene Technology, Institute of Integrative Omics and applied Biotechnology (IIOAB), Nonakuri, Purba Medinipur, West Bengal 721172, India
- Department of Genetics, Ecology and Evolution, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte 31270-901, Brazil
| | - Igor Elman
- Center for Pain and the Brain (PAIN Group), Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children’s Hospital, Harvard School of Medicine, Boston, MA 02115, USA
| | - Panayotis K. Thanos
- Behavioral Neuropharmacology and Neuroimaging Laboratory, Clinical Research Institute on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14203, USA
| | - Rajendra D. Badgaiyan
- Department of Psychiatry, South Texas Veteran Health Care System, Audie L. Murphy Memorial VA Hospital, Long School of Medicine, University of Texas Medical Center, San Antonio, TX 78229, USA
| | - Drew Edwards
- Neurogenesis Project, Jacksonville, FL 32223, USA
| | - Mark S. Gold
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA
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Exercise Modulates Brain Glucose Utilization Response to Acute Cocaine. J Pers Med 2022; 12:jpm12121976. [PMID: 36556197 PMCID: PMC9788493 DOI: 10.3390/jpm12121976] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/22/2022] [Accepted: 11/25/2022] [Indexed: 12/02/2022] Open
Abstract
Exercise, a proven method of boosting health and wellness, is thought to act as a protective factor against many neurological and psychological diseases. Recent studies on exercise and drug exposure have pinpointed some of the neurological mechanisms that may characterize this protective factor. Using positron emission tomography (PET) imaging techniques and the glucose analog [18F]-Fluorodeoxyglucose (18F-FDG), our team sought to identify how chronic aerobic exercise modulates brain glucose metabolism (BGluM) after drug-naïve rats were exposed to an acute dose of cocaine. Using sedentary rats as a control group, we observed significant differences in regional BGluM. Chronic treadmill exercise treatment coupled with acute cocaine exposure induced responses in BGluM activity in the following brain regions: postsubiculum (Post), parasubiculum (PaS), granular and dysgranular insular cortex (GI and DI, respectively), substantia nigra reticular (SNR) and compact part dorsal tier (SNCD), temporal association cortex (TeA), entopenduncular nucleus (EP), and crus 1 of the ansiform lobule (crus 1). Inhibition, characterized by decreased responses due to our exercise, was found in the ventral endopiriform nucleus (VEn). These areas are associated with memory and various motor functions. They also include and share connections with densely dopaminergic areas of the mesolimbic system. In conclusion, these findings suggest that treadmill exercise in rats mediates brain glucose response to an acute dose of cocaine differently as compared to sedentary rats. The modulated brain glucose utilization occurs in brain regions responsible for memory and association, spatial navigation, and motor control as well as corticomesolimbic regions related to reward, emotion, and movement.
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Blum K, Dennen CA, Elman I, Bowirrat A, Thanos PK, Badgaiyan RD, Downs BW, Bagchi D, Baron D, Braverman ER, Gupta A, Green R, McLaughlin T, Barh D, Gold MS. Should Reward Deficiency Syndrome (RDS) Be Considered an Umbrella Disorder for Mental Illness and Associated Genetic and Epigenetic Induced Dysregulation of Brain Reward Circuitry? J Pers Med 2022; 12:1719. [PMID: 36294858 PMCID: PMC9604605 DOI: 10.3390/jpm12101719] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 10/11/2022] [Accepted: 10/11/2022] [Indexed: 11/30/2022] Open
Abstract
Reward Deficiency Syndrome (RDS) is defined as a breakdown of reward neurotransmission that results in a wide range of addictive, compulsive, and impulsive behaviors. RDS is caused by a combination of environmental (epigenetic) influences and DNA-based (genetic) neurotransmission deficits that interfere with the normal satisfaction of human physiological drives (i.e., food, water, and sex). An essential feature of RDS is the lack of integration between perception, cognition, and emotions that occurs because of (1) significant dopaminergic surges in motivation, reward, and learning centers causing neuroplasticity in the striato-thalamic-frontal cortical loop; (2) hypo-functionality of the excitatory glutamatergic afferents from the amygdala-hippocampus complex. A large volume of literature regarding the known neurogenetic and psychological underpinnings of RDS has revealed a significant risk of dopaminergic gene polymorphic allele overlap between cohorts of depression and subsets of schizophrenia. The suggestion is that instead of alcohol, opioids, gambling disorders, etc. being endophenotypes, the true phenotype is RDS. Additionally, reward deficiency can result from depleted or hereditary hypodopaminergia, which can manifest as a variety of personality traits and mental/medical disorders that have been linked to genetic studies with dopamine-depleting alleles. The carrying of known DNA antecedents, including epigenetic insults, results in a life-long vulnerability to RDS conditions and addictive behaviors. Epigenetic repair of hypodopaminergia, the causative basis of addictive behaviors, may involve precision DNA-guided therapy achieved by combining the Genetic Addiction Risk Severity (GARS) test with a researched neutraceutical having a number of variant names, including KB220Z. This nutraceutical formulation with pro-dopamine regulatory capabilities has been studied and published in peer-reviewed journals, mostly from our laboratory. Finally, it is our opinion that RDS should be given an ICD code and deserves to be included in the DSM-VI because while the DSM features symptomology, it is equally important to feature etiological roots as portrayed in the RDS model.
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Affiliation(s)
- Kenneth Blum
- The Kenneth Blum Behavioral & Neurogenetic Institute, LLC., Austin, TX 78701, USA
- Center for Behavioral Health & Sports, Exercise, Psychiatry, Western University Health Sciences, Pomona, CA 91766, USA
- Institute of Psychology, ELTE Eötvös Loránd University, Kazinczy u. 23–27, 1075 Budapest, Hungary
- Department of Molecular Biology and Adelson School of Medicine, Ariel University, Ariel 40700, Israel
| | - Catherine A. Dennen
- The Kenneth Blum Behavioral & Neurogenetic Institute, LLC., Austin, TX 78701, USA
- Department of Family Medicine, Jefferson Health Northeast, Philadelphia, PA 19140, USA
| | - Igor Elman
- Medicine, Boston Children’s Hospital, Boston, MA 02115, USA
- Cambridge Health Alliance, Harvard Medical School, Cambridge, MA 02139, USA
| | - Abdalla Bowirrat
- Department of Molecular Biology and Adelson School of Medicine, Ariel University, Ariel 40700, Israel
| | - Panayotis K. Thanos
- Behavioral Neuropharmacology and Neuroimaging Laboratory, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, Clinical Research Institute on Addictions, University at Buffalo, Buffalo, NY 14203, USA
- Department of Psychology, University at Buffalo, Buffalo, NY 14260, USA
| | - Rajendra D. Badgaiyan
- Department of Psychiatry, South Texas Veteran Health Care System, Audie L. Murphy Memorial VA Hospital, Long School of Medicine, University of Texas Medical Center, San Antonio, TX 78229, USA
| | - B. William Downs
- Division of Precision Nutrition, Victory Nutrition International, LLC., Lederoch, PA 19438, USA
| | - Debasis Bagchi
- Division of Precision Nutrition, Victory Nutrition International, LLC., Lederoch, PA 19438, USA
- Department of Pharmaceutical Science, College of Pharmacy & Health Sciences, Texas Southern University, Houston, TX 77004, USA
| | - David Baron
- Center for Behavioral Health & Sports, Exercise, Psychiatry, Western University Health Sciences, Pomona, CA 91766, USA
| | - Eric R. Braverman
- The Kenneth Blum Behavioral & Neurogenetic Institute, LLC., Austin, TX 78701, USA
| | - Ashim Gupta
- Future Biologics, Lawrenceville, GA 30043, USA
| | - Richard Green
- The Kenneth Blum Behavioral & Neurogenetic Institute, LLC., Austin, TX 78701, USA
| | - Thomas McLaughlin
- The Kenneth Blum Behavioral & Neurogenetic Institute, LLC., Austin, TX 78701, USA
| | - Debmalya Barh
- Centre for Genomics and Applied Gene Technology, Institute of Integrative Omics and Applied Biotechnology, Nonakuri, Purba Medinipur 721172, India
| | - Mark S. Gold
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA
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Bajaj A, Blum K, Bowirrat A, Gupta A, Baron D, Fugel D, Nicholson A, Fitch T, Downs BW, Bagchi D, Dennen CA, Badgaiyan RD. DNA Directed Pro-Dopamine Regulation Coupling Subluxation Repair, H-Wave® and Other Neurobiologically Based Modalities to Address Complexities of Chronic Pain in a Female Diagnosed with Reward Deficiency Syndrome (RDS): Emergence of Induction of “Dopamine Homeostasis” in the Face of the Opioid Crisis. J Pers Med 2022; 12:jpm12091416. [PMID: 36143203 PMCID: PMC9503998 DOI: 10.3390/jpm12091416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 08/27/2022] [Accepted: 08/27/2022] [Indexed: 11/16/2022] Open
Abstract
Addiction is a complex multifactorial condition. Established genetic factors can provide clear guidance in assessing the risk of addiction to substances and behaviors. Chronic stress can accumulate, forming difficult to recognize addiction patterns from both genetic and epigenetic (environmental) factors. Furthermore, psychological/physical/chemical stressors are typically categorized linearly, delaying identification and treatment. The patient in this case report is a Caucasian female, aged 36, who presented with chronic pain and partial disability following a surgically repaired trimalleolar fracture. The patient had a history of unresolved attention deficit disorder and an MRI scan of her brain revealed atrophy and functional asymmetry. In 2018, the patient entered the Bajaj Chiropractic Clinic, where initial treatment focused on re-establishing integrity of the spine and lower extremity biomechanics and graduated into cognitive behavior stabilization assisted by DNA pro-dopamine regulation guided by Genetic Addiction Risk Severity testing. During treatment (2018–2021), progress achieved included: improved cognitive clarity, focus, sleep, anxiety, and emotional stability in addition to pain reduction (75%); elimination of powerful analgesics; and reduced intake of previously unaddressed alcoholism. To help reduce hedonic addictive behaviors and pain, coupling of H-Wave with corrective chiropractic care seems prudent. We emphasize the importance of genetic assessment along with attempts at inducing required dopaminergic homeostasis via precision KB220PAM. It is hypothesized that from preventive care models, a new standard is emerging including self-awareness and accountability for reward deficiency as a function of hypodopaminergia. This case study documents the progression of a patient dealing with the complexities of an injury, pain management, cognitive impairment, anxiety, depression, and the application of universal health principles towards correction versus palliative care.
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Affiliation(s)
- Anish Bajaj
- Bajaj Chiropractic Clinic, New York, NY 10010, USA
| | - Kenneth Blum
- Division of Addiction Research & Education, Center for Psychiatry, Medicine, and Primary Care, (Office of the Provost), Western University Health Sciences, Pomona, CA 91766, USA
- The Kenneth Blum Institute on Behavior & Neurogenetics, Austin, TX 78701, USA
- Correspondence:
| | - Abdalla Bowirrat
- Department of Molecular Biology, Adelson School of Medicine, Ariel University, Ariel 40700, Israel
| | - Ashim Gupta
- Future Biologics, Lawrenceville, GA 30043, USA
| | - David Baron
- Division of Addiction Research & Education, Center for Psychiatry, Medicine, and Primary Care, (Office of the Provost), Western University Health Sciences, Pomona, CA 91766, USA
| | - David Fugel
- Bajaj Chiropractic Clinic, New York, NY 10010, USA
| | | | - Taylor Fitch
- Bajaj Chiropractic Clinic, New York, NY 10010, USA
| | - B. William Downs
- Department of Psychiatry, South Texas Veteran Health Care System, Audie L. Murphy Memorial VA Hospital, Long School of Medicine, University of Texas Medical Center, San Antonio, TX 78229, USA
| | - Debasis Bagchi
- Department of Pharmaceutical Sciences, Southern University College of Pharmacy, Houston, TX 77004, USA
| | - Catherine A. Dennen
- The Kenneth Blum Institute on Behavior & Neurogenetics, Austin, TX 78701, USA
| | - Rajendra D. Badgaiyan
- Department of Psychiatry, South Texas Veteran Health Care System, Audie L. Murphy Memorial VA Hospital, Long School of Medicine, University of Texas Medical Center, San Antonio, TX 78229, USA
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Braverman ER, Dennen CA, Gold MS, Bowirrat A, Gupta A, Baron D, Roy AK, Smith DE, Cadet JL, Blum K. Proposing a "Brain Health Checkup (BHC)" as a Global Potential "Standard of Care" to Overcome Reward Dysregulation in Primary Care Medicine: Coupling Genetic Risk Testing and Induction of "Dopamine Homeostasis". INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5480. [PMID: 35564876 PMCID: PMC9099927 DOI: 10.3390/ijerph19095480] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 04/26/2022] [Accepted: 04/28/2022] [Indexed: 12/27/2022]
Abstract
In 2021, over 100,000 people died prematurely from opioid overdoses. Neuropsychiatric and cognitive impairments are underreported comorbidities of reward dysregulation due to genetic antecedents and epigenetic insults. Recent genome-wide association studies involving millions of subjects revealed frequent comorbidity with substance use disorder (SUD) in a sizeable meta-analysis of depression. It found significant associations with the expression of NEGR1 in the hypothalamus and DRD2 in the nucleus accumbens, among others. However, despite the rise in SUD and neuropsychiatric illness, there are currently no standard objective brain assessments being performed on a routine basis. The rationale for encouraging a standard objective Brain Health Check (BHC) is to have extensive data available to treat clinical syndromes in psychiatric patients. The BHC would consist of a group of reliable, accurate, cost-effective, objective assessments involving the following domains: Memory, Attention, Neuropsychiatry, and Neurological Imaging. Utilizing primarily PUBMED, over 36 years of virtually all the computerized and written-based assessments of Memory, Attention, Psychiatric, and Neurological imaging were reviewed, and the following assessments are recommended for use in the BHC: Central Nervous System Vital Signs (Memory), Test of Variables of Attention (Attention), Millon Clinical Multiaxial Inventory III (Neuropsychiatric), and Quantitative Electroencephalogram/P300/Evoked Potential (Neurological Imaging). Finally, we suggest continuing research into incorporating a new standard BHC coupled with qEEG/P300/Evoked Potentials and genetically guided precision induction of "dopamine homeostasis" to diagnose and treat reward dysregulation to prevent the consequences of dopamine dysregulation from being epigenetically passed on to generations of our children.
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Affiliation(s)
- Eric R. Braverman
- The Kenneth Blum Institute on Behavior & Neurogenetics, Austin, TX 78701, USA; (E.R.B.); (C.A.D.)
| | - Catherine A. Dennen
- The Kenneth Blum Institute on Behavior & Neurogenetics, Austin, TX 78701, USA; (E.R.B.); (C.A.D.)
| | - Mark S. Gold
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA;
- Department of Psychiatry, Tulane School of Medicine, New Orleans, LA 70112, USA;
| | - Abdalla Bowirrat
- Department of Molecular Biology, Adelson School of Medicine, Ariel University, Ariel 40700, Israel;
| | - Ashim Gupta
- Future Biologics, Lawrenceville, GA 30043, USA;
| | - David Baron
- Division of Addiction Research & Education, Center for Psychiatry, Medicine & Primary Care (Office of Provost), Western University Health Sciences, Pomona, CA 91766, USA;
| | - A. Kenison Roy
- Department of Psychiatry, Tulane School of Medicine, New Orleans, LA 70112, USA;
| | - David E. Smith
- Department of Cellular and Molecular Pharmacology, University of California San Francisco, San Francisco, CA 94158, USA;
| | - Jean Lud Cadet
- The Molecular Neuropsychiatry Research Branch, NIH National Institute on Drug Abuse, Baltimore, MD 21224, USA;
| | - Kenneth Blum
- The Kenneth Blum Institute on Behavior & Neurogenetics, Austin, TX 78701, USA; (E.R.B.); (C.A.D.)
- Division of Addiction Research & Education, Center for Psychiatry, Medicine & Primary Care (Office of Provost), Western University Health Sciences, Pomona, CA 91766, USA;
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Blum K, Steinberg B, Gondre-Lewis MC, Baron D, Modestino EJ, Badgaiyan RD, Downs BW, Bagchi D, Brewer R, McLaughlin T, Bowirrat A, Gold M. A Review of DNA Risk Alleles to Determine Epigenetic Repair of mRNA Expression to Prove Therapeutic Effectiveness in Reward Deficiency Syndrome (RDS): Embracing "Precision Behavioral Management". Psychol Res Behav Manag 2021; 14:2115-2134. [PMID: 34949945 PMCID: PMC8691196 DOI: 10.2147/prbm.s292958] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 11/22/2021] [Indexed: 11/23/2022] Open
Abstract
This is a review of research on "Precision Behavioral Management" of substance use disorder (SUD). America is experiencing a high prevalence of substance use disorder, primarily involving legal and illegal opioid use. A 3000% increase in treatment for substance abuse has occurred between 2000 and 2016. Unfortunately, present day treatment of opioid abuse involves providing replacement therapy with powerful opioids to, at best, induce harm reduction, not prophylaxis. These interventions do not enhance gene expression and restore the balance of the brain reward system's neurotransmitters. We are proposing a generalized approach called "Precision Behavioral Management". This approach includes 1) using the Genetic Addiction Risk Severity (GARS, a 10 candidate polymorphic gene panel shown to predict ASI-alcohol and drug severity) to assess early pre-disposition to substance use disorder; 2) using a validated reward deficiency syndrome (RDS) questionnaire; 3) utilization of the Comprehensive Analysis of Reported Drugs (CARD™) to assess treatment compliance and abstinence from illicit drugs during treatment, and, importantly; 4) utilization of a "Pro-dopamine regulator (KB220)" (via IV or oral [KB220Z] delivery systems) to optimize gene expression, restore the balance of the Brain Reward Cascade's neurotransmitter systems and prevent relapse by induction of dopamine homeostasis, and; 5) utilization of targeted DNA polymorphic reward genes to direct mRNA genetic expression profiling during the treatment process. Incorporation of these events can be applied to not only the under-considered African-American RDS community, but all victims of RDS, as a demonstration of a paradigm shift that uniquely provides a novel putative "standard of care" based on DNA guided precision nutrition therapy to induce "dopamine homeostasis" and rebalance neurotransmitters in the Brain Reward Cascade. We are also developing a Reward Deficiency Syndrome Diagnostic Criteria (RDSDC) to assist in potential tertiary treatment.
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Affiliation(s)
- Kenneth Blum
- Center for Psychiatry, Medicine & Primary Care, Division of Addiction Research & Education, Graduate College, Western University Health Sciences, Pomona, CA, USA
- Eötvös Loránd University, Institute of Psychology, Budapest, Hungary
- Department of Psychiatry, Wright State University Boonshoft School of Medicine and Dayton VA Medical Center, Dayton, OH (IE), USA
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
- Division of Nutrigenomics, The Kenneth Blum Behavioral & Neurogenetic Institute, Austin, TX, USA
| | | | - Marjorie C Gondre-Lewis
- Developmental Neuropsychopharmacology Laboratory, Department of Anatomy, Howard University College of Medicine, Washington, DC, USA
| | - David Baron
- Center for Psychiatry, Medicine & Primary Care, Division of Addiction Research & Education, Graduate College, Western University Health Sciences, Pomona, CA, USA
| | | | - Rajendra D Badgaiyan
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, South Texas Veteran Health Care System, Audie L. Murphy Memorial VA Hospital, San Antonio, TX, USA
- Long School of Medicine, University of Texas Medical Center, San Antonio, TX, USA
| | - B William Downs
- Division of Nutrigenomics, Victory Nutrition International, Inc., Harleysville, PA, USA
| | - Debasis Bagchi
- Division of Nutrigenomics, Victory Nutrition International, Inc., Harleysville, PA, USA
| | - Raymond Brewer
- Division of Nutrigenomics, The Kenneth Blum Behavioral & Neurogenetic Institute, Austin, TX, USA
| | - Thomas McLaughlin
- Department of Psychopharmacology, Center for Psychiatric Medicine, Lawrence, MA, USA
| | - Abdalla Bowirrat
- Adelson School of Medicine & Department of Molecular Biology, Ariel University, Ariel, Israel
| | - Mark Gold
- Department of Psychiatry, Washington University, School of Medicine, St. Louis, MO, USA
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Blum K, Modestino EJ, Baron D, Brewer R, Thanos P, Elman I, Badgaiyan RD, Downs BW, Bagchi D, McLaughlin T, Bowirrat A, Roy AK, Gold MS. Endorphinergic Enhancement Attenuation of Post-traumatic Stress Disorder (PTSD) via Activation of Neuro-immunological Function in the Face of a Viral Pandemic. ACTA ACUST UNITED AC 2021; 10:86-97. [PMID: 34466374 DOI: 10.2174/2211556009999210104221215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Introduction Polymorphic gene variants, particularly the genetic determinants of low dopamine function (hypodopaminergia), are known to associate with Substance Use Disorder (SUD) and a predisposition to PTSD. Addiction research and molecular genetic applied technologies supported by the National Institutes of Health (NIH) have revealed the complex functions of brain reward circuitry and its crucial role in addiction and PTSD symptomatology. Discussion It is noteworthy that Israeli researchers compared mice with a normal immune system with mice lacking adaptive immunity and found that the incidence of PTSD increased several-fold. It is well established that raising endorphinergic function increases immune response significantly. Along these lines, Blum's work has shown that D-Phenylalanine (DPA), an enkephalinase inhibitor, increases brain endorphins in animal models and reduces stress in humans. Enkephalinase inhibition with DPA treats Post Traumatic Stress Disorder (PTSD) by restoring endorphin function. The Genetic Addiction Risk Severity (GARS) can characterize relevant phenotypes, genetic risk for stress vulnerability vs. resilience. GARS could be used to pre-test military enlistees for adaptive immunity or as part of PTSD management with customized neuronutrient supplementation upon return from deployment. Conclusion Based on GARS values, with particular emphasis on enhancing immunological function, pro-dopamine regulation may restore dopamine homeostasis. Recognition of the immune system as a "sixth sense" and assisting adaptive immunity with Precision Behavioral Management (PBM), accompanied by other supportive interventions and therapies, may shift the paradigm in treating stress disorders.
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Affiliation(s)
- Kenneth Blum
- Western University Health Sciences, Graduate School of Biomedical Sciences, Pomona, CA, USA.,Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.,Division of Precision Behavioral Management, Geneus Health, San Antonio, TX, USA.,Division of Nutrigenomics, Victory Nutrition International, Lederoch, PA., USA
| | | | - David Baron
- Western University Health Sciences, Graduate School of Biomedical Sciences, Pomona, CA, USA
| | - Raymond Brewer
- Division of Precision Behavioral Management, Geneus Health, San Antonio, TX, USA
| | - Panayotis Thanos
- Behavioral Neuropharmacology & Neuroimaging Laboratory on Addiction, Research Institute on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, University of Buffalo, Buffalo, NY, USA
| | - Igor Elman
- Department of Psychiatry, Harvard School of Medicine, Cambridge MA, USA
| | - Rajendra D Badgaiyan
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Psychiatry, South Texas Veteran Health Care System, Audie L. Murphy I Memorial VA Hospital, San Antonio, TX. and Long School of Medicine, University of Texas Medical Center, San Antonio TX, USA
| | - B William Downs
- Division of Nutrigenomics, Victory Nutrition International, Lederoch, PA., USA
| | - Debasis Bagchi
- Division of Nutrigenomics, Victory Nutrition International, Lederoch, PA., USA.,Department of Pharmaceutical Sciences, University of Houston, School of Pharmacy, Houston, TX., USA
| | | | - Abdalla Bowirrat
- Department of Neuroscience and Genetics, Interdisciplinary Center Herzliya, Herzliya, Israel
| | - A Kenison Roy
- Department of Psychiatry, University of Tulane School of Medicine, New Orleans, LA, USA
| | - Mark S Gold
- Department of Psychiatry, Washington University, School of Medicine, St. Louis, MO., USA
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Blum K, Khalsa J, Cadet JL, Baron D, Bowirrat A, Boyett B, Lott L, Brewer R, Gondré-Lewis M, Bunt G, Kazmi S, Gold MS. Cannabis-Induced Hypodopaminergic Anhedonia and Cognitive Decline in Humans: Embracing Putative Induction of Dopamine Homeostasis. Front Psychiatry 2021; 12:623403. [PMID: 33868044 PMCID: PMC8044913 DOI: 10.3389/fpsyt.2021.623403] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 02/05/2021] [Indexed: 02/01/2023] Open
Abstract
Over years, the regular use of cannabis has substantially increased among young adults, as indicated by the rise in cannabis use disorder (CUD), with an estimated prevalence of 8. 3% in the United States. Research shows that exposure to cannabis is associated with hypodopaminergic anhedonia (depression), cognitive decline, poor memory, inattention, impaired learning performance, reduced dopamine brain response-associated emotionality, and increased addiction severity in young adults. The addiction medicine community is increasing concern because of the high content of delta-9-tetrahydrocannabinol (THC) currently found in oral and vaping cannabis products, the cognitive effects of cannabis may become more pronounced in young adults who use these cannabis products. Preliminary research suggests that it is possible to induce 'dopamine homeostasis,' that is, restore dopamine function with dopamine upregulation with the proposed compound and normalize behavior in chronic cannabis users with cannabis-induced hypodopaminergic anhedonia (depression) and cognitive decline. This psychological, neurobiological, anatomical, genetic, and epigenetic research also could provide evidence to use for the development of an appropriate policy regarding the decriminalization of cannabis for recreational use.
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Affiliation(s)
- Kenneth Blum
- Western University Health Sciences, Pomona, CA, United States
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Division of Nutrigenomics, Precision Translational Medicine, LLC., San Antonio, TX, United States
- Division of Nutrigenomics, Genomic Testing Center, Geneus Health, LLC., San Antonio, TX, United States
- Department of Psychiatry, University of Vermont, Burlington, VT, United States
- Department of Psychiatry, Wright University Boonshoff School of Medicine, Dayton, OH, United States
| | - Jag Khalsa
- Department of Microbiology, Immunology and Tropical Medicine, George Washington University, School of Medicine, Washington, DC, United States
| | - Jean Lud Cadet
- Molecular Neuropsychiatry Research Branch, DHHS/NIH/NIDA Intramural Research Program, National Institutes of Health, Baltimore, MD, United States
| | - David Baron
- Western University Health Sciences, Pomona, CA, United States
| | - Abdalla Bowirrat
- Department of Neuroscience, Interdisciplinary Center (IDC), Herzliya, Israel
| | - Brent Boyett
- Bradford Health Services, Madison, AL, United States
| | - Lisa Lott
- Division of Nutrigenomics, Genomic Testing Center, Geneus Health, LLC., San Antonio, TX, United States
| | - Raymond Brewer
- Division of Nutrigenomics, Precision Translational Medicine, LLC., San Antonio, TX, United States
- Division of Nutrigenomics, Genomic Testing Center, Geneus Health, LLC., San Antonio, TX, United States
| | - Marjorie Gondré-Lewis
- Department of Psychiatry and Behavioral Sciences, Howard University College of Medicine, Washington, DC, United States
| | - Gregory Bunt
- Good Samaritan/Day Top Treatment Center, and NYU School of Medicine, New York, NY, United States
| | - Shan Kazmi
- College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA, United States
| | - Mark S. Gold
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, United States
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Blum K, McLaughlin T, Modestino EJ, Baron D, Bowirrat A, Brewer R, Steinberg B, Roy AK, Febo M, Badgaiyan RD, Gold MS. Epigenetic Repair of Terrifying Lucid Dreams by Enhanced Brain Reward Functional Connectivity and Induction of Dopaminergic Homeostatic Signaling. ACTA ACUST UNITED AC 2021; 10. [PMID: 34707968 DOI: 10.2174/2211556010666210215153513] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
During Lucid Dreams, the dreamer is aware, experiences the dream as if fully awake, and may control the dream content. The dreamer can start, stop, and restart dreaming, depending on the nature and pleasantness of the dream. For patients with Reward Deficiency Syndrome (RDS) behaviors, like Attention Deficit Hyperactivity Disorder (ADHD), Tourette's- Syndrome, and Posttraumatic Stress Disorder (PTSD), the dream content may be pleasant, unpleasant, or terrifying. A sample of psychiatric center patients identified as having RDS reported the effectiveness of a neuronutrient, dopamine agonist, KB200Z, in combating terrifying, lucid dreaming. These reports motivated the study of eight clinical cases with known histories of substance abuse, childhood abuse, and PTSD. The administration of KB200Z, associated with eliminating unpleasant or terrifying lucid dreams in 87.5% of the cases. Subsequently, other published cases have further established the possibility of the long-term elimination of terrifying dreams in PTSD and ADHD patients. Induction of dopamine homeostasis may mitigate the effects of neurogenetic and epigenetic changes in neuroplasticity, identified in the pathogenesis of PTSD and ADHD. The article explores how relief of terrifying lucid dreams may benefit from modulation of dopaminergic signaling activated by the administration of a neuronutrient. Recently, precision formulations of the KB220 neuronutrient guided by Genetic Addiction Risk Score (GARS) test results have been used to repair inheritable deficiencies within the brain reward circuitry. The proposition is that improved dopamine transmodulational signaling may stimulate positive cognitive recall and subsequently attenuate the harmful epigenetic insults from trauma.
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Affiliation(s)
- Kenneth Blum
- Western University Health Sciences, Pomona, CA., USA.,Department Psychiatry, Wright University, Boonshoff School of Medicine, Dayton, OH., USA.,Division of Neuroscience & Addiction Research Therapy, Pathway Healthcare, Birmingham, AL., USA.,Division of Nutrigenomics, Geneus Genomic Testing Center, Geneus Health, LLC., San Antonio, TX., USA.,Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | | | | | - David Baron
- Department Psychiatry, Wright University, Boonshoff School of Medicine, Dayton, OH., USA
| | - Abdalla Bowirrat
- Department of Neuroscience and Genetics, Interdisciplinary Center Herzliya, Israel
| | - Raymond Brewer
- Division of Nutrigenomics, Geneus Genomic Testing Center, Geneus Health, LLC., San Antonio, TX., USA
| | | | - A Kenison Roy
- Department of Psychiatry, School of Medicine, University of Tulane, New Orleans, LA., USA
| | - Marcello Febo
- Department of Psychiatry, McKnight Brain Institute, University of Florida, School of Medicine, Gainesville, FL.USA
| | - Rajendra D Badgaiyan
- Department of Psychiatry, Ichan School of Medicine, Mount Sinai Hospital, New York, NY.& Department of Psychiatry, South Texas Veteran Health Care System, Audie L. Murphy Memorial VA Hospital, San Antonio, TX, Long School of Medicine, University of Texas Medical Center, San Antonio, TX, USA
| | - Marks S Gold
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Mo. USA
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10
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Blum K, Cadet JL, Gold MS. Psychostimulant use disorder emphasizing methamphetamine and the opioid -dopamine connection: Digging out of a hypodopaminergic ditch. J Neurol Sci 2021; 420:117252. [PMID: 33279726 DOI: 10.1016/j.jns.2020.117252] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 11/23/2020] [Accepted: 11/24/2020] [Indexed: 01/04/2023]
Abstract
BACKGROUND Approved food and drug administration (FDA) medications to treat Psychostimulant Use Disorder (PUD) are needed. Both acute and chronic neurological deficits related to the neurophysiological effects of these powerfully addictive drugs can cause stroke and alterations in mood and cognition. OBJECTIVE This article presents a brief review of the psychiatric and neurobiological sequelae of methamphetamine use disorder, some known neurogenetic associations impacted by psychostimulants, and explores treatment modalities and outcomes. HYPOTHESIS The authors propose that gentle D2 receptor stimulation accomplished via some treatment modalities can induce dopamine release, causing alteration of D2-directed mRNA and thus enhanced function of D2 receptors in the human. This proliferation of D2 receptors, in turn, will induce the attenuation of craving behavior, especially in genetically compromised high-risk populations. DISCUSSION A better understanding of the involvement of molecular neurogenetic opioid, mesolimbic dopamine, and psychostimulant connections in "wanting" supports this hypothesis. While both scientific and, clinical professionals search for an FDA approved treatment for PUD the induction of dopamine homeostasis, via activation of the brain reward circuitry, offers treatment for underlying neurotransmitter functional deficits, potential prophylaxis, and support for recovery efforts. CONCLUSION Dopamine regulation may help people dig out of their hypodopaminergia ditch.
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Affiliation(s)
- Kenneth Blum
- Graduate College, Western University Health Sciences, Pomona, CA, Baltimore, MD, United States of America.
| | - Jean Lud Cadet
- Molecular Neuropsychiatry Research Branch, NIH National Institute on Drug Abuse, United States of America
| | - Mark S Gold
- Department of Psychiatry, Washington University, St Louis, MO, United States of America.
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11
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McLaughlin T, Blum K, Steinberg B, Modestino EJ, Fried L, Baron D, Siwicki D, Braverman ER, Badgaiyan RD. Pro-dopamine regulator, KB220Z, attenuates hoarding and shopping behavior in a female, diagnosed with SUD and ADHD. J Behav Addict 2018; 7:192-203. [PMID: 29316800 PMCID: PMC6035027 DOI: 10.1556/2006.6.2017.081] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Background Addictive-like behaviors (e.g., hoarding and shopping) may be the result of the cumulative effects of dopaminergic and other neurotransmitter genetic variants as well as elevated stress levels. We, therefore, propose that dopamine homeostasis may be the preferred goal in combating such challenging and unwanted behaviors, when simple dopaminergic activation through potent agonists may not provide any resolution. Case presentation C.J. is a 38-year-old, single, female, living with her mother. She has a history of substance use disorder as well as attention deficit hyperactivity disorder, inattentive type. She had been stable on buprenorphine/naloxone combination and amphetamine, dextroamphetamine mixed salts for many years when unexpectedly she lost her job for oversleeping and not calling into work. KB200z (a pro-dopamine compound) was added to her regimen for complaints of low drive and motivation. After taking this nutraceutical for 4 weeks, she noticed a marked improvement in her mental status and many behaviors. She noted that her shopping and hoarding addictions had appreciably decreased. Furthermore, her lifelong history of terrifying lucid dreams was eliminated. Finally, she felt more in control; her locus of control shifted from external to more internal. Discussion The hypothesis is that C.J.'s reported, behavioral, and psychological benefits resulted from the pro-dopamine-regulating effect of KB220Z across the brain reward system. Conclusions This effect, we surmise, could be the result of a new dopamine balance, across C.J.'s brain reward system. Dopamine homeostasis is an effect of KB220Z seen in both animal and human placebo-controlled fMRI experiments.
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Affiliation(s)
- Thomas McLaughlin
- 1 Department of Psychopharmacology, Center for Psychiatric Medicine , Lawrence, MA, USA
| | - Kenneth Blum
- 2 Department of Psychiatry, Boonshoft School of Medicine, Dayton VA Medical Center, Wright State University , Dayton, OH, USA
- 3 Department of Psychiatry, McKnight Brain Institute, University of Florida College of Medicine , Gainesville, FL, USA
- 4 Department of Psychiatry and Behavioral Sciences, Keck Medicine University of Southern California , Los Angeles, CA, USA
- 5 Division of Applied Clinical Research & Education, Dominion Diagnostics, LLC , North Kingstown, RI, USA
- 6 Department of Precision Medicine, Geneus Health LLC , San Antonio, TX, USA
- 7 Department of Addiction Research & Therapy, Nupathways Inc. , Innsbrook, MO, USA
- 8 Department of Clinical Neurology, Path Foundation , New York, NY, USA
- 9 Division of Neuroscience Based Addiction Therapy, The Shores Treatment & Recovery Center , Port Saint Lucie, FL, USA
- 10 Institute of Psychology, Eötvös Loránd University , Budapest, Hungary
| | - Bruce Steinberg
- 11 Department of Psychology, Curry College , Milton, MA, USA
| | | | - Lyle Fried
- 9 Division of Neuroscience Based Addiction Therapy, The Shores Treatment & Recovery Center , Port Saint Lucie, FL, USA
| | - David Baron
- 4 Department of Psychiatry and Behavioral Sciences, Keck Medicine University of Southern California , Los Angeles, CA, USA
| | - David Siwicki
- 6 Department of Precision Medicine, Geneus Health LLC , San Antonio, TX, USA
| | - Eric R Braverman
- 8 Department of Clinical Neurology, Path Foundation , New York, NY, USA
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12
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Blum K, Gondré-Lewis MC, Baron D, Thanos PK, Braverman ER, Neary J, Elman I, Badgaiyan RD. Introducing Precision Addiction Management of Reward Deficiency Syndrome, the Construct That Underpins All Addictive Behaviors. Front Psychiatry 2018; 9:548. [PMID: 30542299 PMCID: PMC6277779 DOI: 10.3389/fpsyt.2018.00548] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Accepted: 10/12/2018] [Indexed: 12/21/2022] Open
Affiliation(s)
- Kenneth Blum
- Graduate College of Biomedical Sciences, Western University of Health Sciences, Pomona, CA, United States.,Department of Psychiatry, Boonshoft School of Medicine, Dayton VA Medical Center, Wright State University, Dayton, OH, United States.,University of Vermont College of Medicine, Burlington, VM, United States.,Division of Addictive Services, Dominion Diagnostics, LLC, North Kingston, RI, United States.,Division of Precision Addiction Management, Geneus Health, LLC, San Antonio, TX, United States.,Institute of Psychology, University of Eötvös Loránd, Budapest, Hungary.,Department of Clinical Neurology, Path Foundation, New York, NY, United States.,Division of Neuroscience and Addiction Therapy, Summit Estate Recovery Center, Los Gatos, CA, United States.,Department of Neurogenetics Research and Addiction Therapy, The Florida House Experience, Deerfield Beach, FL, United States.,National Human Genome Center, Howard University, Washington, DC, United States
| | - Marjorie C Gondré-Lewis
- Division of Precision Addiction Management, Geneus Health, LLC, San Antonio, TX, United States.,Department of Anatomy, Howard University College of Medicine, Washington, DC, United States.,Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions, Clinical and Research Institute on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, United States
| | - David Baron
- Graduate College of Biomedical Sciences, Western University of Health Sciences, Pomona, CA, United States.,Division of Precision Addiction Management, Geneus Health, LLC, San Antonio, TX, United States
| | - Panayotis K Thanos
- Division of Precision Addiction Management, Geneus Health, LLC, San Antonio, TX, United States.,Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions, Clinical and Research Institute on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, United States.,Department of Psychology, University at Buffalo, Buffalo, NY, United States
| | - Eric R Braverman
- Department of Clinical Neurology, Path Foundation, New York, NY, United States
| | - Jennifer Neary
- Division of Precision Addiction Management, Geneus Health, LLC, San Antonio, TX, United States
| | - Igor Elman
- Division of Precision Addiction Management, Geneus Health, LLC, San Antonio, TX, United States.,Department of Psychiatry, Cooper Medical School of Rowan University, Camden, NJ, United States
| | - Rajendra D Badgaiyan
- Division of Precision Addiction Management, Geneus Health, LLC, San Antonio, TX, United States.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States
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13
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Febo M, Blum K, Badgaiyan RD, Perez PD, Colon-Perez LM, Thanos PK, Ferris CF, Kulkarni P, Giordano J, Baron D, Gold MS. Enhanced functional connectivity and volume between cognitive and reward centers of naïve rodent brain produced by pro-dopaminergic agent KB220Z. PLoS One 2017; 12:e0174774. [PMID: 28445527 PMCID: PMC5405923 DOI: 10.1371/journal.pone.0174774] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 03/15/2017] [Indexed: 11/20/2022] Open
Abstract
Dopaminergic reward dysfunction in addictive behaviors is well supported in the literature. There is evidence that alterations in synchronous neural activity between brain regions subserving reward and various cognitive functions may significantly contribute to substance-related disorders. This study presents the first evidence showing that a pro-dopaminergic nutraceutical (KB220Z) significantly enhances, above placebo, functional connectivity between reward and cognitive brain areas in the rat. These include the nucleus accumbens, anterior cingulate gyrus, anterior thalamic nuclei, hippocampus, prelimbic and infralimbic loci. Significant functional connectivity, increased brain connectivity volume recruitment (potentially neuroplasticity), and dopaminergic functionality were found across the brain reward circuitry. Increases in functional connectivity were specific to these regions and were not broadly distributed across the brain. While these initial findings have been observed in drug naïve rodents, this robust, yet selective response implies clinical relevance for addicted individuals at risk for relapse, who show reductions in functional connectivity after protracted withdrawal. Future studies will evaluate KB220Z in animal models of addiction.
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Affiliation(s)
- Marcelo Febo
- Department of Psychiatry & McKnight Brain Institute, University of Florida College of Medicine, Gainesville, Florida, United States of America
| | - Kenneth Blum
- Department of Psychiatry & McKnight Brain Institute, University of Florida College of Medicine, Gainesville, Florida, United States of America
- Department of Psychiatry, Wright State University, Boonshoft School of Medicine, Dayton, Ohio, United States of America
- Department of Holistic Medicine, National Institute for Holistic Addiction Studies, North Miami Beach, Florida, United States of America
- Division of Applied Clinical Research & Education, Dominion Diagnostics, LLC, North Kingstown, Rhode Island, United States of America
- Department of Psychiatry, Keck Medicine University of Southern California, Los Angeles, California, United States of America
| | - Rajendra D. Badgaiyan
- Department of Psychiatry, Wright State University, Boonshoft School of Medicine, Dayton, Ohio, United States of America
| | - Pablo D. Perez
- Department of Psychiatry & McKnight Brain Institute, University of Florida College of Medicine, Gainesville, Florida, United States of America
| | - Luis M. Colon-Perez
- Department of Psychiatry & McKnight Brain Institute, University of Florida College of Medicine, Gainesville, Florida, United States of America
| | - Panayotis K. Thanos
- Research Institute on Addictions, University at Buffalo, Buffalo, New York, United States of America
| | - Craig F. Ferris
- Center for Translational Neuroimaging, Department of Psychology and Pharmaceutical Sciences, Northeastern University, Boston, Massachusetts, United States of America
| | - Praveen Kulkarni
- Center for Translational Neuroimaging, Department of Psychology and Pharmaceutical Sciences, Northeastern University, Boston, Massachusetts, United States of America
| | - John Giordano
- Department of Holistic Medicine, National Institute for Holistic Addiction Studies, North Miami Beach, Florida, United States of America
| | - David Baron
- Department of Psychiatry, Keck Medicine University of Southern California, Los Angeles, California, United States of America
| | - Mark S. Gold
- Department of Psychiatry & McKnight Brain Institute, University of Florida College of Medicine, Gainesville, Florida, United States of America
- Department of Psychiatry, Keck Medicine University of Southern California, Los Angeles, California, United States of America
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14
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Blum K, Febo M, Fried L, Li M, Dushaj K, Braverman ER, McLaughlin T, Steinberg B, Badgaiyan RD. Hypothesizing That Neuropharmacological and Neuroimaging Studies of Glutaminergic-Dopaminergic Optimization Complex (KB220Z) Are Associated With "Dopamine Homeostasis" in Reward Deficiency Syndrome (RDS). Subst Use Misuse 2017; 52:535-547. [PMID: 28033474 PMCID: PMC5589271 DOI: 10.1080/10826084.2016.1244551] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND There is need for better treatments of addictive behaviors, both substance and non-substance related, termed Reward Deficiency Syndrome (RDS). While the FDA has approved pharmaceuticals under the umbrella term Medication Assisted Treatment (MAT), these drugs are not optimal. OBJECTIVES It is our contention that these drugs work well in the short-term by blocking dopamine function leading to psychological extinction. However, use of buprenorphine/Naloxone over a long period of time results in unwanted addiction liability, reduced emotional affect, and mood changes including suicidal ideation. METHODS We are thus proposing a paradigm shift in addiction treatment, with the long-term goal of achieving "Dopamine Homeostasis." While this may be a laudable goal, it is very difficult to achieve. Nevertheless, this commentary briefly reviews past history of developing and subsequently, utilizing a glutaminergic-dopaminergic optimization complex [Kb220Z] shown to be beneficial in at least 20 human clinical trials and in a number of published and unpublished studies. RESULTS It is our opinion that, while additional required studies could confirm these findings to date, the cited studies are indicative of achieving enhanced resting state functional connectivity, connectivity volume, and possibly, neuroplasticity. Conclusions/Importance: We are proposing a Reward Deficiency Solution System (RDSS) that includes: Genetic Addiction Risk Score (GARS); Comprehensive Analysis of Reported Drugs (CARD); and a glutaminergic-dopaminergic optimization complex (Kb220Z). Continued investigation of this novel strategy may lead to a better-targeted approach in the long-term, causing dopamine regulation by balancing the glutaminergic-dopaminergic pathways. This may potentially change the landscape of treating all addictions leading us to the promised land.
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Affiliation(s)
- Kenneth Blum
- a Department of Psychiatry & McKnight Brain Institute , University of Florida College of Medicine , Gainesville , Florida , USA.,b Departments of Psychiatry & Behavioral Sciences , Keck School of Medicine of USC , Los Angeles , California , USA.,c Department of Clinical Neurology , PATH Foundation NY , New York , New York , USA.,d Human Integrated Services Unit , University of Vermont Centre for Clinical & Translational Science , Burlington , Vermont , USA.,e Division of Addiction Services , Dominion Diagnostics, LLC , North Kingstown , Rhode Island , USA.,f Division of Neuroscience-Based Therapy , Summit Estate Recovery Center , Los Gatos , California , USA.,g Division of Neuroscience Research and Addiction Therapy , The Shores Treatment and Recovery Center , Port Saint Lucie , Florida , USA.,h Institute of Psychology , Eötvös Loránd University , Budapest , Hungary.,i Department of Psychiatry , Wright State University Boonshoft School of Medicine , Dayton , Ohio, USA
| | - Marcelo Febo
- a Department of Psychiatry & McKnight Brain Institute , University of Florida College of Medicine , Gainesville , Florida , USA
| | - Lyle Fried
- g Division of Neuroscience Research and Addiction Therapy , The Shores Treatment and Recovery Center , Port Saint Lucie , Florida , USA
| | - Mona Li
- b Departments of Psychiatry & Behavioral Sciences , Keck School of Medicine of USC , Los Angeles , California , USA
| | - Kristina Dushaj
- b Departments of Psychiatry & Behavioral Sciences , Keck School of Medicine of USC , Los Angeles , California , USA
| | - Eric R Braverman
- b Departments of Psychiatry & Behavioral Sciences , Keck School of Medicine of USC , Los Angeles , California , USA
| | - Thomas McLaughlin
- j Center for Psychiatric Medicine , North Andover , Massachusetts , USA
| | - Bruce Steinberg
- k Department of Psychology , Curry College , Milton , Massachusetts , USA
| | - Rajendra D Badgaiyan
- i Department of Psychiatry , Wright State University Boonshoft School of Medicine , Dayton , Ohio, USA
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15
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Blum K, Madigan MA, Fried L, Braverman ER, Giordano J, Badgaiyan RD. Coupling Genetic Addiction Risk Score (GARS) and Pro Dopamine Regulation (KB220) to Combat Substance Use Disorder (SUD). ACTA ACUST UNITED AC 2017; 1. [PMID: 29399668 DOI: 10.19080/gjarm.2017.01.555556] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Kenneth Blum
- Department of Psychiatry & McKnight Brain Institute, University of Florida College of Medicine, USA.,Department of Psychiatry and Behavioral Sciences, Keck Medicine University of Southern California, USA.,Division of Applied Clinical Research & Education, Dominion Diagnostics, USA.,Department of Neurogenetics, Igene, USA.,National Institute for Holistic Addiction Studies, USA.,Department of Clinical Neurology, Path Foundation NY, USA.,Division of Neuroscience Based Addiction Therapy, The Shores Treatment & Recovery Center, USA.,Eötvös Loránd University, Institute of Psychology, Europe.,Department of Psychiatry, Wright State University Boonshoft School of Medicine and Dayton VA Medical Center, US.,Division of Reward Deficiency Syndrome, Nupathways, Inc., Innsbrook, MO, USA
| | | | - Lyle Fried
- Division of Neuroscience Based Addiction Therapy, The Shores Treatment & Recovery Center, USA
| | | | - John Giordano
- National Institute for Holistic Addiction Studies, USA
| | - Rajendra D Badgaiyan
- Department of Psychiatry, Wright State University Boonshoft School of Medicine and Dayton VA Medical Center, US
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16
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Reward deficiency and anti-reward in pain chronification. Neurosci Biobehav Rev 2016; 68:282-297. [DOI: 10.1016/j.neubiorev.2016.05.033] [Citation(s) in RCA: 132] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 05/26/2016] [Accepted: 05/27/2016] [Indexed: 12/12/2022]
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17
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Blum K, Whitney D, Fried L, Febo M, Waite RL, Braverman ER, Dushaj K, Li M, Giordano J, Demetrovics Z, Badgaiyan RD. Hypothesizing that a Pro-Dopaminergic Regulator (KB220z ™ Liquid Variant) can Induce "Dopamine Homeostasis" and Provide Adjunctive Detoxification Benefits in Opiate/Opioid Dependence. CLINICAL MEDICAL REVIEWS AND CASE REPORTS 2016; 3:125. [PMID: 29034323 PMCID: PMC5638455 DOI: 10.23937/2378-3656/1410125] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
In order to explore the initiation of detoxification of addictive patients to opiates/opioids (along with some other anti-withdrawal agents), we developed a protocol to be utilized in treatment centers particularly with heavily dependent opiate/opioid subjects. Out of 17 subjects, only three received Buprenorphine/Naloxone (Bup/nx) along with KB220Z. In this pilot, we first used a dose of KB220Z of 2 oz twice daily before meals along with clonidine and benzodiazepines and other anti-nausea and sleep aids including Gabapentin. The dose of KB220Z was maintained for 6 days in five individuals. In a second scenario, we utilized a higher dose of 4 oz every 6 hours, over a 6-day period. The higher dose was employed in another 12 patients. It is noteworthy that only 3 people have relapsed utilizing these two protocols during the first two weeks of the study, allowing for the remaining 82% to be maintained on KB220Z. The patients have been maintained without any additional Bup/nx for a minimum of 120 days and in one subject, 214 days. We are in the process of testing this hypothesis in multiple treatment centers across the United Sates utilizing data from the Clinical opiate Withdrawal Scale (COWS) pre and post KB220Z. We are in the process of testing this hypothesis in multiple treatment centers across the United Sates. While this does not constitute an acceptable controlled experiment, it does provide some preliminary evidence that agrees with an earlier study. Moreover, because of the utilization of standard detoxifying agents in this detoxification protocol, we cannot make any inference to KB220Z's effects. However, out of 17 subjects, only three required Bup/nx suggesting an interesting finding. If further confirmed in larger studies, the utilization for opiate/opioid detoxification may provide a novel way to eliminate the need for addictive opioids during withdrawal and detoxification. This paradigm shift may translate to a reduction in utilizing powerful and addictive opioids like buprenorphine and methadone (especially in these patients at high genetic risk for addiction) as not only detoxifying agents, but also maintenance drugs. While extensive research is required, this pilot paves the way for future investigations that could assist in the reduction of addictive opiate/opioid use and mortalities amongst both the young and old in America.
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Affiliation(s)
- Kenneth Blum
- Department of Psychiatry & McKnight Brain Institute, University of Florida College of Medicine, USA
- Department of Psychiatry & Behavioral Sciences, Keck School of Medicine of USC, USA
- Division of Applied Clinical Research & Education, Dominion Diagnostics, LLC, USA
- Division of Neuroscience-Based Therapy, Summit Estate Recovery Center, USA
- Division of Clinical Neurology, Path Foundation New York, USA
- Division of Personalized Medicine, IGENE, LLC, USA
- Division of Molecular Neurobiology, LaVitaRDS, USA
- National Institute for Holistic Studies in Addiction, USA
- Division of Neuroscience Research and Addiction Therapy, Shores Treatment & Recovery Center, USA
- Department of Clinical Psychology and Addiction, Eotvos Lorand University, Hungary
| | - Debra Whitney
- Division of Clinical Addiction Medicine, Pure Recovery, USA
| | - Lye Fried
- Division of Neuroscience Research and Addiction Therapy, Shores Treatment & Recovery Center, USA
| | - Marcelo Febo
- Department of Psychiatry & Behavioral Sciences, Keck School of Medicine of USC, USA
| | - Roger L Waite
- National Institute for Holistic Studies in Addiction, USA
| | | | | | - Mona Li
- Division of Personalized Medicine, IGENE, LLC, USA
| | - John Giordano
- National Institute for Holistic Studies in Addiction, USA
| | - Zsolt Demetrovics
- Department of Clinical Psychology and Addiction, Eotvos Lorand University, Hungary
| | - Rajendra D Badgaiyan
- Department of Psychiatry, Laboratory of Molecular and Functional Imaging, University at Minnesota, USA
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Blum K, Downs B, Dushaj K, Li M, Braverman ER, Fried L, Waite R, Demotrovics Z, Badgaiyan RD. THE BENEFITS OF CUSTOMIZED DNA DIRECTED NUTRITION TO BALANCE THE BRAIN REWARD CIRCUITRY AND REDUCE ADDICTIVE BEHAVIORS. PRECISION MEDICINE 2016; 1:18-33. [PMID: 28066828 PMCID: PMC5210211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
DNA Customization of nutraceutical products is here. In the truest sense, "Gene Guided Precision Nutrition™" and KB220 variants (a complex mixture of amino-acids, trace metals, and herbals) are the pioneers and standard-bearers for a state of the art DNA customization. Findings by both, Kenneth Blum, Ph.D. and Ernest Noble, Ph.D. concerning the role of genes in shaping cravings and pleasure- seeking, opened the doors to comprehension of how genetics control our actions and effect our mental and physical health. Moreover, technology that is related to KB220 variants in order to reduce or eradicate excessive cravings by influencing gene expression is a cornerstone in the pioneering of the practical applications of nutrigenomics. Continuing discoveries have been an important catalyst for the evolution, expansion, and scientific recognition of the significance of nutrigenomics and its remarkable contributions to human health. Neuro-Nutrigenomics is now a very important field of scientific investigation that offers great promise to improving the human condition. In the forefront is the development of the Genetic Addiction Risk Score (GARS™), which unlike 23andMe, has predictive value for the severity of drug and alcohol abuse as well as other non-substance related addictive behaviors. While customization of neuronutrients has not yet been commercialized, there is emerging evidence that in the future, the concept will be developed and could have a significant impact in addiction medicine.
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Affiliation(s)
- Kenneth Blum
- Department of Psychiatry & McKnight Brain Institute, University of Florida College of Medicine, Gainesville, FL, USA
- Departments of Psychiatry & Behavioral Sciences, Keck School of Medicine of USC, Los Angeles, CA, USA
- Department of Clinical Neurology, PATH Foundation NY, New York, NY, USA
- Human Integrated Services Unit, University of Vermont Centre for Clinical & Translational Science, College of Medicine, Burlington, VT, USA
- Division of Addiction Services, Dominion Diagnostics, LLC., North Kingstown, RI, USA
- Division of Neuroscience-based Therapy, Summit Estate Recovery Center, Los Gatos, CA, USA
- The Shores Treatment & Recovery, Port Saint Lucie, FL, USA
- Department of Precision Medicine, IGENE, LLC., Austin, TX, USA
- Division of Nutrigenomics, LaVitaRDS, Draper, UT, USA
- Institute of Psychology, Eötvös Loránd University Budapest, HUNGARY
| | - B.W. Downs
- Victory Nutrition International, Lederoch, PA, USA
| | - Kristina Dushaj
- Department of Clinical Neurology, PATH Foundation NY, New York, NY, USA
| | - Mona Li
- Department of Clinical Neurology, PATH Foundation NY, New York, NY, USA
| | - Eric R. Braverman
- Department of Clinical Neurology, PATH Foundation NY, New York, NY, USA
| | - Lyle Fried
- The Shores Treatment & Recovery, Port Saint Lucie, FL, USA
| | - Roger Waite
- Division of Nutrigenomics, LaVitaRDS, Draper, UT, USA
| | | | - Rajendra D. Badgaiyan
- Department of Psychiatry, Laboratory of Molecular and Functional Imaging, University at Minnesota, Minneapolis, MN, USA
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Blum K, Badgaiyan RD, Braverman ER, Dushaj K, Li M, Thanos PK, Demetrovics Z, Febo M. Hypothesizing that, A Pro-Dopamine Regulator (KB220Z) Should Optimize, but Not Hyper-Activate the Activity of Trace Amine-Associated Receptor 1 (TAAR-1) and Induce Anti-Craving of Psychostimulants in the Long-Term. JOURNAL OF REWARD DEFICIENCY SYNDROME AND ADDICTION SCIENCE 2016; 2:14-21. [PMID: 28317038 PMCID: PMC5351297 DOI: 10.17756/jrdsas.2016-023] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Unlike other drugs of abuse such as alcohol, nicotine, opiates/opioids, the FDA has not approved any agent to treat psychostimulant dependence. Certainly, it is widely acceptable that dopaminergic signaling is a key factor in both the initiation and continued motivation to abuse this class of stimulant substances. It is also well accepted that psychostimulants such as cocaine affect not only the release of neuronal dopamine at the nucleus accumbens (NAc), but also has powerful inhibitory actions on the dopamine transporter system. Understandably, certain individuals are at high risk and very vulnerable to abuse this class of substances. Trace-amine-associated receptor 1 (TAAR1) is a G -protein coupled receptor activated by trace amines. The encoded protein responds little or not at all to dopamine, serotonin, epinephrine, or histamine, but responds well to beta-phenylethylamine, p-tyramine, octopamine, and tryptamine. This gene is thought to be intronless. TAAR1 agonists reduce the neurochemical effects of cocaine and amphetamines as well as attenuate addiction and abuse associated with these two psychostimulants. The mechanism involves blocking the firing rate of dopamine in the limbic system thereby decreasing a hyperdopaminergic trait/state, whereby the opposite is true for TAAR1 antagonists. Based on many studies, it is accepted that in Reward Deficiency Syndrome (RDS), there is weakened tonic and improved phasic dopamine discharge leading to a hypodopaminergic/glutamatergic trait. The dopamine pro-complex mixture KB220, following many clinical trials including neuroimaging studies, has been shown to enhance resting state functional connectivity in humans (abstinent heroin addicts), naïve rodent models, and regulates extensive theta action in the cingulate gyrus of abstinent psychostimulant abusers. In this article, we are hypothesizing that KB220 may induce its action on resting state functional connectivity, for example, by actually balancing (optimizing) the effects of TAAR1 on the glutamatergic system allowing for optimization of this system. This will lead to a normalized and homeostatic release of NAc dopamine. This proposed optimization, and not enhanced activation of TAAR1, should lead to well-being of the individual. Hyper-activation instead of optimizing the TAAR1 system unfortunately will lead to a prolonged hypodopaminergic state and as such, will cause enhanced craving for not only psychoactive substances, but also other drug-related and even non-drug related RDS behaviors. This hypothesis will require extensive research, which seems warranted based on the global epidemic of drug and behavioral addictions.
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Affiliation(s)
- Kenneth Blum
- Department of Psychiatry & McKnight Brain Institute, University of Florida College of Medicine, PO Box 100256, 1149 Newell Dr, L4-100, Gainesville, FL 32611, USA
- Division of Applied Clinical Research and Education, Dominion Diagnostics, LLC., 211 Circuit Dr, North Kingstown, RI 02852, USA
- Division of Neuroscience-Based Therapy, Summit Estate Recovery Center, 399 Old Mill Pond Rd, Los Gatos, CA 95033, USA
- Division of Clinical Neurology, PATH Foundation NY, 304 Park Ave South, Floor 6, New York, NY 10010, USA
- Division of Nutrigenomics, LaVita RDS, 1878 W 12800S, Ste 314, Averton, UT 84085, USA
- Department of Psychiatry & Behavioral Sciences, Keck School of Medicine of USC, Los Angeles, CA 90033, USA
- Division of Neuroscience Research & Addiction Therapy, Shores Recovery & Treatment Center, Port Saint Louie, FL 34952, USA
- Department of Clinical Psychology and Addiction, Eötvös Loránd University, 1064 Budapest, Izabella Street 46, Hungary
| | - Rajendra D. Badgaiyan
- Department of Psychiatry and Neuroimaging, University of Minnesota, F282/2A West, 2450 Riverside Avenue South, Minneapolis, MN 55454, USA
| | - Eric R. Braverman
- Division of Clinical Neurology, PATH Foundation NY, 304 Park Ave South, Floor 6, New York, NY 10010, USA
| | - Kristina Dushaj
- Division of Clinical Neurology, PATH Foundation NY, 304 Park Ave South, Floor 6, New York, NY 10010, USA
| | - Mona Li
- Division of Clinical Neurology, PATH Foundation NY, 304 Park Ave South, Floor 6, New York, NY 10010, USA
| | - Peter K. Thanos
- Research Institute on Addictions, University of Buffalo, 1021 Main Street, Buffalo, NY 14203, USA
| | - Zsolt Demetrovics
- Department of Clinical Psychology and Addiction, Eötvös Loránd University, 1064 Budapest, Izabella Street 46, Hungary
| | - Marcelo Febo
- Department of Psychiatry & McKnight Brain Institute, University of Florida College of Medicine, PO Box 100256, 1149 Newell Dr, L4-100, Gainesville, FL 32611, USA
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Duquette LL, Mattiace F, Blum K, Waite RL, Boland T, McLaughlin T, Dushaj K, Febo M, Badgaiyan RD. Neurobiology of KB220Z-Glutaminergic-Dopaminergic Optimization Complex [GDOC] as a Liquid Nano: Clinical Activation of Brain in a Highly Functional Clinician Improving Focus, Motivation and Overall Sensory Input Following Chronic Intake. ACTA ACUST UNITED AC 2016; 3. [PMID: 29214221 PMCID: PMC5714519 DOI: 10.23937/2378-3656/1410104] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Background With neurogenetic and epigenetic tools utilized in research and neuroimaging, we are unraveling the mysteries of brain function, especially as it relates to Reward Deficiency (RDS). We encourage the development of pharmaceuticals or nutraceuticals that promote a reduction in dopamine resistance and balance brain neurochemistry, leading to dopamine homeostasis. We disclose self-assessment of a highly functional professional under work-related stress following KB220Z use, a liquid (aqua) nano glutaminergic-dopaminergic optimization complex (GDOC). Case presentation Subject took GDOC for one month. Subject self-administered GDOC using one-half-ounce twice a day. During first three days, unique brain activation occurred; resembling white noise after 30 minutes and sensation was strong for 45 minutes and then dissipated. He described effect as if his eyesight improved slightly and pointed out that his sense of smell and sleep greatly improved. Subject experienced a calming effect similar to meditation that could be linked to dopamine release. He also reported control of going over the edge after a hard day’s work, which was coupled with a slight increase in energy, increased motivation to work, increased focus and multi-tasking, with clearer purpose of task at hand. Subject felt less inhibited in a social setting and suggested Syndrome that GDOC increased his Behavior Activating System (reward), while having a decrease in the Behavior Inhibition System (caution). Conclusion These results and other related studies reveal an improved mood, work-related focus, and sleep. These effects as a subjective feeling of brain activation maybe due to direct or indirect dopaminergic interaction. While this case is encouraging, we must await more research in a larger randomized placebo-controlled study to map the role of GDOC, especially in a nano-sized product, to determine the possible effects on circuit inhibitory control and memory banks and the induction of dopamine homeostasis independent of either hypo- or hyper-dopaminergic traits/states.
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Affiliation(s)
- Lucien L Duquette
- New Pathway Counseling Services Inc., Paramus, NJ, USA.,Behavior Wellness Center, Englewood, NJ, USA
| | | | - Kenneth Blum
- Department of Psychiatry & McKnight Brain Institute, University of Florida College of Medicine, Gainesville, FL, USA.,Division of Addiction Services, Dominion Diagnostics, LLC., North Kingstown, RI, USA.,Division of Neuroscience-Based Therapy, Summit Estate Recovery Center, Los Gatos, CA, USA.,Department of Psychiatry & Behavioral Sciences, Keck School of Medicine of USC, Los Angeles, CA, USA.,Department of Clinical Neurology, PATH Foundation NY, New York, NY, USA.,Department of Nutrigenomic Translational Research, LaVita RDS, Salt Lake City, UT, USA.,Division of Neuroscience Research & Addiction Therapy, Shores Treatment & Recovery Center, Port Saint Lucie, FL, USA
| | - Roger L Waite
- Department of Nutrigenomic Translational Research, LaVita RDS, Salt Lake City, UT, USA
| | | | | | - Kristina Dushaj
- Department of Clinical Neurology, PATH Foundation NY, New York, NY, USA
| | - Marcelo Febo
- Department of Psychiatry & McKnight Brain Institute, University of Florida College of Medicine, Gainesville, FL, USA
| | - Rajendra D Badgaiyan
- Department of Psychiatry, Laboratory of Molecular and Functional Imaging, University of Minnesota, Minneapolis, MN, USA
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Vitali M, Napolitano C, Berman MO, Minuto SF, Battagliese G, Attilia ML, Braverman ER, Romeo M, Blum K, Ceccanti M. Neurophysiological Measures and Alcohol Use Disorder (AUD): Hypothesizing Links between Clinical Severity Index and Molecular Neurobiological Patterns. ACTA ACUST UNITED AC 2016; 5. [PMID: 28090374 PMCID: PMC5231399 DOI: 10.4172/2155-6105.1000181] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Background In 1987, Cloninger proposed a clinical description and classification of different personality traits genetically defined and independent from each other. Moreover, he elaborated a specific test the TCI to investigate these traits/states. The study of craving in Alcohol Use Disorder (AUD) assumed a greater significance, since ever more data seems to suggest a direct correlation between high levels of craving and a higher risk of relapse in alcoholics. Thus, our study aim is to explore the possible correlations among TCI linked molecular neurobiological pattern (s), craving and alcohol addiction severity measures in a sample of Italian alcoholics. Materials and Methods 191 alcoholics were recruited in a Day Hospital (DH) setting at the Alcohol Addiction Program Latium Region Referral Center, Sapienza University of Rome. After 7 days detoxification treatment a psychodiagnostic protocol was administered, including TCI, VAS-C, ASI and SADQ. All patients signed an Institutional Review Board (IRB) approved informed consent. Results Principally, we detected a significant positive correlation between HA-scale scores and the VAS scale: increasing in HA-scale corresponds to an increase in craving perception for both intensity (r=0.310; p ≤ 0.001) and frequency (r=0.246; p ≤ 0.001). Moreover, perception of dependence severity, measured with SADQ was also found to be significantly associated positively to both HA-scale (r=0.246; p ≤ 0.001) and NS-scale (r=0.224; p ≤ 0.01). While, for character scales, Persistence (r=−0.195; p=.008) and Self-directedness (r=−0.294; p ≤ 0.001) was negatively associated with ASI linked to alcohol problems. Self-directedness was also negatively correlated with ASI linked to family and social problems (r=−0.349; p ≤ 0.001), employment and support problems (r=−0.220; p=0.003) and psychiatric problems (r=−0.358; p ≤ 0.001). Cooperativeness was a negative correlate with Legal Problems (r=−0.173; p=0.019). and Self-Transcendence was positive correlated with Medical Problems (r=0.276; p ≤ 0.001) Conclusions In view of recent addiction neurobiological theories, such as the “Reward Deficiency Syndrome (RDS)” and the Koob model, our data could suggest that our cohort of patients could possibly be in a particular stage of the course of their addiction history. Thus, if our hypothesis will be confirmed, the TCI-based assessment of alcoholics would allow an optimization of the treatment. Clinicians understanding these newer concepts will be able to translate this information to their patients and potentially enhance clinical outcome (s), because it could suggest a functional hypothesis of neurotransmitter circuits that helps to frame the patient in his/her history of addiction.
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Affiliation(s)
- Mario Vitali
- Alcohol Addiction Program Latium Region Referral Center, Sapienza University of Rome
| | - Carmen Napolitano
- Alcohol Addiction Program Latium Region Referral Center, Sapienza University of Rome
| | - Marlene Oscar Berman
- Department of Psychiatry and Neurology, Boston University School of Medicine and Veterans Administration System, Boston, Massachusetts, USA
| | | | - Gemma Battagliese
- Alcohol Addiction Program Latium Region Referral Center, Sapienza University of Rome
| | - Maria Luisa Attilia
- Alcohol Addiction Program Latium Region Referral Center, Sapienza University of Rome
| | - Eric R Braverman
- Department of Psychiatry & McKnight Brain Institute, University of Florida, College of Medicine, Gainesville, Florida, USA; Department of Clinical Neurology, Path Foundation, NY, New York, New York, USA
| | - Marina Romeo
- Alcohol Addiction Program Latium Region Referral Center, Sapienza University of Rome
| | - Kenneth Blum
- Department of Psychiatry & McKnight Brain Institute, University of Florida, College of Medicine, Gainesville, Florida, USA; Department of Clinical Neurology, Path Foundation, NY, New York, New York, USA; Department of Addiction Research & Therapy, Malibu Beach Recovery Center, Malibu Beach, California, USA; Department of Psychiatry & Human Integrated Services Unit University of Vermont Center for Clinical & Translational Science, College of Medicine, Burlington, Vermont, USA; Department of Nutrigenomics, RD Solutions, LLC, La Jolla, California, USA; Department of Personalized Medicine, IGENE, LLC, Austin, Texas, USA; Dominion Diagnostics, LLC, North Kingstown, Rhode Island, USA; Basic & Clinical Research Center, Victory Nutrition, LLC., Austin, Texas, USA
| | - Mauro Ceccanti
- Alcohol Addiction Program Latium Region Referral Center, Sapienza University of Rome
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Blum K, Febo M, Fahlke C, Archer T, Berggren U, Demetrovics Z, Dushaj K, Badgaiyan RD. Hypothesizing Balancing Endorphinergic and Glutaminergic Systems to Treat and Prevent Relapse to Reward Deficiency Behaviors: Coupling D-Phenylalanine and N-Acetyl-L-Cysteine (NAC) as a Novel Therapeutic Modality. ACTA ACUST UNITED AC 2015; 2. [PMID: 26900600 PMCID: PMC4760695 DOI: 10.23937/2378-3656/1410076] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Kenneth Blum
- Department of Psychiatry, University of Florida College of Medicine, Gainesville, FL, USA; Division of Nutrigenomics, LaVita RDS, LLC, Draper, UT, USA; Division of Applied Clinical Research & Education, Dominion Diagnostics, LLC, North Kingstown, RI, USA; Division of Neuroscience-Based Therapy, Summit Estate Recovery Center, Los Gatos, CA, USA; Division of Clinical Neurology, PATH Foundation NY, New York, NY, USA; Departments of Psychiatry & Behavioral Sciences, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Marcelo Febo
- Department of Psychiatry, University of Florida College of Medicine, Gainesville, FL, USA
| | - Claudia Fahlke
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden
| | - Trevor Archer
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden
| | - U Berggren
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden
| | - Zsolt Demetrovics
- Department of Clinical Psychology and Addiction, Eotvos Lorand University, Budapest, Hungary
| | - Kristina Dushaj
- Division of Clinical Neurology, PATH Foundation NY, New York, NY, USA
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Gold MS, Badgaiyan RD, Blum K. A Shared Molecular and Genetic Basis for Food and Drug Addiction: Overcoming Hypodopaminergic Trait/State by Incorporating Dopamine Agonistic Therapy in Psychiatry. Psychiatr Clin North Am 2015; 38:419-62. [PMID: 26300032 DOI: 10.1016/j.psc.2015.05.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
This article focuses on the shared molecular and neurogenetics of food and drug addiction tied to the understanding of reward deficiency syndrome. Reward deficiency syndrome describes a hypodopaminergic trait/state that provides a rationale for commonality in approaches for treating long-term reduced dopamine function across the reward brain regions. The identification of the role of DNA polymorphic associations with reward circuitry has resulted in new understanding of all addictive behaviors.
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Affiliation(s)
- Mark S Gold
- Departments of Psychiatry & Behavioral Sciences, Keck School of Medicine, University of Southern California, 1975 Zonal Avenue, Los Angeles, CA 90033, USA; Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, St. Louis, MO 63110, USA; Rivermend Health Scientific Advisory Board, 2300 Windy Ridge Parkway South East, Suite 210S, Atlanta, GA 30339, USA; Drug Enforcement Administration (DEA) Educational Foundation, Washington, DC, USA.
| | - Rajendra D Badgaiyan
- Laboratory of Advanced Radiochemistry and Molecular and Functioning Imaging, Department of Psychiatry, College of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Kenneth Blum
- Department of Psychiatry, McKnight Brain Institute, University of Florida College of Medicine, Gainesville, FL, USA; Department of Psychiatry, Center for Clinical & Translational Science, Community Mental Health Institute, University of Vermont College of Medicine, University of Vermont, Burlington, VT, USA; Division of Applied Clinical Research, Dominion Diagnostics, LLC, 211 Circuit Drive, North Kingstown, RI 02852, USA; Rivermend Health Scientific Advisory Board, Atlanta, GA, USA
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Blum K, Thompson B, Demotrovics Z, Femino J, Giordano J, Oscar-Berman M, Teitelbaum S, Smith DE, Roy AK, Agan G, Fratantonio J, Badgaiyan RD, Gold MS. The Molecular Neurobiology of Twelve Steps Program & Fellowship: Connecting the Dots for Recovery. JOURNAL OF REWARD DEFICIENCY SYNDROME 2015; 1:46-64. [PMID: 26306329 PMCID: PMC4545669 DOI: 10.17756/jrds.2015-008] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
There are some who suggest that alcoholism and drug abuse are not diseases at all and that they are not consequences of a brain disorder as espoused recently by the American Society of Addiction Medicine (ASAM). Some would argue that addicts can quit on their own and moderate their alcohol and drug intake. When they present to a treatment program or enter the 12 Step Program & Fellowship, many addicts finally achieve complete abstinence. However, when controlled drinking fails, there may be successful alternatives that fit particular groups of individuals. In this expert opinion, we attempt to identify personal differences in recovery, by clarifying the molecular neurobiological basis of each step of the 12 Step Program. We explore the impact that the molecular neurobiological basis of the 12 steps can have on Reward Deficiency Syndrome (RDS) despite addiction risk gene polymorphisms. This exploration has already been accomplished in part by Blum and others in a 2013 Springer Neuroscience Brief. The purpose of this expert opinion is to briefly, outline the molecular neurobiological and genetic links, especially as they relate to the role of epigenetic changes that are possible in individuals who regularly attend AA meetings. It begs the question as to whether "12 steps programs and fellowship" does induce neuroplasticity and continued dopamine D2 receptor proliferation despite carrying hypodopaminergic type polymorphisms such as DRD2 A1 allele. "Like-minded" doctors of ASAM are cognizant that patients in treatment without the "psycho-social-spiritual trio," may not be obtaining the important benefits afforded by adopting 12-step doctrines. Are we better off with coupling medical assisted treatment (MAT) that favors combining dopamine agonist modalities (DAM) as possible histone-deacetylase activators with the 12 steps followed by a program that embraces either one or the other? While there are many unanswered questions, at least we have reached a time when "science meets recovery," and in doing so, can further redeem joy in recovery.
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Affiliation(s)
- Kenneth Blum
- Department of Psychiatry, School of Medicine and McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Addiction Research and Therapy, Malibu Beach Recovery Center, Malibu Beach, CA, USA
- Dominion Diagnostics, Inc., North Kingstown, RI, USA
- IGENE, LLC., Austin, TX, USA
- RDSolutions, Del Mar, CA, USA
- National Institute for Holistic Medicine, North Miami Beach, FL, USA
| | - Benjamin Thompson
- Behavioral Neuroscience Program, Boston University School of Medicine, and Boston VA Healthcare System, Boston, MA, USA
| | - Zsolt Demotrovics
- Eötvös Loránd University, Institute of Psychology, Budapest, Hungary
| | - John Femino
- Dominion Diagnostics, Inc., North Kingstown, RI, USA
- Meadows Edge Recovery Center, North Kingstown, RI, USA
| | - John Giordano
- National Institute for Holistic Medicine, North Miami Beach, FL, USA
| | - Marlene Oscar-Berman
- Departments of Psychiatry, Neurology, and Anatomy & Neurobiology, Boston University School of Medicine, and Boston VA Healthcare System, Boston, MA, USA
| | - Scott Teitelbaum
- Department of Psychiatry, School of Medicine and McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - David E. Smith
- Dominion Diagnostics, Inc., North Kingstown, RI, USA
- Institute of Health & Aging, University of California at San Francisco, San Francisco, CA, USA
| | | | - Gozde Agan
- Dominion Diagnostics, Inc., North Kingstown, RI, USA
| | | | - Rajendra D. Badgaiyan
- Department of Psychiatry, University of Minnesota College of Medicine, Minneapolis, MN, USA
| | - Mark S. Gold
- Director of Research, Drug Enforcement Administration (DEA) Educational Foundation, Washington, D.C, USA
- Departments of Psychiatry & Behavioral Sciences at the Keck, University of Southern California, School of Medicine, CA, USA
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Blum K, Simpatico T, Badgaiyan RD, Demetrovics Z, Fratantonio J, Agan G, Febo M, Gold MS. Coupling Neurogenetics (GARS™) and a Nutrigenomic Based Dopaminergic Agonist to Treat Reward Deficiency Syndrome (RDS): Targeting Polymorphic Reward Genes for Carbohydrate Addiction Algorithms. JOURNAL OF REWARD DEFICIENCY SYNDROME 2015; 1:75-80. [PMID: 27617300 PMCID: PMC5013730 DOI: 10.17756/jrds.2015-012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Earlier work from our laboratory, showing anti-addiction activity of a nutraceutical consisting of amino-acid precursors and enkephalinase inhibition properties and our discovery of the first polymorphic gene (Dopamine D2 Receptor Gene [DRD2]) to associate with severe alcoholism serves as a blue-print for the development of "Personalized Medicine" in addiction. Prior to the later genetic finding, we developed the concept of Brain Reward Cascade, which continues to act as an important component for stratification of addiction risk through neurogenetics. In 1996 our laboratory also coined the term "Reward Deficiency Syndrome (RDS)" to define a common genetic rubric for both substance and non-substance related addictive behaviors. Following many reiterations we utilized polymorphic targets of a number of reward genes (serotonergic, Opioidergic, GABAergic and Dopaminergic) to customize KB220 [Neuroadaptogen- amino-acid therapy (NAAT)] by specific algorithms. Identifying 1,000 obese subjects in the Netherlands a subsequent small subset was administered various KB220Z formulae customized according to respective DNA polymorphisms individualized that translated to significant decreases in both Body Mass Index (BMI) and weight in pounds. Following these experiments, we have been successfully developing a panel of genes known as "Genetic Addiction Risk Score" (GARSpDX)™. Selection of 10 genes with appropriate variants, a statistically significant association between the ASI-Media Version-alcohol and drug severity scores and GARSpDx was found A variant of KB220Z in abstinent heroin addicts increased resting state functional connectivity in a putative network including: dorsal anterior cingulate, medial frontal gyrus, nucleus accumbens, posterior cingulate, occipital cortical areas, and cerebellum. In addition, we show that KB220Z significantly activates, above placebo, seed regions of interest including the left nucleus accumbens, cingulate gyrus, anterior thalamic nuclei, hippocampus, pre-limbic and infra-limbic loci. KB220Z demonstrates significant functional connectivity, increased brain volume recruitment and enhanced dopaminergic functionality across the brain reward circuitry. We propose a Reward Deficiency System Solution that promotes early identification and stratification of risk alleles by utilizing GARSDx, allowing for customized nutrigenomic targeting of these risk alleles by altering KB220Z ingredients as an algorithmic function of carrying these polymorphic DNA-SNPS, potentially yielding the first ever nutrigenomic solution for addiction and pain.
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Affiliation(s)
- Kenneth Blum
- Department of Psychiatry & McKnight Brain Institute, University of Florida College of Medicine, Gainesville, FL, USA
- Department of Nutrigenomics, RD Solutions Inc., Salt Lake City, UT, USA
- Department of Addiction Research & Therapy, Malibu Beach Recovery Center, Malibu Beach, CA, USA
- Department of Psychiatry, Human Integrated Services Unit, University of Vermont Center for Clinical & Translational Science, University of Vermont College of Medicine, Burlington, VT, USA
- Department of Personalized Addiction Medicine IGENE, LLC, Austin, TX, USA
- Division of Applied Research & Education and Addition Services, Dominion Diagnostics, LLC., North Kingstown RI, USA
- Department of Nutrigenetic & Nutrigenomic Research, Victory Nutrition International, Austin, TX, USA
- Department of Personalized Medicine, Path Foundation, NY, USA
| | - Thomas Simpatico
- Department of Addiction Research & Therapy, Malibu Beach Recovery Center, Malibu Beach, CA, USA
- Division of Applied Research & Education and Addition Services, Dominion Diagnostics, LLC., North Kingstown RI, USA
| | | | - Zsolt Demetrovics
- Eotvos Lorand University, Institute of Psychology, Department of Clinical Psychology and Addiction, Izabella utca, Budapest, Hungary
| | - James Fratantonio
- Division of Applied Research & Education and Addition Services, Dominion Diagnostics, LLC., North Kingstown RI, USA
| | - Gozde Agan
- Division of Applied Research & Education and Addition Services, Dominion Diagnostics, LLC., North Kingstown RI, USA
| | - Marcelo Febo
- Department of Psychiatry & McKnight Brain Institute, University of Florida College of Medicine, Gainesville, FL, USA
| | - Mark S. Gold
- Departments of Psychiatry & Behavioral Sciences, Keck School of Medicine of USC, Los Angeles, CA, USA
- Department of Psychiatry, Washington University School of Medicine. St. Louis, MO, USA
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McLaughlin T, Blum K, Oscar-Berman M, Febo M, Demetrovics Z, Agan G, Fratantonio J, Gold MS. Using the Neuroadaptagen KB200z™ to Ameliorate Terrifying, Lucid Nightmares in RDS Patients: the Role of Enhanced, Brain-Reward, Functional Connectivity and Dopaminergic Homeostasis. JOURNAL OF REWARD DEFICIENCY SYNDROME 2015; 1:24-35. [PMID: 26065033 PMCID: PMC4459746 DOI: 10.17756/jrds.2015-006] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Lucid Dreams are a form of dream life, during which the dreamer may be aware that he/she is dreaming, can stop/re-start the dreams, depending on the pleasantness or unpleasant nature of the dream, and experiences the dream as if he/she were fully awake. Depending on their content, they may be pleasant, un-pleasant or terrifying, at least in the context of patients, who also exhibit characteristics of Reward Deficiency Syndrome (RDS) and Posttraumatic Stress Disorder (PTSD). CASE SERIES We present eight clinical cases, with known substance abuse, childhood abuse and diagnosed PTSD/RDS. The administration of a putative dopamine agonist, KB200Z™, was associated with the elimination of unpleasant and/or terrifying, lucid dreams in 87.5% of the cases presented, whereas one very heavy cocaine abuser showed a minimal response. These results required the continuous use of this nutraceutical. The lucid dreams themselves were distinguishable from typical, PTSD nightmares insofar as their content did not appear to reflect a symbolic rendition of an originally-experienced, historical trauma. Each of the cases was diagnosed with a form of RDS, i.e., ADHD, ADD, and/or Tourette's syndrome. They all also suffered from some form of Post-Traumatic-Stress-Disorder (PTSD) and other psychiatric diagnoses as well. CONCLUSION The reduction or elimination of terrifying Lucid Dreams seemed to be dependent on KB220Z, whereby voluntary stopping of the agent results in reinstatement of the terrifying non-pleasant nature of the dreams. Following more required research on a much larger population we anticipate confirmation of these seemingly interesting observations. If these results in a small number of patients are indeed confirmed we may have found a frontline solution to a very perplexing and complicated symptom known as lucid dreams.
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Affiliation(s)
| | - Kenneth Blum
- Department of Psychiatry and McKnight Brain Institute, University of Florida, College of Medicine, Gainesville, FL, USA
- Department of Clinical Medicine, Malibu Beach Recovery Center, Malibu Beach, CA, USA
- Department of Addiction Medicine, Victory Nutrition International, LLC., Lederoch, PA, USA
- Community Mental Health Institute, Center for Clinical & Translational Science, University of Vermont and Department of Psychiatry, University of Vermont College of Medicine, Burlington, VT, USA
- Dominion Diagnostics, Inc. North Kingstown, RI, USA
- Center for Genomics and Applied Gene Technology, Institute of Integrative Omics and Applied Biotechnology (IIOAB), Nonakuri, Purbe Medinpur, West Bengal, India
- Center for RDS Research, Victory Nutrition, LLC, Austin, TX, USA
- Department of Nutrigenomics, RDSolutions, Inc., Salt Lake City, UT, USA
- Department of Personalized Medicine, IGENE, LLC., Austin, TX, USA
| | - Marlene Oscar-Berman
- Departments of Psychiatry, Anatomy and Neurobiology, and Boston VA and Boston University School of Medicine, MA, USA
| | - Marcelo Febo
- Department of Psychiatry and McKnight Brain Institute, University of Florida, College of Medicine, Gainesville, FL, USA
| | - Zsolt Demetrovics
- Department of Clinical Psychology and Addiction, Institute of Psychology, Eötvös Loránd University, Hungary
| | - Gozde Agan
- Divisions of Addiction Services, & Applied Clinical Research & Education, Dominion Diagnostics, LLC, North Kingstown, RI, USA
| | - James Fratantonio
- Divisions of Addiction Services, & Applied Clinical Research & Education, Dominion Diagnostics, LLC, North Kingstown, RI, USA
| | - Mark S. Gold
- Departments of Psychiatry & Behavioral Sciences at the Keck, University of Southern California, School of Medicine, CA, USA
- Director of Research, Drug Enforcement Administration (DEA) Educational Foundation, Washington, D.C, USA
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McLaughlin T, Blum K, Oscar-Berman M, Febo M, Agan G, Fratantonio JL, Simpatico T, Gold MS. Putative dopamine agonist (KB220Z) attenuates lucid nightmares in PTSD patients: role of enhanced brain reward functional connectivity and homeostasis redeeming joy. J Behav Addict 2015; 4:106-15. [PMID: 26132915 PMCID: PMC4500891 DOI: 10.1556/2006.4.2015.008] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Lucid dreams are frequently pleasant and training techniques have been developed to teach dreamers to induce them. In addition, the induction of lucid dreams has also been used as a way to ameliorate nightmares. On the other hand, lucid dreams may be associated with psychiatric conditions, including Post-Traumatic Stress Disorder (PTSD) and Reward Deficiency Syndrome-associated diagnoses. In the latter conditions, lucid dreams can assume an unpleasant and frequently terrifying character. CASE PRESENTATIONS We present two cases of dramatic alleviation of terrifying lucid dreams in patients with PTSD. In the first case study, a 51-year-old, obese woman, diagnosed with PTSD and depression, had attempted suicide and experienced terrifying lucid nightmares linked to sexual/physical abuse from early childhood by family members including her alcoholic father. Her vivid "bad dreams" remained refractory in spite of 6 months of treatment with Dialectical Behavioral Therapy (DBT) and standard pharmaceutical agents which included prazosin, clonidie and Adderall. The second 39-year-old PTSD woman patient had also suffered from lucid nightmares. RESULTS The medication visit notes reveal changes in the frequency, intensity and nature of these dreams after the complex putative dopamine agonist KB220Z was added to the first patient's regimen. The patient reported her first experience of an extended period of happy dreams. The second PTSD patient, who had suffered from lucid nightmares, was administered KB220Z to attenuate methadone withdrawal symptoms and incidentally reported dreams full of happiness and laughter. CONCLUSIONS These cases are discussed with reference to the known effects of KB220Z including enhanced dopamine homeostasis and functional connectivity of brain reward circuitry in rodents and humans. Their understanding awaits intensive investigation involving large-population, double-blinded studies.
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Affiliation(s)
| | - Kenneth Blum
- Department of Psychiatry and McKnight Brain Institute, University of Florida, College of Medicine, Gainesville, FL, USA,Department of Personalized Medicine, IGENE, LLC, Austin, TX, USA,Division of Applied Clinical Research, Dominion Diagnostics, LLC, North Kingstown, RI, USA,* Corresponding author: Kenneth Blum, PhD; Department of Psychiatry & McKnight Brain Institute, University of Florida, College of Medicine, Box 100183 Gainesville, FL, 32610-0183, USA; Phone: +1-352-392-6680; Fax: +1-352-392-8217; E-mail:
| | - Marlene Oscar-Berman
- Departments of Psychiatry, Neurology, and Anatomy & Neurobiology, Boston University School of Medicine, and Boston VA Healthcare, Boston, MA, USA
| | - Marcelo Febo
- Department of Psychiatry and McKnight Brain Institute, University of Florida, College of Medicine, Gainesville, FL, USA
| | - Gozde Agan
- Division of Addiction Services, Dominion Diagnostics, LLC, North Kingstown, RI, USA
| | - James L. Fratantonio
- Division of Applied Clinical Research, Dominion Diagnostics, LLC, North Kingstown, RI, USA
| | - Thomas Simpatico
- Community Mental Health Institute, Center for Clinical & Translational Science, University of Vermont and Department of Psychiatry, University of Vermont College of Medicine, Burlington, VT, USA
| | - Mark S. Gold
- Department of Psychiatry and McKnight Brain Institute, University of Florida, College of Medicine, Gainesville, FL, USA,Rivermend Health, LLC, Atlanta, GA, USA
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Blum K, Thanos PK, Badgaiyan RD, Febo M, Oscar-Berman M, Fratantonio J, Demotrovics Z, Gold MS. Neurogenetics and gene therapy for reward deficiency syndrome: are we going to the Promised Land? Expert Opin Biol Ther 2015; 15:973-85. [PMID: 25974314 DOI: 10.1517/14712598.2015.1045871] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Addiction is a substantial health issue with limited treatment options approved by the FDA and as such currently available. The advent of neuroimaging techniques that link neurochemical and neurogenetic mechanisms to the reward circuitry brain function provides a framework for potential genomic-based therapies. AREAS COVERED Through candidate and genome-wide association studies approaches, many gene polymorphisms and clusters have been implicated in drug, food and behavioral dependence linked by the common rubric reward deficiency syndrome (RDS). The results of selective studies that include the role of epigenetics, noncoding micro RNAs in RDS behaviors especially drug abuse involving alcohol, opioids, cocaine, nicotine, pain and feeding are reviewed in this article. New targets for addiction treatment and relapse prevention, treatment alternatives such as gene therapy in animal models, and pharmacogenomics and nutrigenomics methods to manipulate transcription and gene expression are explored. EXPERT OPINION The recognition of the clinical benefit of early genetic testing to determine addiction risk stratification and dopaminergic agonistic, rather than antagonistic therapies are potentially the genomic-based wave of the future. In addition, further development, especially in gene transfer work and viral vector identification, could make gene therapy for RDS a possibility in the future.
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Affiliation(s)
- Kenneth Blum
- Department of Psychiatry & McKnight Brain Institute, University of Florida College of Medicine , Gainesville, FL , USA
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Blum K, Febo M, Thanos PK, Baron D, Fratantonio J, Gold M. Clinically Combating Reward Deficiency Syndrome (RDS) with Dopamine Agonist Therapy as a Paradigm Shift: Dopamine for Dinner? Mol Neurobiol 2015; 52:1862-1869. [PMID: 25750061 PMCID: PMC4586005 DOI: 10.1007/s12035-015-9110-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Accepted: 01/21/2015] [Indexed: 01/23/2023]
Abstract
Everyday, there are several millions of people that are increasingly unable to combat their frustrating and even fatal romance with getting high and/or experiencing “normal” feelings of well-being. In the USA, the FDA has approved pharmaceuticals for drug and alcohol abuse: tobacco and nicotine replacement therapy. The National Institute on Drug Abuse (NIDA) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA) remarkably continue to provide an increasing understanding of the intricate functions of brain reward circuitry through sophisticated neuroimaging and molecular genetic applied technology. Similar work is intensely investigated on a worldwide basis with enhanced clarity and increased interaction between not only individual scientists but across many disciplines. However, while it is universally agreed that dopamine is a major neurotransmitter in terms of reward dependence, there remains controversy regarding how to modulate its role clinically to treat and prevent relapse for both substance and non-substance-related addictive behaviors. While the existing FDA-approved medications promote blocking dopamine, we argue that a more prudent paradigm shift should be biphasic—short-term blockade and long-term upregulation, enhancing functional connectivity of brain reward circuits.
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Affiliation(s)
- Kenneth Blum
- Department of Psychiatry and McKnight Brain Institute, College of Medicine, University of Florida, P. O. Box 100256, Gainesville, FL 32610-0256 USA
- Human Integrated Services Unit, Center for Clinical and Translational Science, Department of Psychiatry, College of Medicine, University of Vermont, Burlington, VT USA
- Division of Applied Clinical Research, Dominion Diagnostics, LLC, North Kingstown, RI USA
- Department of Addiction Research and Therapy, Malibu Beach Recovery Center, Malibu, CA USA
| | - Marcelo Febo
- Department of Psychiatry and McKnight Brain Institute, College of Medicine, University of Florida, P. O. Box 100256, Gainesville, FL 32610-0256 USA
| | - Panayotis K. Thanos
- Behavior Neuropharmacology and Neuroimaging Laboratory, Department of Psychology, SUNY at Stony Brook, Stony Brook, NY USA
| | - David Baron
- Department of Psychiatry, Keck School of Medicine, University of Southern California, Los Angeles, CA USA
- Keck School of Medicine, University of Southern California, Los Angeles, CA USA
| | - James Fratantonio
- Division of Applied Clinical Research, Dominion Diagnostics, LLC, North Kingstown, RI USA
| | - Mark Gold
- Department of Psychiatry and McKnight Brain Institute, College of Medicine, University of Florida, P. O. Box 100256, Gainesville, FL 32610-0256 USA
- Department of Research, Rivermernd Health, Atlanta, GA USA
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Blum K, Badgaiyan RD, Demotrovics Z, Fratantonio J, Agan G, Febo M. Can Genetic Testing Provide Information to Develop Customized Nutrigenomic Solutions for Reward Deficiency Syndrome? ACTA ACUST UNITED AC 2015. [PMID: 26225358 DOI: 10.23937/2378-3656/1410018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Kenneth Blum
- Department of Psychiatry & McKnight Brain Institute, University of Florida College of Medicine, USA ; National Institute of Holistic Addiction Studies, USA
| | - Rajendra D Badgaiyan
- RD Solutions Inc, Salt Lake City Utah, USA ; Department of Psychiatry, University of Minnesota, College of Medicine, USA
| | - Zsolt Demotrovics
- Eotvos Lorand University, Institute of Psychology, Department of Clinical Psychology and Addiction, Hungary
| | - James Fratantonio
- Eotvos Lorand University, Institute of Psychology, Department of Clinical Psychology and Addiction, Hungary
| | - Gozde Agan
- Department of Psychiatry & McKnight Brain Institute, University of Florida College of Medicine, USA
| | - Marcelo Febo
- Department of Psychiatry & McKnight Brain Institute, University of Florida College of Medicine, USA
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Blum K, Liu Y, Wang W, Wang Y, Zhang Y, Oscar-Berman M, Smolen A, Febo M, Han D, Simpatico T, Cronjé FJ, Demetrovics Z, Gold MS. rsfMRI effects of KB220Z™ on neural pathways in reward circuitry of abstinent genotyped heroin addicts. Postgrad Med 2014; 127:232-41. [PMID: 25526228 DOI: 10.1080/00325481.2015.994879] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Recently, Willuhn et al. reported that cocaine use and even non-substance-related addictive behavior increases as dopaminergic function is reduced. Chronic cocaine exposure has been associated with decreases in D2/D3 receptors and was also associated with lower activation of cues in occipital cortex and cerebellum, in a recent PET study by Volkow's et al. Therefore, treatment strategies, like dopamine agonist therapy, that might conserve dopamine function may be an interesting approach to relapse prevention in psychoactive drug and behavioral addictions. To this aim, we evaluated the effect of KB220Z™ on reward circuitry of 10 heroin addicts undergoing protracted abstinence (average 16.9 months). In a randomized placebo-controlled crossover study of KB220Z, five subjects completed a triple-blinded experiment in which the subject, the person administering the treatment, and the person evaluating the response to treatment were blinded to the treatment that any particular subject was receiving. In addition, nine subjects were genotyped utilizing the GARSDX™ test. We preliminarily report that KB220Z induced an increase in BOLD activation in caudate-accumbens-dopaminergic pathways compared to placebo following 1-hour acute administration. Furthermore, KB220Z also reduced resting-state activity in the putamen of abstinent heroin addicts. In the second phase of this pilot study of all 10 abstinent heroin-dependent subjects, we observed that three brain regions of interest were significantly activated from resting state by KB220Z compared to placebo (p < 0.05). Increased functional connectivity was observed in a putative network that included the dorsal anterior cingulate, medial frontal gyrus, nucleus accumbens, posterior cingulate, occipital cortical areas, and cerebellum. These results and other quantitative electroencephalogy (qEEG) study results suggest a putative anti-craving/anti-relapse role of KB220Z in addiction by direct or indirect dopaminergic interaction. Due to small sample size, we caution definitive interpretation of these preliminary results, and confirmation with additional research and ongoing rodent and human studies of KB220Z is required.
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Affiliation(s)
- Kenneth Blum
- Department of Psychiatry & McKnight Brain Institute, University of Florida, College of Medicine , Gainesville, FL , USA
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Blum K, Schoenthaler SJ, Oscar-Berman M, Giordano J, Madigan MA, Braverman ER, Han D. Drug abuse relapse rates linked to level of education: can we repair hypodopaminergic-induced cognitive decline with nutrient therapy? PHYSICIAN SPORTSMED 2014; 42:130-45. [PMID: 24875980 DOI: 10.3810/psm.2014.05.2065] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
It is well known that athletes and other individuals who have suffered painful injuries are at increased risk for all reward deficiency syndrome (RDS) behaviors, including substance use disorder (SUD). Comparing patient demographics and relapse rates in chemical dependence programs is pertinent because demographics may affect outcomes. Increased risk for relapse and lower academic achievement were found to have a significant association in recent outcome data from a holistic treatment center (HTC) located in North Miami Beach, FL. Relapse outcomes from the Drug Addiction Treatment Outcome Study (DATOS; n = 1738) and HTC (n = 224) were compared for a 12-month period. Post-discharge relapse was reported by 26% of HTC patients and 58% of patients in DATOS. When broken out by education level-less than high school, high school diploma, college degree, and graduate degree-HTC patient relapse was 50%, 36%, 33%, and 16%, respectively, and demonstrated an inverse linear association (F = 5.702; P = 0.017). Looking at DATOS patient relapse rates broken down by educational grades/years completed, patients who attended school between 7th grade and 4 years of college also demonstrated an inverse linear association (F = 5.563; P = 0.018). Additionally, the lowest performers, patients who reported their academic performance as "not so good," had the highest relapse (F = 4.226; P = 0.04). Albeit certain limitations, compared with DATOS patients, HTC patients produced significantly larger net differences in relapse rates (X 2 = 84.09; P = 0.0001), suggesting that other variables, such as the treatment model may also affect patient relapse. Our results implicate the use of vitamin and mineral supplements coupled with a well-researched natural dopamine agonist nutrient therapy; both have been shown to improve cognition and behavior, and thus academic achievement. That relapse is highest among addicts who have less education and who report lower grades is a factor that can be useful when considering treatment type and controlled for when comparing treatment outcomes.
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Affiliation(s)
- Kenneth Blum
- Department of Psychiatry and McKnight Brain Institute, University of Florida College of Medicine, Gainesville, FL.
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Waite RL, Oscar-Berman M, RBraverman E, Barh D, Blum K. Quantitative Electroencephalography Analysis (qEEG) of Neuro-Electro-Adaptive Therapy 12™ [NEAT12] Up-Regulates Cortical Potentials in an Alcoholic during Protracted Abstinence: Putative Anti-Craving Implications. ACTA ACUST UNITED AC 2014; 5:1-7. [PMID: 25927012 PMCID: PMC4410813 DOI: 10.4172/2155-6105.1000171] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
INTRODUCTION Cranial electrotherapy stimulation (CES) is a noninvasive therapy that has been used for decades in the United States to treat anxiety, depression, and insomnia in the general population. The effectiveness of CES has been questioned by many and its use is considered controversial. In this study we are presenting data on one alcoholic patient using a newly engineered device we call Neuro-Electro-Adaptive Therapy 12™ [NEAT12]. This hybrid device utilizes TENS current characteristics yielding CES effects. This device has been found to primarily target the excitation of the Cingulate Gyrus region of the brain. CASE PRESENTATION This is a 42 year old male who has been abstinent from alcohol for approximately two months. The data presented herein represents the pre to post qEEG differences of an alcoholic in protracted abstinence. This subject was evaluated both before and after using the NEAT-12 device. The pre to post comparisons suggest that the cortical potentials especially at the Cingulate Gyrus are up regulated after using the device. The absolute power changes obtained shows a decrease of more than 2 SD as noted in the delta wave spectrum. Also noted is an overall cortical increase in the alpha spectrum. The resting alert state of a neuro typical population is most prominently marked by a regulation of 7.5-11 Hz alpha throughout the cortex. The decreased in delta and theta suggests an up regulation of the prefrontal cortex and the anterior Cingulate Gyrus a site involved in substance use disorder (SUD). CONCLUSION A presence of dominant slow waves through the prefrontal cortex and the anterior Cingulate Gyrus is often associated with OCD, anxiety, impulsivity and cravings in addicted populations. It is conceivable that our initial finding of altered electrical activity of the brain using qEEG analysis suggests the NEAT-12 may induce a "normalization" of aberrant electrical activity of the cortical region of the brain known to occur during protracted abstinence of alcoholics. It may have utility as a putative anti-craving CES device and therefore warrants intensive investigation.
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Affiliation(s)
- Roger L Waite
- Department of Nutrigenomic Research, Bio-Clarity, LLC, San Diego, California USA
| | - Marlene Oscar-Berman
- Department of Psychiatry and Neurology, Boston University School of Medicine and Veterans Administration System, Boston, Massachusetts, USA
| | - Eric RBraverman
- Department of Psychiatry, University of Florida, College of Medicine and McKnight Brain Institute, Gainesville, Florida, USA ; Path Foundation NY, New York, New York, USA
| | - Debmalya Barh
- Center for Genomics and Applied Gene Therapy, Institute of Integrative Omics and Applied Biotechnology (IIOAB),Nonakuri, Purba Medinipur, West Bengal, India
| | - Kenneth Blum
- Department of Nutrigenomic Research, Bio-Clarity, LLC, San Diego, California USA ; Department of Psychiatry, University of Florida, College of Medicine and McKnight Brain Institute, Gainesville, Florida, USA ; Center for Genomics and Applied Gene Therapy, Institute of Integrative Omics and Applied Biotechnology (IIOAB),Nonakuri, Purba Medinipur, West Bengal, India ; Department of Addiction Research & Therapy, Malibu Beach Recovery Center, Malibu Beach, California, USA ; Dominion Diagnostics, LLC, North Kingstown, Rhode Island, USA ; Path Foundation NY, New York, New York, USA
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Downs BW, Oscar-Berman M, Waite RL, Madigan MA, Giordano J, Beley T, Jones S, Simpatico T, Hauser M, Borsten J, Marcelo F, Braverman ER, Lohmann R, Dushaj K, Helman M, Barh D, Schoenthaler ST, Han D, Blum K. Have We Hatched the Addiction Egg: Reward Deficiency Syndrome Solution System™. JOURNAL OF GENETIC SYNDROMES & GENE THERAPY 2013; 4:14318. [PMID: 24077767 PMCID: PMC3783340 DOI: 10.4172/2157-7412.1000136] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This article co-authored by a number of scientists, ASAM physicians, clinicians, treatment center owners, geneticists, neurobiologists, psychologists, social workers, criminologists, nurses, nutritionist, and students, is dedicated to all the people who have lost loved ones in substance-abuse and "reward deficiency syndrome" related tragedies. Why are we failing at reducing the incidence of 'Bad Behaviors'? Are we aiming at the wrong treatment targets for behavioral disorders? We are proposing a paradigm shift and calling it "Reward Deficiency Solution System" providing evidence for its adoption.
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Affiliation(s)
- BW Downs
- Department of Nutrigenomics, LifeGen, Inc., Austin, Texas, USA
| | - M Oscar-Berman
- Department of Psychiatry, Anatomy & Neurobiology, Boston VA and Boston University School of Medicine, Boston Massachusetts, USA
| | - RL Waite
- Department of Nutrigenomics, LifeGen, Inc., Austin, Texas, USA
| | - MA Madigan
- Department of Nutrigenomics, LifeGen, Inc., Austin, Texas, USA
| | - J Giordano
- Department of Holistic Medicine, G&G Health Care Services, LLC., North Miami Beach Florida, USA
| | - T Beley
- Department of Holistic Medicine, G&G Health Care Services, LLC., North Miami Beach Florida, USA
| | - S Jones
- Department of Holistic Medicine, G&G Health Care Services, LLC., North Miami Beach Florida, USA
| | - T Simpatico
- Department of Psychiatry, Global Integrated Services Unit of Vermont Center for Clinical & Translational Science, College of Medicine, Burlington, Vermont, USA
| | - M Hauser
- Dominion Diagnostics, LLc, North Kingstown, Rhode Island, USA
| | - J Borsten
- Department of Addiction Research & Therapy, Malibu Beach Recovery Center, Malibu Beach, California, USA
| | - F Marcelo
- Department of Psychiatry & Mcknight Brain Institute, University of Florida, College of Medicine, Gainesville, Florida, USA
| | | | | | - K Dushaj
- Path Foundation NY, New York, USA
| | - M Helman
- Willamette Valley Treatment center, Salem, Oregon, USA
| | - D Barh
- Institute of Integrative Omics & Applied Biotechnology, Nonakuri, India
| | - ST Schoenthaler
- Department of Sociology, California State University, Turlock, CA, USA
| | - D Han
- Department of Management Science and Statistics, University of Texas at San Antonio, San Antonio, Texas, USA
| | - K Blum
- Department of Nutrigenomics, LifeGen, Inc., Austin, Texas, USA
- Department of Holistic Medicine, G&G Health Care Services, LLC., North Miami Beach Florida, USA
- Department of Psychiatry, Global Integrated Services Unit of Vermont Center for Clinical & Translational Science, College of Medicine, Burlington, Vermont, USA
- Dominion Diagnostics, LLc, North Kingstown, Rhode Island, USA
- Department of Addiction Research & Therapy, Malibu Beach Recovery Center, Malibu Beach, California, USA
- Department of Psychiatry & Mcknight Brain Institute, University of Florida, College of Medicine, Gainesville, Florida, USA
- Path Foundation NY, New York, USA
- Institute of Integrative Omics & Applied Biotechnology, Nonakuri, India
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Mclaughlin T, Oscar-Berman M, Simpatico T, Giordano J, Jones S, Barh D, Downs WB, Waite RL, Madigan M, Dushaj K, Lohmann R, Braverman ER, Han D, Blum K. Hypothesizing repetitive paraphilia behavior of a medication refractive Tourette's syndrome patient having rapid clinical attenuation with KB220Z-nutrigenomic amino-acid therapy (NAAT). J Behav Addict 2013; 2:117-24. [PMID: 26165932 DOI: 10.1556/jba.2.2013.2.8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background and aims Many patients presenting multiple behaviors including drug and food abuse as well as other pathological repetitive unwanted activities such as gambling, self-mutilation and paraphilias may not be appropriately diagnosed. Here we present a case of a male presenting many of these seemingly diverse behaviors and finally diagnosed with reward deficiency syndrome (RDS) by his attending physician. Methods The use of the dopamine agonist, ropinirole after two weeks showed improvement in terms of sexual behavior but tolerance set in and was discontinued especially when an infraction occurred with the patient's insurance. In this article, we carefully explore the potential of ropinirole to downregulate dopamine receptors causing adenylate cyclase receptor supersensitivity and tolerance a feature of neurotransmitter cross-talk. Based on previous scientific evidence showing KB220Znutrigenomic amino-acid therapy (NAAT) to rapidly (post one-hour) activate dopaminergic pathways in both the pre-frontal cortex cingulate gyrus (relapse loci) and ventral tegmental area-caudate-accumbens-putamen (craving and emotion loci) the patient was prescribed NAAT. Results and discussion Within one week of utilization the repetitive paraphilia was eliminated. There were also a number of other positive effects such as enhanced focus that persisted even after the patient stopped using KB220Z suggesting neuroplasticity (e.g. altruistic thoughts). However, these observed profound benefits require more in-depth study, especially in a large cohort against a placebo. While this report focused on a rapid response rather than long-term benefits previously associated with NAAT, it is somewhat encouraging and longer term required follow-up and larger placebo controlled studies are warranted before any definitive conclusions could be gleaned from this case report.
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Harrison R, Rucklidge JJ, Blampied N. Use of Micronutrients Attenuates Cannabis and Nicotine Abuse as Evidenced From a Reversal Design: A Case Study. J Psychoactive Drugs 2013; 45:168-78. [DOI: 10.1080/02791072.2013.785840] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Blum K, Oscar-Berman M, Stuller E, Miller D, Giordano J, Morse S, McCormick L, Downs WB, Waite RL, Barh D, Neal D, Braverman ER, Lohmann R, Borsten J, Hauser M, Han D, Liu Y, Helman M, Simpatico T. Neurogenetics and Nutrigenomics of Neuro-Nutrient Therapy for Reward Deficiency Syndrome (RDS): Clinical Ramifications as a Function of Molecular Neurobiological Mechanisms. ACTA ACUST UNITED AC 2013; 3:139. [PMID: 23926462 DOI: 10.4172/2155-6105.1000139] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
In accord with the new definition of addiction published by American Society of Addiction Medicine (ASAM) it is well-known that individuals who present to a treatment center involved in chemical dependency or other documented reward dependence behaviors have impaired brain reward circuitry. They have hypodopaminergic function due to genetic and/or environmental negative pressures upon the reward neuro-circuitry. This impairment leads to aberrant craving behavior and other behaviors such as Substance Use Disorder (SUD). Neurogenetic research in both animal and humans revealed that there is a well-defined cascade in the reward site of the brain that leads to normal dopamine release. This cascade has been termed the "Brain Reward Cascade" (BRC). Any impairment due to either genetics or environmental influences on this cascade will result in a reduced amount of dopamine release in the brain reward site. Manipulation of the BRC has been successfully achieved with neuro-nutrient therapy utilizing nutrigenomic principles. After over four decades of development, neuro-nutrient therapy has provided important clinical benefits when appropriately utilized. This is a review, with some illustrative case histories from a number of addiction professionals, of certain molecular neurobiological mechanisms which if ignored may lead to clinical complications.
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Affiliation(s)
- Kenneth Blum
- Department of Psychiatry, University of Florida, McKnight Brain Institute, Gainesville, Fl, 100183, USA ; Department of Nutrigenomic, LifeGen, Inc. San Diego, CA, 92101, USA ; Department of Holistic Medicine, G&G Holistic Addiction Treatment Center, North Miami Beach, Fl, 33162, USA ; Center for Genomics and Applied Gene Technology, Institute of Integrative Omics and applied Biotechnology (IIOAB), Nonakuri, Purbe Medinpur, West Bengal, 721172, India ; Path Foundation NY, New York, 10001, New York USA ; Malibu Beach Recovery Center, Malibu Beach, California, 9026, USA ; Dominion Diagnostics, North Kingstown Rhode Island, 02852, USA ; Global Integrated Services Unit University of Vermont Center for Clinical & Translational Science, College of Medicine, Burlington, VT, USA
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Miller M, Chen ALC, Stokes SD, Silverman S, Bowirrat A, Manka M, Manka D, Miller DK, Perrine K, Chen TJH, Bailey JA, Downs W, Waite RL, Madigan MA, Braverman ER, Damle U, Kerner M, Giordano J, Morse S, Oscar-Berman M, Barh D, Blum K. Early intervention of intravenous KB220IV--neuroadaptagen amino-acid therapy (NAAT) improves behavioral outcomes in a residential addiction treatment program: a pilot study. J Psychoactive Drugs 2012; 44:398-409. [PMID: 23457891 PMCID: PMC4074362 DOI: 10.1080/02791072.2012.737727] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Substance use disorders (SUD) are inheritable and the culprit is hypodopaminergic function regulated by reward genes. We evaluated a natural dopaminergic agonist; KB220 intravenous (IV) and oral variants, to improve dopaminergic function in SUD. Our pilot experiment found a significant reduction of chronic symptoms, measured by the Chronic Abstinence Symptom Severity (CASS) Scale. The combined group (IV and oral) did significantly better than the oral-only group over the first week and 30-day follow-up period. Next, the combination was given to 129 subjects and three factors; Emotion, Somatic, and Impaired Cognition, with eigenvalues greater than one were extracted for baseline CASS-Revised (CASS-R) variables. Paired sample t-tests for pre and post-treatment scales showed significant declines (p = .00001) from pre- to post-treatment: t = 19.1 for Emotion, t = 16.1 for Somatic, and t = 14.9 for Impaired Cognition. In a two-year follow-up of 23 subjects who underwent KB220IV therapy (at least five IV treatments over seven days) plus orals for 30+ days: 21 (91%) were sober at six months, 19 (82%) having no relapse; 19 (82%) were sober at one year, 18 (78%) having no relapse; and 21 (91%) were sober two-years post-treatment, 16(70%) having no relapse. We await additional research and advise caution in interpreting these encouraging results.
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Blum K, Oscar-Berman M, Giordano J, Downs BW, Simpatico T, Han D, Femino J. Neurogenetic Impairments of Brain Reward Circuitry Links to Reward Deficiency Syndrome (RDS): Potential Nutrigenomic Induced Dopaminergic Activation. JOURNAL OF GENETIC SYNDROMES & GENE THERAPY 2012; 3:1000e115. [PMID: 23264886 PMCID: PMC3525955 DOI: 10.4172/2157-7412.1000e115] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Work from our laboratory in both in-patient and outpatient facilities utilizing the Comprehensive Analysis of Reported Drugs (CARD)(™) found a significant lack of compliance to prescribed treatment medications and a lack of abstinence from drugs of abuse during active recovery. This unpublished, ongoing research provides an impetus to develop accurate genetic diagnosis and holistic approaches that will safely activate brain reward circuitry in the mesolimbic dopamine system. This editorial focuses on the neurogenetics of brain reward systems with particular reference to genes related to dopaminergic function. The terminology "Reward Deficiency Syndrome" (RDS), used to describe behaviors found to have an association with gene-based hypodopaminergic function, is a useful concept to help expand our understanding of Substance Use Disorder (SUD), process addictions, and other obsessive, compulsive and impulsive behaviors. This editorial covers the neurological basis of pleasure and the role of natural and unnatural reward in motivating and reinforcing behaviors. Additionally, it briefly describes the concept of natural dopamine D2 receptor agonist therapy coupled with genetic testing of a panel of reward genes, the Genetic Addiction Risk Score (GARS). It serves as a spring-board for this combination of novel approaches to the prevention and treatment of RDS that was developed from fundamental genomic research. We encourage further required studies.
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Affiliation(s)
- K Blum
- Department of Psychiatry & McKnight Brain Institute, University of Florida, College of Medicine, Gainesville, FL, USA
- G & G Holistic Addiction Treatment Center, North Miami Beach, FL, USA
- Dominion Diagnostics, Inc. North Kingstown, Rhode Island, USA
- Path Foundation NY, New York, NY, USA
- Department of Addiction Research a & Therapy, Malibu Beach Recovery Center, Malibu Beach, CA, USA
- Department of Nutrigenomics, LifeGen, Inc., Austin, TX, USA
- Institute of Integrative Omics & Applied Biotechnology, Nonakuri, Purba Medinipur, West Bengal, India
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - M Oscar-Berman
- Departments of Psychiatry, Neurology, and Anatomy & Neurobiology, Boston University School of Medicine, and Boston VA Healthcare System, Boston, MA, USA
| | - J Giordano
- G & G Holistic Addiction Treatment Center, North Miami Beach, FL, USA
| | - BW Downs
- Department of Nutrigenomics, LifeGen, Inc., Austin, TX, USA
| | - T Simpatico
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - D Han
- Department of Management Science and Statistics, University of Texas at San Antonio, San Antonio, TX, USA
| | - John Femino
- Meadows Edge Treatment Center, North Kingstown, RI, USA
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Blum K, Werner T, Carnes S, Carnes P, Bowirrat A, Giordano J, Oscar-Berman M, Gold M. Sex, drugs, and rock 'n' roll: hypothesizing common mesolimbic activation as a function of reward gene polymorphisms. J Psychoactive Drugs 2012; 44:38-55. [PMID: 22641964 DOI: 10.1080/02791072.2012.662112] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
The nucleus accumbens, a site within the ventral striatum, plays a prominent role in mediating the reinforcing effects of drugs of abuse, food, sex, and other addictions. Indeed, it is generally believed that this structure mandates motivated behaviors such as eating, drinking, and sexual activity, which are elicited by natural rewards and other strong incentive stimuli. This article focuses on sex addiction, but we hypothesize that there is a common underlying mechanism of action for the powerful effects that all addictions have on human motivation. That is, biological drives may have common molecular genetic antecedents, which if impaired, lead to aberrant behaviors. Based on abundant scientific support, we further hypothesize that dopaminergic genes, and possibly other candidate neurotransmitter-related gene polymorphisms, affect both hedonic and anhedonic behavioral outcomes. Genotyping studies already have linked gene polymorphic associations with alcohol and drug addictions and obesity, and we anticipate that future genotyping studies of sex addicts will provide evidence for polymorphic associations with specific clustering of sexual typologies based on clinical instrument assessments. We recommend that scientists and clinicians embark on research coupling the use of neuroimaging tools with dopaminergic agonistic agents to target specific gene polymorphisms systematically for normalizing hyper- or hypo-sexual behaviors.
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Affiliation(s)
- Kenneth Blum
- Department of Psychiatry, University of Florida College of Medicine and McKnight Brain Institute, Gainesville, FL 32610-0256, USA.
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Hasan Mohajeri M, Goralczyk R, Dimpfel W. Modulation of Neurotransmission by a Specified Oregano Extract Alters Brain Electrical Potentials Indicative of Antidepressant-Like and Neuroprotective Activities. ACTA ACUST UNITED AC 2012. [DOI: 10.4236/nm.2012.31006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Blum K, Bailey J, Gonzalez AM, Oscar-Berman M, Liu Y, Giordano J, Braverman E, Gold M. Neuro-Genetics of Reward Deficiency Syndrome (RDS) as the Root Cause of "Addiction Transfer": A New Phenomenon Common after Bariatric Surgery. JOURNAL OF GENETIC SYNDROMES & GENE THERAPY 2011; 2012:S2-001. [PMID: 23483116 PMCID: PMC3593106 DOI: 10.4172/2157-7412.s2-001] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Now after many years of successful bariatric (weight-loss) surgeries directed at the obesity epidemic clinicians are reporting that some patients are replacing compulsive overeating with newly acquired compulsive disorders such as alcoholism, gambling, drugs, and other addictions like compulsive shopping and exercise. This review article explores evidence from psychiatric genetic animal and human studies that link compulsive overeating and other compulsive disorders to explain the phenomenon of addiction transfer. Possibly due to neurochemical similarities, overeating and obesity may act as protective factors reducing drug reward and addictive behaviors. In animal models of addiction withdrawal from sugar induces imbalances in the neurotransmitters, acetylcholine and dopamine, similar to opiate withdrawal. Many human neuroimaging studies have supported the concept of linking food craving to drug craving behavior. Previously our laboratory coined the term Reward Deficiency Syndrome (RDS) for common genetic determinants in predicting addictive disorders and reported that the predictive value for future RDS behaviors in subjects carrying the DRD2 Taq A1 allele was 74%. While poly genes play a role in RDS, we have also inferred that disruptions in dopamine function may predispose certain individuals to addictive behaviors and obesity. It is now known that family history of alcoholism is a significant obesity risk factor. Therefore, we hypothesize here that RDS is the root cause of substituting food addiction for other dependencies and potentially explains this recently described Phenomenon (addiction transfer) common after bariatric surgery.
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Affiliation(s)
- Kenneth Blum
- Department of Psychiatry, Mcknight Brain Institute, University of Florida, College of Medicine, Gainesville, Florida, USA
- Department of Holistic Medicine, G & G Holistic Addiction Treatment Center, North Miami Beach, Florida, USA
- Department of Clinical Neurology, PATH Foundation NY, New York, USA
| | - John Bailey
- Department of Psychiatry, Mcknight Brain Institute, University of Florida, College of Medicine, Gainesville, Florida, USA
| | - Anthony M Gonzalez
- Department of General and Bariatric Surgery, South Miami Hospital, Miami, Florida, USA
| | - Marlene Oscar-Berman
- Department of Veterans Affairs Healthcare System, and Boston University School of Medicine, Boston, MA, USA
| | - Yijun Liu
- Department of Psychiatry, Mcknight Brain Institute, University of Florida, College of Medicine, Gainesville, Florida, USA
| | - John Giordano
- Department of Holistic Medicine, G & G Holistic Addiction Treatment Center, North Miami Beach, Florida, USA
| | - Eric Braverman
- Department of Clinical Neurology, PATH Foundation NY, New York, USA
- Department of Neurosurgery, Weill Cornell College of Medicine, New York, USA
| | - Mark Gold
- Department of Psychiatry, Mcknight Brain Institute, University of Florida, College of Medicine, Gainesville, Florida, USA
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Blum K, Chen TJH, Bailey J, Bowirrat A, Femino J, Chen ALC, Simpatico T, Morse S, Giordano J, Damle U, Kerner M, Braverman ER, Fornari F, Downs BW, Rector C, Barh D, Oscar-Berman M. Can the chronic administration of the combination of buprenorphine and naloxone block dopaminergic activity causing anti-reward and relapse potential? Mol Neurobiol 2011; 44:250-68. [PMID: 21948099 DOI: 10.1007/s12035-011-8206-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2011] [Accepted: 09/07/2011] [Indexed: 01/21/2023]
Abstract
Opiate addiction is associated with many adverse health and social harms, fatal overdose, infectious disease transmission, elevated health care costs, public disorder, and crime. Although community-based addiction treatment programs continue to reduce the harms of opiate addiction with narcotic substitution therapy such as methadone maintenance, there remains a need to find a substance that not only blocks opiate-type receptors (mu, delta, etc.) but also provides agonistic activity; hence, the impetus arose for the development of a combination of narcotic antagonism and mu receptor agonist therapy. After three decades of extensive research, the federal Drug Abuse Treatment Act 2000 (DATA) opened a window of opportunity for patients with addiction disorders by providing increased access to options for treatment. DATA allows physicians who complete a brief specialty-training course to become certified to prescribe buprenorphine and buprenorphine/naloxone (Subutex, Suboxone) for treatment of patients with opioid dependence. Clinical studies indicate that buprenorphine maintenance is as effective as methadone maintenance in retaining patients in substance abuse treatment and in reducing illicit opioid use. With that stated, we must consider the long-term benefits or potential toxicity attributed to Subutex or Suboxone. We describe a mechanism whereby chronic blockade of opiate receptors, in spite of only partial opiate agonist action, may ultimately block dopaminergic activity causing anti-reward and relapse potential. While the direct comparison is not as yet available, toxicity to buprenorphine can be found in the scientific literature. In considering our cautionary note in this commentary, we are cognizant that, to date, this is what we have available, and until such a time when the real magic bullet is discovered, we will have to endure. However, more than anything else this commentary should at least encourage the development of thoughtful new strategies to target the specific brain regions responsible for relapse prevention.
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Affiliation(s)
- Kenneth Blum
- Department of Psychiatry and McKnight Brain Institute, University of Florida College of Medicine, Gainesville, FL 32610, USA.
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Neuro-chemical activation of brain reward meso-limbic circuitry is associated with relapse prevention and drug hunger: A hypothesis. Med Hypotheses 2011; 76:576-84. [DOI: 10.1016/j.mehy.2011.01.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2010] [Revised: 11/22/2010] [Accepted: 01/06/2011] [Indexed: 12/31/2022]
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Chen TJ, Blum K, Chen AL, Bowirrat A, Downs WB, Madigan MA, Waite RL, Bailey JA, Kerner M, Yeldandi S, Majmundar N, Giordano J, Morse S, Miller D, Fornari F, Braverman ER. Neurogenetics and Clinical Evidence for the Putative Activation of the Brain Reward Circuitry by a Neuroadaptagen: Proposing an Addiction Candidate Gene Panel Map. J Psychoactive Drugs 2011; 43:108-27. [DOI: 10.1080/02791072.2011.587393] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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