1
|
Morgan CJA. Commentary on Keyes and Patrick: Changes in psychedelic use in the United States may require changes in our narrative of psychedelic harms. Addiction 2023; 118:2455-2456. [PMID: 37919093 DOI: 10.1111/add.16367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 09/25/2023] [Indexed: 11/04/2023]
Affiliation(s)
- Celia J A Morgan
- Department of Psychology, University of Exeter, Washington Singer Labs, Exeter, UK
| |
Collapse
|
2
|
Ruffell SGD, Netzband N, Tsang W, Davies M, Inserra A, Butler M, Rucker JJH, Tófoli LF, Dempster EL, Young AH, Morgan CJA. Corrigendum: Ceremonial ayahuasca in amazonian retreats-mental health and epigenetic outcomes from a six-month naturalistic study. Front Psychiatry 2023; 14:1304503. [PMID: 37904854 PMCID: PMC10613463 DOI: 10.3389/fpsyt.2023.1304503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 09/29/2023] [Indexed: 11/01/2023] Open
Abstract
[This corrects the article DOI: 10.3389/fpsyt.2021.687615.].
Collapse
Affiliation(s)
- Simon G. D. Ruffell
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London & South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, United Kingdom
- College of Life and Environmental Sciences, Washington Singer Laboratories, University of Exeter, Exeter, United Kingdom
| | - Nige Netzband
- Department of Health and Applied Sciences, University of the West of England, Bristol, United Kingdom
| | - WaiFung Tsang
- Kings College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| | - Merlin Davies
- College of Life and Environmental Sciences, Washington Singer Laboratories, University of Exeter, Exeter, United Kingdom
| | - Antonio Inserra
- Neurobiological Psychiatry Unit, Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Matthew Butler
- Kings College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| | - James J. H. Rucker
- Kings College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| | - Luís Fernando Tófoli
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), University of Campinas, São Paulo, Brazil
| | - Emma Louise Dempster
- College of Life and Environmental Sciences, Washington Singer Laboratories, University of Exeter, Exeter, United Kingdom
| | - Allan H. Young
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London & South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, United Kingdom
| | - Celia J. A. Morgan
- College of Life and Environmental Sciences, Washington Singer Laboratories, University of Exeter, Exeter, United Kingdom
| |
Collapse
|
3
|
Grabski M, McAndrew A, Lawn W, Marsh B, Raymen L, Stevens T, Hardy L, Warren F, Bloomfield M, Borissova A, Maschauer E, Broomby R, Price R, Coathup R, Gilhooly D, Palmer E, Gordon-Williams R, Hill R, Harris J, Mollaahmetoglu OM, Curran HV, Brandner B, Lingford-Hughes A, Morgan CJA. Adjunctive Ketamine With Relapse Prevention-Based Psychological Therapy in the Treatment of Alcohol Use Disorder. Am J Psychiatry 2022; 179:152-162. [PMID: 35012326 DOI: 10.1176/appi.ajp.2021.21030277] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Early evidence suggests that ketamine may be an effective treatment to sustain abstinence from alcohol. The authors investigated the safety and efficacy of ketamine compared with placebo in increasing abstinence in patients with alcohol use disorder. An additional aim was to pilot ketamine combined with mindfulness-based relapse prevention therapy compared with ketamine and alcohol education as a therapy control. METHODS In a double-blind placebo-controlled phase 2 clinical trial, 96 patients with severe alcohol use disorder were randomly assigned to one of four conditions: 1) three weekly ketamine infusions (0.8 mg/kg i.v. over 40 minutes) plus psychological therapy, 2) three saline infusions plus psychological therapy, 3) three ketamine infusions plus alcohol education, or 4) three saline infusions plus alcohol education. The primary outcomes were self-reported percentage of days abstinent and confirmed alcohol relapse at 6-month follow-up. RESULTS Ninety-six participants (35 women; mean age, 44.07 years [SD=10.59]) were included in the intention-to-treat analysis. The treatment was well tolerated, and no serious adverse events were associated with the study drug. Although confidence intervals were wide, consistent with a proof-of-concept study, there were a significantly greater number of days abstinent from alcohol in the ketamine group compared with the placebo group at 6-month follow-up (mean difference=10.1%, 95% CI=1.1, 19.0), with the greatest reduction in the ketamine plus therapy group compared with the saline plus education group (15.9%, 95% CI=3.8, 28.1). There was no significant difference in relapse rate between the ketamine and placebo groups. CONCLUSIONS This study demonstrated that treatment with three infusions of ketamine was well tolerated in patients with alcohol use disorder and was associated with more days of abstinence from alcohol at 6-month follow-up. The findings suggest a possible beneficial effect of adding psychological therapy alongside ketamine treatment.
Collapse
Affiliation(s)
- Meryem Grabski
- Psychopharmacology and Addiction Research Centre (Grabski, McAndrew, Marsh, Raymen, Stevens, Hardy, Maschauer, Palmer, Mollaahmetoglu, Morgan) and College of Medicine and Health (Warren), University of Exeter, Exeter, U.K.; Clinical Psychopharmacology Unit (Grabski, Lawn, Marsh, Bloomfield, Borissova, Curran) and Translational Psychiatry Research Group (Bloomfield), University College London; Royal Devon and Exeter NHS Foundation Trust, Exeter, U.K. (Broomby, Price); University College London Hospitals NHS Foundation Trust, London (Coathup, Gilhooly, Gordon-Williams, Brandner); South London and Maudsley NHS Foundation Trust, London (Hill, Harris); Faculty of Medicine, Department of Brain Sciences, Imperial College London (Lingford-Hughes)
| | - Amy McAndrew
- Psychopharmacology and Addiction Research Centre (Grabski, McAndrew, Marsh, Raymen, Stevens, Hardy, Maschauer, Palmer, Mollaahmetoglu, Morgan) and College of Medicine and Health (Warren), University of Exeter, Exeter, U.K.; Clinical Psychopharmacology Unit (Grabski, Lawn, Marsh, Bloomfield, Borissova, Curran) and Translational Psychiatry Research Group (Bloomfield), University College London; Royal Devon and Exeter NHS Foundation Trust, Exeter, U.K. (Broomby, Price); University College London Hospitals NHS Foundation Trust, London (Coathup, Gilhooly, Gordon-Williams, Brandner); South London and Maudsley NHS Foundation Trust, London (Hill, Harris); Faculty of Medicine, Department of Brain Sciences, Imperial College London (Lingford-Hughes)
| | - Will Lawn
- Psychopharmacology and Addiction Research Centre (Grabski, McAndrew, Marsh, Raymen, Stevens, Hardy, Maschauer, Palmer, Mollaahmetoglu, Morgan) and College of Medicine and Health (Warren), University of Exeter, Exeter, U.K.; Clinical Psychopharmacology Unit (Grabski, Lawn, Marsh, Bloomfield, Borissova, Curran) and Translational Psychiatry Research Group (Bloomfield), University College London; Royal Devon and Exeter NHS Foundation Trust, Exeter, U.K. (Broomby, Price); University College London Hospitals NHS Foundation Trust, London (Coathup, Gilhooly, Gordon-Williams, Brandner); South London and Maudsley NHS Foundation Trust, London (Hill, Harris); Faculty of Medicine, Department of Brain Sciences, Imperial College London (Lingford-Hughes)
| | - Beth Marsh
- Psychopharmacology and Addiction Research Centre (Grabski, McAndrew, Marsh, Raymen, Stevens, Hardy, Maschauer, Palmer, Mollaahmetoglu, Morgan) and College of Medicine and Health (Warren), University of Exeter, Exeter, U.K.; Clinical Psychopharmacology Unit (Grabski, Lawn, Marsh, Bloomfield, Borissova, Curran) and Translational Psychiatry Research Group (Bloomfield), University College London; Royal Devon and Exeter NHS Foundation Trust, Exeter, U.K. (Broomby, Price); University College London Hospitals NHS Foundation Trust, London (Coathup, Gilhooly, Gordon-Williams, Brandner); South London and Maudsley NHS Foundation Trust, London (Hill, Harris); Faculty of Medicine, Department of Brain Sciences, Imperial College London (Lingford-Hughes)
| | - Laura Raymen
- Psychopharmacology and Addiction Research Centre (Grabski, McAndrew, Marsh, Raymen, Stevens, Hardy, Maschauer, Palmer, Mollaahmetoglu, Morgan) and College of Medicine and Health (Warren), University of Exeter, Exeter, U.K.; Clinical Psychopharmacology Unit (Grabski, Lawn, Marsh, Bloomfield, Borissova, Curran) and Translational Psychiatry Research Group (Bloomfield), University College London; Royal Devon and Exeter NHS Foundation Trust, Exeter, U.K. (Broomby, Price); University College London Hospitals NHS Foundation Trust, London (Coathup, Gilhooly, Gordon-Williams, Brandner); South London and Maudsley NHS Foundation Trust, London (Hill, Harris); Faculty of Medicine, Department of Brain Sciences, Imperial College London (Lingford-Hughes)
| | - Tobias Stevens
- Psychopharmacology and Addiction Research Centre (Grabski, McAndrew, Marsh, Raymen, Stevens, Hardy, Maschauer, Palmer, Mollaahmetoglu, Morgan) and College of Medicine and Health (Warren), University of Exeter, Exeter, U.K.; Clinical Psychopharmacology Unit (Grabski, Lawn, Marsh, Bloomfield, Borissova, Curran) and Translational Psychiatry Research Group (Bloomfield), University College London; Royal Devon and Exeter NHS Foundation Trust, Exeter, U.K. (Broomby, Price); University College London Hospitals NHS Foundation Trust, London (Coathup, Gilhooly, Gordon-Williams, Brandner); South London and Maudsley NHS Foundation Trust, London (Hill, Harris); Faculty of Medicine, Department of Brain Sciences, Imperial College London (Lingford-Hughes)
| | - Lorna Hardy
- Psychopharmacology and Addiction Research Centre (Grabski, McAndrew, Marsh, Raymen, Stevens, Hardy, Maschauer, Palmer, Mollaahmetoglu, Morgan) and College of Medicine and Health (Warren), University of Exeter, Exeter, U.K.; Clinical Psychopharmacology Unit (Grabski, Lawn, Marsh, Bloomfield, Borissova, Curran) and Translational Psychiatry Research Group (Bloomfield), University College London; Royal Devon and Exeter NHS Foundation Trust, Exeter, U.K. (Broomby, Price); University College London Hospitals NHS Foundation Trust, London (Coathup, Gilhooly, Gordon-Williams, Brandner); South London and Maudsley NHS Foundation Trust, London (Hill, Harris); Faculty of Medicine, Department of Brain Sciences, Imperial College London (Lingford-Hughes)
| | - Fiona Warren
- Psychopharmacology and Addiction Research Centre (Grabski, McAndrew, Marsh, Raymen, Stevens, Hardy, Maschauer, Palmer, Mollaahmetoglu, Morgan) and College of Medicine and Health (Warren), University of Exeter, Exeter, U.K.; Clinical Psychopharmacology Unit (Grabski, Lawn, Marsh, Bloomfield, Borissova, Curran) and Translational Psychiatry Research Group (Bloomfield), University College London; Royal Devon and Exeter NHS Foundation Trust, Exeter, U.K. (Broomby, Price); University College London Hospitals NHS Foundation Trust, London (Coathup, Gilhooly, Gordon-Williams, Brandner); South London and Maudsley NHS Foundation Trust, London (Hill, Harris); Faculty of Medicine, Department of Brain Sciences, Imperial College London (Lingford-Hughes)
| | - Michael Bloomfield
- Psychopharmacology and Addiction Research Centre (Grabski, McAndrew, Marsh, Raymen, Stevens, Hardy, Maschauer, Palmer, Mollaahmetoglu, Morgan) and College of Medicine and Health (Warren), University of Exeter, Exeter, U.K.; Clinical Psychopharmacology Unit (Grabski, Lawn, Marsh, Bloomfield, Borissova, Curran) and Translational Psychiatry Research Group (Bloomfield), University College London; Royal Devon and Exeter NHS Foundation Trust, Exeter, U.K. (Broomby, Price); University College London Hospitals NHS Foundation Trust, London (Coathup, Gilhooly, Gordon-Williams, Brandner); South London and Maudsley NHS Foundation Trust, London (Hill, Harris); Faculty of Medicine, Department of Brain Sciences, Imperial College London (Lingford-Hughes)
| | - Anya Borissova
- Psychopharmacology and Addiction Research Centre (Grabski, McAndrew, Marsh, Raymen, Stevens, Hardy, Maschauer, Palmer, Mollaahmetoglu, Morgan) and College of Medicine and Health (Warren), University of Exeter, Exeter, U.K.; Clinical Psychopharmacology Unit (Grabski, Lawn, Marsh, Bloomfield, Borissova, Curran) and Translational Psychiatry Research Group (Bloomfield), University College London; Royal Devon and Exeter NHS Foundation Trust, Exeter, U.K. (Broomby, Price); University College London Hospitals NHS Foundation Trust, London (Coathup, Gilhooly, Gordon-Williams, Brandner); South London and Maudsley NHS Foundation Trust, London (Hill, Harris); Faculty of Medicine, Department of Brain Sciences, Imperial College London (Lingford-Hughes)
| | - Emily Maschauer
- Psychopharmacology and Addiction Research Centre (Grabski, McAndrew, Marsh, Raymen, Stevens, Hardy, Maschauer, Palmer, Mollaahmetoglu, Morgan) and College of Medicine and Health (Warren), University of Exeter, Exeter, U.K.; Clinical Psychopharmacology Unit (Grabski, Lawn, Marsh, Bloomfield, Borissova, Curran) and Translational Psychiatry Research Group (Bloomfield), University College London; Royal Devon and Exeter NHS Foundation Trust, Exeter, U.K. (Broomby, Price); University College London Hospitals NHS Foundation Trust, London (Coathup, Gilhooly, Gordon-Williams, Brandner); South London and Maudsley NHS Foundation Trust, London (Hill, Harris); Faculty of Medicine, Department of Brain Sciences, Imperial College London (Lingford-Hughes)
| | - Rupert Broomby
- Psychopharmacology and Addiction Research Centre (Grabski, McAndrew, Marsh, Raymen, Stevens, Hardy, Maschauer, Palmer, Mollaahmetoglu, Morgan) and College of Medicine and Health (Warren), University of Exeter, Exeter, U.K.; Clinical Psychopharmacology Unit (Grabski, Lawn, Marsh, Bloomfield, Borissova, Curran) and Translational Psychiatry Research Group (Bloomfield), University College London; Royal Devon and Exeter NHS Foundation Trust, Exeter, U.K. (Broomby, Price); University College London Hospitals NHS Foundation Trust, London (Coathup, Gilhooly, Gordon-Williams, Brandner); South London and Maudsley NHS Foundation Trust, London (Hill, Harris); Faculty of Medicine, Department of Brain Sciences, Imperial College London (Lingford-Hughes)
| | - Robert Price
- Psychopharmacology and Addiction Research Centre (Grabski, McAndrew, Marsh, Raymen, Stevens, Hardy, Maschauer, Palmer, Mollaahmetoglu, Morgan) and College of Medicine and Health (Warren), University of Exeter, Exeter, U.K.; Clinical Psychopharmacology Unit (Grabski, Lawn, Marsh, Bloomfield, Borissova, Curran) and Translational Psychiatry Research Group (Bloomfield), University College London; Royal Devon and Exeter NHS Foundation Trust, Exeter, U.K. (Broomby, Price); University College London Hospitals NHS Foundation Trust, London (Coathup, Gilhooly, Gordon-Williams, Brandner); South London and Maudsley NHS Foundation Trust, London (Hill, Harris); Faculty of Medicine, Department of Brain Sciences, Imperial College London (Lingford-Hughes)
| | - Rachel Coathup
- Psychopharmacology and Addiction Research Centre (Grabski, McAndrew, Marsh, Raymen, Stevens, Hardy, Maschauer, Palmer, Mollaahmetoglu, Morgan) and College of Medicine and Health (Warren), University of Exeter, Exeter, U.K.; Clinical Psychopharmacology Unit (Grabski, Lawn, Marsh, Bloomfield, Borissova, Curran) and Translational Psychiatry Research Group (Bloomfield), University College London; Royal Devon and Exeter NHS Foundation Trust, Exeter, U.K. (Broomby, Price); University College London Hospitals NHS Foundation Trust, London (Coathup, Gilhooly, Gordon-Williams, Brandner); South London and Maudsley NHS Foundation Trust, London (Hill, Harris); Faculty of Medicine, Department of Brain Sciences, Imperial College London (Lingford-Hughes)
| | - David Gilhooly
- Psychopharmacology and Addiction Research Centre (Grabski, McAndrew, Marsh, Raymen, Stevens, Hardy, Maschauer, Palmer, Mollaahmetoglu, Morgan) and College of Medicine and Health (Warren), University of Exeter, Exeter, U.K.; Clinical Psychopharmacology Unit (Grabski, Lawn, Marsh, Bloomfield, Borissova, Curran) and Translational Psychiatry Research Group (Bloomfield), University College London; Royal Devon and Exeter NHS Foundation Trust, Exeter, U.K. (Broomby, Price); University College London Hospitals NHS Foundation Trust, London (Coathup, Gilhooly, Gordon-Williams, Brandner); South London and Maudsley NHS Foundation Trust, London (Hill, Harris); Faculty of Medicine, Department of Brain Sciences, Imperial College London (Lingford-Hughes)
| | - Edward Palmer
- Psychopharmacology and Addiction Research Centre (Grabski, McAndrew, Marsh, Raymen, Stevens, Hardy, Maschauer, Palmer, Mollaahmetoglu, Morgan) and College of Medicine and Health (Warren), University of Exeter, Exeter, U.K.; Clinical Psychopharmacology Unit (Grabski, Lawn, Marsh, Bloomfield, Borissova, Curran) and Translational Psychiatry Research Group (Bloomfield), University College London; Royal Devon and Exeter NHS Foundation Trust, Exeter, U.K. (Broomby, Price); University College London Hospitals NHS Foundation Trust, London (Coathup, Gilhooly, Gordon-Williams, Brandner); South London and Maudsley NHS Foundation Trust, London (Hill, Harris); Faculty of Medicine, Department of Brain Sciences, Imperial College London (Lingford-Hughes)
| | - Richard Gordon-Williams
- Psychopharmacology and Addiction Research Centre (Grabski, McAndrew, Marsh, Raymen, Stevens, Hardy, Maschauer, Palmer, Mollaahmetoglu, Morgan) and College of Medicine and Health (Warren), University of Exeter, Exeter, U.K.; Clinical Psychopharmacology Unit (Grabski, Lawn, Marsh, Bloomfield, Borissova, Curran) and Translational Psychiatry Research Group (Bloomfield), University College London; Royal Devon and Exeter NHS Foundation Trust, Exeter, U.K. (Broomby, Price); University College London Hospitals NHS Foundation Trust, London (Coathup, Gilhooly, Gordon-Williams, Brandner); South London and Maudsley NHS Foundation Trust, London (Hill, Harris); Faculty of Medicine, Department of Brain Sciences, Imperial College London (Lingford-Hughes)
| | - Robert Hill
- Psychopharmacology and Addiction Research Centre (Grabski, McAndrew, Marsh, Raymen, Stevens, Hardy, Maschauer, Palmer, Mollaahmetoglu, Morgan) and College of Medicine and Health (Warren), University of Exeter, Exeter, U.K.; Clinical Psychopharmacology Unit (Grabski, Lawn, Marsh, Bloomfield, Borissova, Curran) and Translational Psychiatry Research Group (Bloomfield), University College London; Royal Devon and Exeter NHS Foundation Trust, Exeter, U.K. (Broomby, Price); University College London Hospitals NHS Foundation Trust, London (Coathup, Gilhooly, Gordon-Williams, Brandner); South London and Maudsley NHS Foundation Trust, London (Hill, Harris); Faculty of Medicine, Department of Brain Sciences, Imperial College London (Lingford-Hughes)
| | - Jen Harris
- Psychopharmacology and Addiction Research Centre (Grabski, McAndrew, Marsh, Raymen, Stevens, Hardy, Maschauer, Palmer, Mollaahmetoglu, Morgan) and College of Medicine and Health (Warren), University of Exeter, Exeter, U.K.; Clinical Psychopharmacology Unit (Grabski, Lawn, Marsh, Bloomfield, Borissova, Curran) and Translational Psychiatry Research Group (Bloomfield), University College London; Royal Devon and Exeter NHS Foundation Trust, Exeter, U.K. (Broomby, Price); University College London Hospitals NHS Foundation Trust, London (Coathup, Gilhooly, Gordon-Williams, Brandner); South London and Maudsley NHS Foundation Trust, London (Hill, Harris); Faculty of Medicine, Department of Brain Sciences, Imperial College London (Lingford-Hughes)
| | - O Merve Mollaahmetoglu
- Psychopharmacology and Addiction Research Centre (Grabski, McAndrew, Marsh, Raymen, Stevens, Hardy, Maschauer, Palmer, Mollaahmetoglu, Morgan) and College of Medicine and Health (Warren), University of Exeter, Exeter, U.K.; Clinical Psychopharmacology Unit (Grabski, Lawn, Marsh, Bloomfield, Borissova, Curran) and Translational Psychiatry Research Group (Bloomfield), University College London; Royal Devon and Exeter NHS Foundation Trust, Exeter, U.K. (Broomby, Price); University College London Hospitals NHS Foundation Trust, London (Coathup, Gilhooly, Gordon-Williams, Brandner); South London and Maudsley NHS Foundation Trust, London (Hill, Harris); Faculty of Medicine, Department of Brain Sciences, Imperial College London (Lingford-Hughes)
| | - H Valerie Curran
- Psychopharmacology and Addiction Research Centre (Grabski, McAndrew, Marsh, Raymen, Stevens, Hardy, Maschauer, Palmer, Mollaahmetoglu, Morgan) and College of Medicine and Health (Warren), University of Exeter, Exeter, U.K.; Clinical Psychopharmacology Unit (Grabski, Lawn, Marsh, Bloomfield, Borissova, Curran) and Translational Psychiatry Research Group (Bloomfield), University College London; Royal Devon and Exeter NHS Foundation Trust, Exeter, U.K. (Broomby, Price); University College London Hospitals NHS Foundation Trust, London (Coathup, Gilhooly, Gordon-Williams, Brandner); South London and Maudsley NHS Foundation Trust, London (Hill, Harris); Faculty of Medicine, Department of Brain Sciences, Imperial College London (Lingford-Hughes)
| | - Brigitta Brandner
- Psychopharmacology and Addiction Research Centre (Grabski, McAndrew, Marsh, Raymen, Stevens, Hardy, Maschauer, Palmer, Mollaahmetoglu, Morgan) and College of Medicine and Health (Warren), University of Exeter, Exeter, U.K.; Clinical Psychopharmacology Unit (Grabski, Lawn, Marsh, Bloomfield, Borissova, Curran) and Translational Psychiatry Research Group (Bloomfield), University College London; Royal Devon and Exeter NHS Foundation Trust, Exeter, U.K. (Broomby, Price); University College London Hospitals NHS Foundation Trust, London (Coathup, Gilhooly, Gordon-Williams, Brandner); South London and Maudsley NHS Foundation Trust, London (Hill, Harris); Faculty of Medicine, Department of Brain Sciences, Imperial College London (Lingford-Hughes)
| | - Anne Lingford-Hughes
- Psychopharmacology and Addiction Research Centre (Grabski, McAndrew, Marsh, Raymen, Stevens, Hardy, Maschauer, Palmer, Mollaahmetoglu, Morgan) and College of Medicine and Health (Warren), University of Exeter, Exeter, U.K.; Clinical Psychopharmacology Unit (Grabski, Lawn, Marsh, Bloomfield, Borissova, Curran) and Translational Psychiatry Research Group (Bloomfield), University College London; Royal Devon and Exeter NHS Foundation Trust, Exeter, U.K. (Broomby, Price); University College London Hospitals NHS Foundation Trust, London (Coathup, Gilhooly, Gordon-Williams, Brandner); South London and Maudsley NHS Foundation Trust, London (Hill, Harris); Faculty of Medicine, Department of Brain Sciences, Imperial College London (Lingford-Hughes)
| | - Celia J A Morgan
- Psychopharmacology and Addiction Research Centre (Grabski, McAndrew, Marsh, Raymen, Stevens, Hardy, Maschauer, Palmer, Mollaahmetoglu, Morgan) and College of Medicine and Health (Warren), University of Exeter, Exeter, U.K.; Clinical Psychopharmacology Unit (Grabski, Lawn, Marsh, Bloomfield, Borissova, Curran) and Translational Psychiatry Research Group (Bloomfield), University College London; Royal Devon and Exeter NHS Foundation Trust, Exeter, U.K. (Broomby, Price); University College London Hospitals NHS Foundation Trust, London (Coathup, Gilhooly, Gordon-Williams, Brandner); South London and Maudsley NHS Foundation Trust, London (Hill, Harris); Faculty of Medicine, Department of Brain Sciences, Imperial College London (Lingford-Hughes)
| |
Collapse
|
4
|
Walsh Z, Mollaahmetoglu OM, Rootman J, Golsof S, Keeler J, Marsh B, Nutt DJ, Morgan CJA. Ketamine for the treatment of mental health and substance use disorders: comprehensive systematic review - CORRIGENDUM. BJPsych Open 2022; 8:e29. [PMID: 35040425 PMCID: PMC8811778 DOI: 10.1192/bjo.2022.5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
|
5
|
Walsh Z, Mollaahmetoglu OM, Rootman J, Golsof S, Keeler J, Marsh B, Nutt DJ, Morgan CJA. Ketamine for the treatment of mental health and substance use disorders: comprehensive systematic review. BJPsych Open 2021; 8:e19. [PMID: 35048815 PMCID: PMC8715255 DOI: 10.1192/bjo.2021.1061] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND In the past two decades, subanaesthetic doses of ketamine have been demonstrated to have rapid and sustained antidepressant effects, and accumulating research has demonstrated ketamine's therapeutic effects for a range of psychiatric conditions. AIMS In light of these findings surrounding ketamine's psychotherapeutic potential, we systematically review the extant evidence on ketamine's effects in treating mental health disorders. METHOD The systematic review protocol was registered in PROSPERO (identifier CRD42019130636). Human studies investigating the therapeutic effects of ketamine in the treatment of mental health disorders were included. Because of the extensive research in depression, bipolar disorder and suicidal ideation, only systematic reviews and meta-analyses were included. We searched Medline and PsycINFO on 21 October 2020. Risk-of-bias analysis was assessed with the Cochrane Risk of Bias tools and A Measurement Tool to Assess Systematic Reviews (AMSTAR) Checklist. RESULTS We included 83 published reports in the final review: 33 systematic reviews, 29 randomised controlled trials, two randomised trials without placebo, three non-randomised trials with controls, six open-label trials and ten retrospective reviews. The results were presented via narrative synthesis. CONCLUSIONS Systematic reviews and meta-analyses provide support for robust, rapid and transient antidepressant and anti-suicidal effects of ketamine. Evidence for other indications is less robust, but suggests similarly positive and short-lived effects. The conclusions should be interpreted with caution because of the high risk of bias of included studies. Optimal dosing, modes of administration and the most effective forms of adjunctive psychotherapeutic support should be examined further.
Collapse
Affiliation(s)
- Zach Walsh
- Department of Psychology, University of British Columbia, Canada
| | | | - Joseph Rootman
- Department of Psychology, University of British Columbia, Canada
| | - Shannon Golsof
- Department of Psychology, University of British Columbia, Canada
| | - Johanna Keeler
- Eating Disorders Research Group, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, Kings College London, UK
| | - Beth Marsh
- Psychopharmacology and Addiction Research Centre, Department of Psychology, University of Exeter, UK; and Clinical Psychopharmacology Unit, Department of Clinical, Educational and Health Psychology, University College London, UK
| | - David J Nutt
- Drug Science, UK; and Neuropsychopharmacology Unit, Division of Psychiatry, Department of Brain Sciences, Imperial College London, UK
| | - Celia J A Morgan
- Psychopharmacology and Addiction Research Centre, Department of Psychology, University of Exeter, UK
| |
Collapse
|
6
|
Carlyle M, Broomby R, Simpson G, Hannon R, Fawaz L, Mollaahmetoglu OM, Drain J, Mostazir M, Morgan CJA. A randomised, double-blind study investigating the relationship between early childhood trauma and the rewarding effects of morphine. Addict Biol 2021; 26:e13047. [PMID: 34155732 DOI: 10.1111/adb.13047] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 03/12/2021] [Accepted: 04/13/2021] [Indexed: 12/11/2022]
Abstract
Experiences of childhood trauma (abuse and neglect) are disproportionately higher in those with opioid use disorder (OUD). Childhood trauma may affect the reinforcing and rewarding properties of opioid drugs and responses to pain, potentially via developmental changes to the endogenous opioid system. This has been supported by preclinical research, yet this has not been investigated in non-addicted humans. Physically healthy participants with either a history of severe childhood trauma or no previous history of childhood trauma attended two sessions where they received either an intramuscular active dose of morphine (0.15 mg/kg) or a very low dose control (0.01 mg/kg) in a randomised, double-blind crossover design. Sessions were held 1 week apart. Participants' physical pain threshold and tolerance were measured pre- and post-drug administration using the cold water pressor test, alongside acute subjective and behavioural responses over 2.5 h. The trauma group reported liking the effects of morphine, feeling more euphoric and wanting more of the drug over the session, as well as feeling less nauseous, dizzy, and dislike of the effects of morphine compared to the non-trauma comparison group. Morphine increased pain threshold and tolerance, yet this did not differ between the groups. Childhood trauma may therefore sensitise individuals to the pleasurable and motivational effects of opioids and reduce sensitivity to the negative effects, providing compelling evidence for individual differences in opioid reward sensitivity. This may explain the link between childhood trauma and vulnerability to OUD, with consequent implications on interventions for OUD, the prescribing of opioids, and reducing stigmas surrounding OUD.
Collapse
Affiliation(s)
- Molly Carlyle
- Psychopharmacology and Addiction Research Centre University of Exeter Exeter UK
| | - Rupert Broomby
- Anaesthesia & Pain Management Royal Devon and Exeter NHS Foundation Trust Exeter UK
| | - Graham Simpson
- Anaesthesia & Pain Management Royal Devon and Exeter NHS Foundation Trust Exeter UK
| | - Rachel Hannon
- Psychopharmacology and Addiction Research Centre University of Exeter Exeter UK
| | - Leah Fawaz
- Psychopharmacology and Addiction Research Centre University of Exeter Exeter UK
| | | | - Jade Drain
- Psychopharmacology and Addiction Research Centre University of Exeter Exeter UK
| | - Mohammod Mostazir
- College of Life and Environmental Sciences University of Exeter Exeter UK
| | - Celia J. A. Morgan
- Psychopharmacology and Addiction Research Centre University of Exeter Exeter UK
| |
Collapse
|
7
|
Mokrysz C, Shaban NDC, Freeman TP, Lawn W, Pope RA, Hindocha C, Freeman A, Wall MB, Bloomfield MAP, Morgan CJA, Nutt DJ, Curran HV. Acute effects of cannabis on speech illusions and psychotic-like symptoms: two studies testing the moderating effects of cannabidiol and adolescence. Psychol Med 2021; 51:2134-2142. [PMID: 32340632 DOI: 10.1017/s0033291720001038] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Acute cannabis administration can produce transient psychotic-like effects in healthy individuals. However, the mechanisms through which this occurs and which factors predict vulnerability remain unclear. We investigate whether cannabis inhalation leads to psychotic-like symptoms and speech illusion; and whether cannabidiol (CBD) blunts such effects (study 1) and adolescence heightens such effects (study 2). METHODS Two double-blind placebo-controlled studies, assessing speech illusion in a white noise task, and psychotic-like symptoms on the Psychotomimetic States Inventory (PSI). Study 1 compared effects of Cann-CBD (cannabis containing Δ-9-tetrahydrocannabinol (THC) and negligible levels of CBD) with Cann+CBD (cannabis containing THC and CBD) in 17 adults. Study 2 compared effects of Cann-CBD in 20 adolescents and 20 adults. All participants were healthy individuals who currently used cannabis. RESULTS In study 1, relative to placebo, both Cann-CBD and Cann+CBD increased PSI scores but not speech illusion. No differences between Cann-CBD and Cann+CBD emerged. In study 2, relative to placebo, Cann-CBD increased PSI scores and incidence of speech illusion, with the odds of experiencing speech illusion 3.1 (95% CIs 1.3-7.2) times higher after Cann-CBD. No age group differences were found for speech illusion, but adults showed heightened effects on the PSI. CONCLUSIONS Inhalation of cannabis reliably increases psychotic-like symptoms in healthy cannabis users and may increase the incidence of speech illusion. CBD did not influence psychotic-like effects of cannabis. Adolescents may be less vulnerable to acute psychotic-like effects of cannabis than adults.
Collapse
Affiliation(s)
- Claire Mokrysz
- Clinical Psychopharmacology Unit, University College London, London, UK
| | | | - Tom P Freeman
- Clinical Psychopharmacology Unit, University College London, London, UK
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
- National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Will Lawn
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Rebecca A Pope
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Chandni Hindocha
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Abigail Freeman
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Matthew B Wall
- Clinical Psychopharmacology Unit, University College London, London, UK
- Invicro, Burlington Danes Building, Imperial College London, Hammersmith Hospital, Du Cane Road, London, UK
- Division of Brain Sciences, Imperial College London, London, UK
| | - Michael A P Bloomfield
- Clinical Psychopharmacology Unit, University College London, London, UK
- Psychiatric Imaging Group, Medical Research Council Clinical Sciences Centre, Hammersmith Hospital, London, UK
- Division of Psychiatry, Translational Psychiatry Research Group, University College London, Maple House, London, UK
- NIHR University College London Hospitals Biomedical Research Centre, University College Hospitals NHS Foundation Trust, London, UK
| | - Celia J A Morgan
- Clinical Psychopharmacology Unit, University College London, London, UK
- Psychopharmacology and Addiction Research Centre, University of Exeter, Exeter, UK
| | - David J Nutt
- Neuropsychopharmacology Unit, Division of Experimental Medicine, Imperial College London, Burlington Danes Building, Du Cane Road, London, UK
| | - H Valerie Curran
- Clinical Psychopharmacology Unit, University College London, London, UK
| |
Collapse
|
8
|
Ruffell SGD, Netzband N, Tsang W, Davies M, Inserra A, Butler M, Rucker JJH, Tófoli LF, Dempster EL, Young AH, Morgan CJA. Ceremonial Ayahuasca in Amazonian Retreats-Mental Health and Epigenetic Outcomes From a Six-Month Naturalistic Study. Front Psychiatry 2021; 12:687615. [PMID: 34177670 PMCID: PMC8221532 DOI: 10.3389/fpsyt.2021.687615] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 05/14/2021] [Indexed: 12/29/2022] Open
Abstract
Ayahuasca is a natural psychoactive brew, used in traditional ceremonies in the Amazon basin. Recent research has indicated that ayahuasca is pharmacologically safe and its use may be positively associated with improvements in psychiatric symptoms. The mechanistic effects of ayahuasca are yet to be fully established. In this prospective naturalistic study, 63 self-selected participants took part in ayahuasca ceremonies at a retreat centre in the Peruvian Amazon. Participants undertook the Beck Depression Inventory (BDI-II), State-Trait Anxiety Inventory (STAI), Self-compassion Scale (SCS), Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM), as well as secondary measures, pre- and post-retreat and at 6-months. Participants also provided saliva samples for pre/post epigenetic analysis. Overall, a statistically significant decrease in BDI-II (13.9 vs. 6.1, p < 0.001), STAI (44.4 vs. 34.3 p < 0.001) scores, and CORE-OM scores were observed (37.3 vs. 22.3 p < 0.001) at post-retreat, as well as a concurrent increase in SCS (3.1 vs. 3.6, p < 0.001). Psychometric improvements were sustained, and on some measures values further decreased at 6-month follow-up, suggesting a potential for lasting therapeutic effects. Changes in memory valence were linked to the observed psychometric improvements. Epigenetic findings were equivocal, but indicated that further research in candidate genes, such as sigma non-opioid intracellular receptor 1 (SIGMAR1), is warranted. This data adds to the literature supporting ayahuasca's possible positive impact on mental health when conducted in a ceremonial context. Further investigation into clinical samples, as well as greater analyses into the mechanistic action of ayahuasca is advised.
Collapse
Affiliation(s)
- Simon G. D. Ruffell
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London & South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, United Kingdom
- College of Life and Environmental Sciences, Washington Singer Laboratories, University of Exeter, Exeter, United Kingdom
| | - Nige Netzband
- Department of Health and Applied Sciences, University of the West of England, Bristol, United Kingdom
| | - WaiFung Tsang
- Kings College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| | - Merlin Davies
- College of Life and Environmental Sciences, Washington Singer Laboratories, University of Exeter, Exeter, United Kingdom
| | - Antonio Inserra
- Neurobiological Psychiatry Unit, Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Matthew Butler
- Kings College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| | - James J. H. Rucker
- Kings College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| | - Luís Fernando Tófoli
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), University of Campinas, São Paulo, Brazil
| | - Emma Louise Dempster
- College of Life and Environmental Sciences, Washington Singer Laboratories, University of Exeter, Exeter, United Kingdom
| | - Allan H. Young
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London & South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, United Kingdom
| | - Celia J. A. Morgan
- College of Life and Environmental Sciences, Washington Singer Laboratories, University of Exeter, Exeter, United Kingdom
| |
Collapse
|
9
|
Mollaahmetoglu OM, Keeler J, Ashbullby KJ, Ketzitzidou-Argyri E, Grabski M, Morgan CJA. "This Is Something That Changed My Life": A Qualitative Study of Patients' Experiences in a Clinical Trial of Ketamine Treatment for Alcohol Use Disorders. Front Psychiatry 2021; 12:695335. [PMID: 34483991 PMCID: PMC8415567 DOI: 10.3389/fpsyt.2021.695335] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 07/14/2021] [Indexed: 12/18/2022] Open
Abstract
Background: The therapeutic benefits of ketamine have been demonstrated for a variety of psychiatric disorders. However, the role of ketamine induced psychoactive experiences in mediating the therapeutic effects is unclear. Despite the growing quantitative research on the efficacy of ketamine treatment, very few studies examined participant experiences of ketamine infusions in a treatment setting. Aims: The current study aimed to examine participant experiences of ketamine infusions and how these relate to therapeutic mechanisms in a clinical trial setting. Methods: We conducted semi-structured interviews with 12 participants who received up to three ketamine infusions (0.8 mg/kg) as part of a Phase II double blind, randomised controlled trial. The interviews explored participants' acute experiences of ketamine infusions, experiences of psychotherapy/education, and the lasting effects of the trial. The interviews were transcribed verbatim and analysed using thematic analysis. Results: Six key themes were identified. (1) Participants reported multifaceted motivations for trial participation. (2) The set and setting was found to be influential in determining acute ketamine experiences. The acute ketamine experiences included: (3) the inherent contradictions of the experience (e.g., dissociation vs feelings of connection), (4) rapidly fluctuating and changing experiences, (5) meaningful, mystical and spiritual experiences. Finally, the final theme (6) relates to the transformational effects of the infusions and the trial. Conclusion: Provided in a supportive and professional environment, ketamine treatment led to a significant change in relationship with alcohol. Ketamine induced ego dissolution and dissociation were reported to be related to the transformational effects on relationship with alcohol. The extent to which the acute psychoactive effects of ketamine mediate therapeutic effects on drinking outcomes remain to be investigated in the trial data. The acute effects of ketamine reported by our participants transcend its traditional conceptualisation as a "dissociative anaesthetic"; therefore, we suggest the development or use of new measures alongside ketamine infusions to fully capture the spectrum of these effects which may be crucial in its therapeutic and transformative effects.
Collapse
Affiliation(s)
- O Merve Mollaahmetoglu
- Psychology Department, Psychopharmacology and Addiction Research Centre, University of Exeter, Exeter, United Kingdom
| | - Johanna Keeler
- Psychology Department, Psychopharmacology and Addiction Research Centre, University of Exeter, Exeter, United Kingdom
| | - Katherine J Ashbullby
- Psychology Department, Psychopharmacology and Addiction Research Centre, University of Exeter, Exeter, United Kingdom
| | - Eirini Ketzitzidou-Argyri
- Psychology Department, Psychopharmacology and Addiction Research Centre, University of Exeter, Exeter, United Kingdom
| | - Meryem Grabski
- Psychology Department, Psychopharmacology and Addiction Research Centre, University of Exeter, Exeter, United Kingdom.,Department of Clinical, Educational and Health Psychology, Clinical Psychopharmacology Unit, University College London, London, United Kingdom
| | - Celia J A Morgan
- Psychology Department, Psychopharmacology and Addiction Research Centre, University of Exeter, Exeter, United Kingdom
| |
Collapse
|
10
|
Mollaahmetoglu OM, Palmer E, Maschauer E, Nolan MC, Stevens T, Carlyle M, Hardy L, Watkins ER, Morgan CJA. The acute effects of alcohol on state rumination in the laboratory. Psychopharmacology (Berl) 2021; 238:1671-1686. [PMID: 33635385 PMCID: PMC8139935 DOI: 10.1007/s00213-021-05802-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 02/11/2021] [Indexed: 11/29/2022]
Abstract
RATIONALE Rumination is a repetitive, negative, self-focused thinking style associated with various forms of psychopathology. Recent studies suggest that rumination increases craving for alcohol and predicts harmful drinking and alcohol-related problems. However, the acute effects of alcohol on rumination have not been previously studied. It is proposed that alcohol may reduce ruminative thinking through decreasing negative mood. OBJECTIVES In the present study, we aimed to test the previously unexplored effects of acute alcohol consumption on rumination in a hazardous drinking population. METHODS We conducted a randomised placebo-controlled laboratory study to examine the effect of low (0.4 g kg-1) and high doses (0.8 g kg-1) of alcohol on state rumination compared to placebo. Participants completed a rumination induction task prior to receiving drinks. We then measured state rumination and mood at repeated time points; 30 min, 60 min and 90 min post-drinks consumption. RESULTS We found a significant decrease in state rumination in the low-dose alcohol group compared to placebo at 30 min post-alcohol consumption, but no difference was observed between the high-dose alcohol and placebo groups. Mediation analysis provided evidence for an indirect effect of alcohol on state rumination through concurrent changes in negative mood. CONCLUSIONS These findings suggest that acute alcohol consumption can regulate negative mood and concurrently rumination, providing preliminary evidence for the role of rumination in alcohol use disorders. Rumination may be a treatment target in alcohol use disorders.
Collapse
Affiliation(s)
- O. Merve Mollaahmetoglu
- Psychopharmacology and Addiction Research Centre (PARC), University of Exeter, Washington Singer Building, Perry Road, Exeter, EX4 4QG UK
| | - Edward Palmer
- Psychopharmacology and Addiction Research Centre (PARC), University of Exeter, Washington Singer Building, Perry Road, Exeter, EX4 4QG UK
| | - Emily Maschauer
- Psychopharmacology and Addiction Research Centre (PARC), University of Exeter, Washington Singer Building, Perry Road, Exeter, EX4 4QG UK
| | - Melissa C. Nolan
- Psychopharmacology and Addiction Research Centre (PARC), University of Exeter, Washington Singer Building, Perry Road, Exeter, EX4 4QG UK
| | - Tobias Stevens
- Psychopharmacology and Addiction Research Centre (PARC), University of Exeter, Washington Singer Building, Perry Road, Exeter, EX4 4QG UK
| | - Molly Carlyle
- School of Psychology, University of Queensland, St. Lucia, QLD Australia
| | - Lorna Hardy
- Psychopharmacology and Addiction Research Centre (PARC), University of Exeter, Washington Singer Building, Perry Road, Exeter, EX4 4QG UK
| | - Edward R. Watkins
- SMART Lab, University of Exeter, Washington Singer Building, Perry Road, Exeter, EX4 4QG UK
| | - Celia J. A. Morgan
- Psychopharmacology and Addiction Research Centre (PARC), University of Exeter, Washington Singer Building, Perry Road, Exeter, EX4 4QG UK
| |
Collapse
|
11
|
Rossi GN, Osório FL, Morgan CJA, Crippa JAS, Bouso JC, Rocha JM, Zuardi AW, Hallak JEC, Santos RGD. The effects of Cannabidiol (CBD) and Delta-9-Tetrahydrocannabinol (THC) on the recognition of emotions in facial expressions: A systematic review of randomized controlled trials. Neurosci Biobehav Rev 2020; 118:236-246. [PMID: 32745478 DOI: 10.1016/j.neubiorev.2020.07.034] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 06/03/2020] [Accepted: 07/27/2020] [Indexed: 11/25/2022]
Abstract
Tetrahydrocannabinol (THC) and cannabidiol (CBD) are phytocannabinoids being linked with modulation of anxiety and depression. The recognition of emotions in facial expressions (REFE) is impaired in these disorders. Both drugs could modulate anxiety and mood by interfering with REFE. Thus, a systematic review of controlled trials assessing the effects of THC and CBD on REFE was performed. Ten studies describing seven distinct experiments were found (n = 170). THC (7.5-15 mg) did not alter REFE in three experiments, but reduced task performance in other three experiments. CBD did not alter REFE in two experiments, but improved task performance and counteracted the effects of THC in one experiment. THC (≥ 10 mg) and CBD (600 mg) showed opposite effects on brain activation, skin conductance, and anxiety measures with negative/threatening faces. The limited number of studies precludes firm conclusions on the effects of these substances on REFE. Further controlled trials are needed to elucidate the effects of THC and CBD on REFE. The PROSPERO ID for this study is CRD42019135085.
Collapse
Affiliation(s)
- Giordano Novak Rossi
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, SP, Brazil.
| | - Flávia L Osório
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, SP, Brazil; National Institute for Translational Medicine (INCT-TM), CNPq, Brazil.
| | - Celia J A Morgan
- Clinical Psychopharmacology Unit, University College London, London, UK; Psychopharmacology and Addiction Research Centre, University of Exeter, Exeter, UK.
| | - José Alexandre S Crippa
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, SP, Brazil; National Institute for Translational Medicine (INCT-TM), CNPq, Brazil.
| | - José Carlos Bouso
- ICEERS Foundation (International Center for Ethnobotanical Education, Research and Services), Barcelona, Spain.
| | - Juliana Mendes Rocha
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, SP, Brazil.
| | - Antônio W Zuardi
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, SP, Brazil; National Institute for Translational Medicine (INCT-TM), CNPq, Brazil.
| | - Jaime E C Hallak
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, SP, Brazil; National Institute for Translational Medicine (INCT-TM), CNPq, Brazil.
| | - Rafael G Dos Santos
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, SP, Brazil; National Institute for Translational Medicine (INCT-TM), CNPq, Brazil; ICEERS Foundation (International Center for Ethnobotanical Education, Research and Services), Barcelona, Spain.
| |
Collapse
|
12
|
Lawn W, Mithchener L, Freeman TP, Benattayallah A, Bisby JA, Wall MB, Dodds CM, Curran HV, Morgan CJA. Value-based decision-making of cigarette and nondrug rewards in dependent and occasional cigarette smokers: An FMRI study. Addict Biol 2020; 25:e12802. [PMID: 31328850 DOI: 10.1111/adb.12802] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2018] [Revised: 04/22/2019] [Accepted: 05/29/2019] [Indexed: 11/27/2022]
Abstract
Little is known about the neural functioning that underpins drug valuation and choice in addiction, including nicotine dependence. Following ad libitum smoking, 19 dependent smokers (smoked≥10/day) and 19 occasional smokers (smoked 0.5-5/week) completed a decision-making task. First, participants stated how much they were willing-to-pay for various amounts of cigarettes and shop vouchers. Second, during functional magnetic resonance imaging, participants decided if they wanted to buy these cigarettes and vouchers for a set amount of money. We examined decision-making behaviour and brain activity when faced with cigarette and voucher decisions, purchasing (vs not purchasing) cigarettes and vouchers, and "value signals" where brain activity correlated with cigarette and voucher value. Dependent smokers had a higher willingness-to-pay for cigarettes and greater activity in the bilateral middle temporal gyrus when faced with cigarette decisions than occasional smokers. Across both groups, the decision to buy cigarettes was associated with activity in the left paracingulate gyrus, right nucleus accumbens, and left amygdala. The decision to buy vouchers was associated with activity in the left superior frontal gyrus, but dependent smokers showed weaker activity in the left posterior cingulate gyrus than occasional smokers. Across both groups, cigarette value signals were observed in the left striatum and ventromedial prefrontal cortex. To summarise, nicotine dependence was associated with greater behavioural valuation of cigarettes and brain activity during cigarette decisions. When purchasing cigarettes and vouchers, reward and decision-related brain regions were activated in both groups. For the first time, we identified value signals for cigarettes in the brain.
Collapse
Affiliation(s)
- Will Lawn
- Clinical Psychopharmacology Unit, University College London, UK
| | - Ludo Mithchener
- Clinical Psychopharmacology Unit, University College London, UK
| | - Tom P Freeman
- Clinical Psychopharmacology Unit, University College London, UK
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
- Addiction and Mental Health Group (AIM), University of Bath, UK
| | | | - James A Bisby
- Institute of Cognitive Neuroscience, University College London, UK
| | - Matt B Wall
- Clinical Psychopharmacology Unit, University College London, UK
- Invicro, Invicro London, UK
| | | | - Helen V Curran
- Clinical Psychopharmacology Unit, University College London, UK
| | - Celia J A Morgan
- Clinical Psychopharmacology Unit, University College London, UK
- Psychopharmacology and Addiction Research Centre, University of Exeter, UK
| |
Collapse
|
13
|
Hindocha C, Quattrone D, Freeman TP, Murray RM, Mondelli V, Breen G, Curtis C, Morgan CJA, Valerie Curran H, Di Forti M. Do AKT1, COMT and FAAH influence reports of acute cannabis intoxication experiences in patients with first episode psychosis, controls and young adult cannabis users? Transl Psychiatry 2020; 10:143. [PMID: 32398646 PMCID: PMC7217850 DOI: 10.1038/s41398-020-0823-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 04/07/2020] [Accepted: 04/28/2020] [Indexed: 12/22/2022] Open
Abstract
Epidemiological and biological evidence support the association between heavy cannabis use and psychosis. However, it is unclear which cannabis users are susceptible to its psychotogenic effect. Therefore, understanding genetic factors contributing to this relationship might prove an important strategy to identify the mechanisms underlying cannabis-associated psychotic experiences. We aimed to determine how variation in AKT1, COMT and FAAH genotypes, and their interaction with three different groups (first episode psychosis (FEP) patients (n = 143), controls (n = 92) and young adult (YA) cannabis users n = 485)) influenced cannabis experiences, in those who had used cannabis at least once. We investigated the role of AKT1 (rs2494732), COMT Val158Met (rs4680) and FAAH (rs324420) on cannabis experiences by combining data from a large case-control study of FEP patients, with a naturalistic study of YA cannabis users (n = 720). Outcome measures were cannabis-induced psychotic-like experiences (cPLEs) and euphoric experiences (cEEs). We used linear mixed effects models to assess the effects of each genotype and their interaction with group, adjusting for age, sex, ethnicity, age of first cannabis use, years of use and frequency. cPLEs were more frequent in FEP patients than controls and YA cannabis users. cEEs were more prevalent in YA cannabis users than FEP patients or controls. Variation in AKT1, COMT or FAAH was not associated with cPLEs/cEEs. There was no interaction between genotype and group (FEP cases, controls and YA cannabis users) on cPLEs/cEEs. In conclusion, AKT1, COMT or FAAH did not modulate specific psychotomimetic response to cannabis and did not interact with group, contrary to previous research.
Collapse
Affiliation(s)
- Chandni Hindocha
- Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom. .,Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, London, United Kingdom. .,NIHR University College London Hospitals Biomedical Research Centre, University College Hospital, London, United Kingdom.
| | - Diego Quattrone
- grid.13097.3c0000 0001 2322 6764Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, SE5 8AF UK ,grid.451056.30000 0001 2116 3923National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London, London, UK ,grid.451052.70000 0004 0581 2008South London and Maudsley NHS Mental Health Foundation Trust, London, UK
| | - Tom P. Freeman
- grid.83440.3b0000000121901201Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom ,grid.83440.3b0000000121901201Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, London, United Kingdom ,grid.7340.00000 0001 2162 1699Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
| | - Robin M. Murray
- grid.451056.30000 0001 2116 3923National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London, London, UK ,grid.37640.360000 0000 9439 0839NIHR BioResource Centre Maudsley, NIHR Maudsley Biomedical Research Centre (BRC) at South London and Maudsley NHS Foundation Trust (SLaM), London, UK
| | - Valeria Mondelli
- grid.13097.3c0000 0001 2322 6764Department of Psychological Medicine, Institute of Psychiatry, Kings College London, De Crespigny Park, SE5 8AF London, UK
| | - Gerome Breen
- grid.13097.3c0000 0001 2322 6764Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, SE5 8AF UK ,grid.451056.30000 0001 2116 3923National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London, London, UK ,grid.13097.3c0000 0001 2322 6764Department of Psychosis Studies, Institute of Psychiatry, King’s College London, De Crespigny Park, Denmark Hill, London, SE5 8AF UK
| | - Charles Curtis
- grid.13097.3c0000 0001 2322 6764Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, SE5 8AF UK ,grid.451056.30000 0001 2116 3923National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London, London, UK ,grid.13097.3c0000 0001 2322 6764Department of Psychosis Studies, Institute of Psychiatry, King’s College London, De Crespigny Park, Denmark Hill, London, SE5 8AF UK
| | - Celia J. A. Morgan
- grid.83440.3b0000000121901201Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom ,grid.8391.30000 0004 1936 8024Psychopharmacology and Addiction Research Centre (PARC), University of Exeter, Exeter, UK
| | - H. Valerie Curran
- grid.83440.3b0000000121901201Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom ,grid.439749.40000 0004 0612 2754NIHR University College London Hospitals Biomedical Research Centre, University College Hospital, London, United Kingdom
| | - Marta Di Forti
- grid.13097.3c0000 0001 2322 6764Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, SE5 8AF UK ,grid.451056.30000 0001 2116 3923National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London, London, UK ,grid.451052.70000 0004 0581 2008South London and Maudsley NHS Mental Health Foundation Trust, London, UK
| |
Collapse
|
14
|
Carlyle M, Rowley M, Stevens T, Karl A, Morgan CJA. Impaired empathy and increased anger following social exclusion in non-intoxicated opioid users. Psychopharmacology (Berl) 2020; 237:419-430. [PMID: 31686176 PMCID: PMC7018792 DOI: 10.1007/s00213-019-05378-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 10/05/2019] [Indexed: 12/25/2022]
Abstract
RATIONALE Social functioning is modulated by the endogenous opioid system. In opioid use disorder, social functioning appears disrupted, but little research has delineated the nature of these deficits and their relationship to acute opioid use. OBJECTIVES The current study aimed to assess both emotional and cognitive empathy, along with subjective and physiological responses to social exclusion in opioid users who were either acutely intoxicated or non-intoxicated from using opioids. METHODS Individuals on an opioid substitution medication (OSM) were divided into 'intoxicated users' (had taken their OSM the same day as testing, n = 20) and 'non-intoxicated users' (had taken their OSM > 12 h ago, n = 20) and compared with opioid-naïve controls (n = 24). Empathy was assessed using the multifaceted empathy test and self-report questionnaire. Participants also underwent a period of social exclusion (Cyberball Game) and completed measures of mood and physiological responses (salivary cortisol and heart rate). RESULTS Non-intoxicated users had significantly lower emotional empathy (the ability to experience others' emotions), as well as greater anger after social exclusion when compared with the intoxicated users and controls. Anger did not change with social exclusion in the intoxicated user group and cortisol levels were lower overall. CONCLUSIONS Reduced ability to spontaneously share the emotions of others was reported in non-intoxicated users, particularly regarding positive emotions. There was some support for the idea of hyperalgesia to social pain, but this was restricted to an enhanced anger response in non-intoxicated users. Equivalent rates of empathy between the intoxicated users and controls could indicate some remediating effects of acute opioids.
Collapse
Affiliation(s)
- Molly Carlyle
- Psychopharmacology and Addiction Research Centre (PARC), University of Exeter, Washington Singer Building, Perry Road, Exeter, EX4 4QG, UK.
| | - Megan Rowley
- Psychopharmacology and Addiction Research Centre (PARC), University of Exeter, Washington Singer Building, Perry Road, Exeter, EX4 4QG, UK
| | - Tobias Stevens
- Psychopharmacology and Addiction Research Centre (PARC), University of Exeter, Washington Singer Building, Perry Road, Exeter, EX4 4QG, UK
| | - Anke Karl
- Psychopharmacology and Addiction Research Centre (PARC), University of Exeter, Washington Singer Building, Perry Road, Exeter, EX4 4QG, UK
| | - Celia J A Morgan
- Psychopharmacology and Addiction Research Centre (PARC), University of Exeter, Washington Singer Building, Perry Road, Exeter, EX4 4QG, UK
| |
Collapse
|
15
|
Lawn W, Freeman TP, East K, Gaule A, Aston ER, Bloomfield MAP, Das RK, Morgan CJA, Curran HV. The Acute Effects of a Dopamine D3 Receptor Preferring Agonist on Motivation for Cigarettes in Dependent and Occasional Cigarette Smokers. Nicotine Tob Res 2019; 20:800-809. [PMID: 29065193 PMCID: PMC5991206 DOI: 10.1093/ntr/ntx159] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 07/12/2017] [Indexed: 12/13/2022]
Abstract
Background Dopaminergic functioning is thought to play critical roles in both motivation and addiction. There is preliminary evidence that dopamine agonists reduce the motivation for cigarettes in smokers. However, the effects of pramipexole, a dopamine D3 receptor preferring agonist, have not been investigated. The aim of this study was to examine the effects of an acute dose of pramipexole on the motivation to earn cigarettes and nondrug rewards. Methods Twenty dependent and 20 occasional smokers received 0.5 mg pramipexole using a double-blind, placebo-controlled crossover design. Motivation for cigarettes and consummatory nondrug rewards was measured using the DReaM-Choice task, in which participants earned, and later “consumed,” cigarettes, music, and chocolate. Demand for cigarettes was measured using the Cigarette Purchase Task (CPT). Self-reported craving, withdrawal, and drug effects were also recorded. Results Dependent smokers chose (p < .001) and button-pressed for (p < .001) cigarettes more, and chose chocolate less (p < .001), than occasional smokers. Pramipexole did not affect the number of choices for or amount of button-pressing for any reward including cigarettes, which was supported by a Bayesian analysis. The dependent smokers had greater demand for cigarettes than occasional smokers across all CPT outcomes (ps < .021), apart from elasticity. Pramipexole did not affect demand for cigarettes, and this was supported by Bayesian analyses. Pramipexole produced greater subjective “feel drug” and “dislike drug” effects than placebo. Conclusions Dependent and occasional cigarette smokers differed in their motivation for cigarettes but not for the nondrug rewards. Pramipexole did not acutely alter motivation for cigarettes. These findings question the role of dopamine D3 receptors in cigarette-seeking behavior in dependent and occasional smokers. Implications This study adds to the growing literature about cigarette versus nondrug reward processing in nicotine dependence and the role of dopamine in cigarette-seeking behavior. Our results suggest nicotine dependence is associated with a hypersensitivity to cigarette rewards but not a hyposensitivity to nondrug rewards. Furthermore, our results question the importance of dopamine D3 receptors in motivational processing of cigarettes in occasional and dependent smokers.
Collapse
Affiliation(s)
- Will Lawn
- Clinical Psychopharmacology unit, University College London, London, UK
| | - Tom P Freeman
- Clinical Psychopharmacology unit, University College London, London, UK.,Addictions Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Katie East
- Addictions Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Annie Gaule
- Clinical Psychopharmacology unit, University College London, London, UK
| | - Elizabeth R Aston
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI
| | - Michael A P Bloomfield
- Clinical Psychopharmacology unit, University College London, London, UK.,Psychiatric Imaging Group, Medical Research Council Clinical Sciences Centre, Hammersmith Hospital, London, UK.,Division of Psychiatry, University College London, Maple House, London, UK
| | - Ravi K Das
- Clinical Psychopharmacology unit, University College London, London, UK
| | - Celia J A Morgan
- Clinical Psychopharmacology unit, University College London, London, UK.,Department of Psychology, University of Exeter, Washington Singer Building, Exeter, UK
| | - H Valerie Curran
- Clinical Psychopharmacology unit, University College London, London, UK
| |
Collapse
|
16
|
Curran HV, Hindocha C, Morgan CJA, Shaban N, Das RK, Freeman TP. Which biological and self-report measures of cannabis use predict cannabis dependency and acute psychotic-like effects? Psychol Med 2019; 49:1574-1580. [PMID: 30176957 PMCID: PMC6541869 DOI: 10.1017/s003329171800226x] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 07/27/2018] [Accepted: 08/02/2018] [Indexed: 12/23/2022]
Abstract
BACKGROUND Changes in cannabis regulation globally make it increasingly important to determine what predicts an individual's risk of experiencing adverse drug effects. Relevant studies have used diverse self-report measures of cannabis use, and few include multiple biological measures. Here we aimed to determine which biological and self-report measures of cannabis use predict cannabis dependency and acute psychotic-like symptoms. METHOD In a naturalistic study, 410 young cannabis users were assessed once when intoxicated with their own cannabis and once when drug-free in counterbalanced order. Biological measures of cannabinoids [(Δ9-tetrahydrocannabinol (THC), cannabidiol (CBD), cannabinol (CBN) and their metabolites)] were derived from three samples: each participant's own cannabis (THC, CBD), a sample of their hair (THC, THC-OH, THC-COOH, CBN, CBD) and their urine (THC-COOH/creatinine). Comprehensive self-report measures were also obtained. Self-reported and clinician-rated assessments were taken for cannabis dependency [Severity of Dependence Scale (SDS), DSM-IV-TR] and acute psychotic-like symptoms [Psychotomimetic State Inventory (PSI) and Brief Psychiatric Rating Scale (BPRS)]. RESULTS Cannabis dependency was positively associated with days per month of cannabis use on both measures, and with urinary THC-COOH/creatinine for the SDS. Acute psychotic-like symptoms were positively associated with age of first cannabis use and negatively with urinary THC-COOH/creatinine; no predictors emerged for BPRS. CONCLUSIONS Levels of THC exposure are positively associated with both cannabis dependency and tolerance to the acute psychotic-like effects of cannabis. Combining urinary and self-report assessments (use frequency; age first used) enhances the measurement of cannabis use and its association with adverse outcomes.
Collapse
Affiliation(s)
- H. Valerie Curran
- Clinical Psychopharmacology Unit, University College London, Gower St, London, UK
| | - Chandni Hindocha
- Clinical Psychopharmacology Unit, University College London, Gower St, London, UK
| | - Celia J. A. Morgan
- Clinical Psychopharmacology Unit, University College London, Gower St, London, UK
- Department of Psychology, University of Exeter, Washington Singer Building, Perry Road, Exeter, UK
| | - Natacha Shaban
- Clinical Psychopharmacology Unit, University College London, Gower St, London, UK
| | - Ravi K. Das
- Clinical Psychopharmacology Unit, University College London, Gower St, London, UK
| | - Tom P. Freeman
- Clinical Psychopharmacology Unit, University College London, Gower St, London, UK
- National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| |
Collapse
|
17
|
Hindocha C, Freeman TP, Grabski M, Crudgington H, Davies AC, Stroud JB, Das RK, Lawn W, Morgan CJA, Curran HV. The effects of cannabidiol on impulsivity and memory during abstinence in cigarette dependent smokers. Sci Rep 2018; 8:7568. [PMID: 29765102 PMCID: PMC5954148 DOI: 10.1038/s41598-018-25846-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Accepted: 04/30/2018] [Indexed: 02/03/2023] Open
Abstract
Acute nicotine abstinence in cigarette smokers results in deficits in performance on specific cognitive processes, including working memory and impulsivity which are important in relapse. Cannabidiol (CBD), the non-intoxicating cannabinoid found in cannabis, has shown pro-cognitive effects and preliminary evidence has indicated it can reduce the number of cigarettes smoked in dependent smokers. However, the effects of CBD on cognition have never been tested during acute nicotine withdrawal. The present study therefore aimed to investigate if CBD can improve memory and reduce impulsivity during acute tobacco abstinence. Thirty, non-treatment seeking, dependent, cigarette smokers attended two laboratory-based sessions after overnight abstinence, in which they received either 800 mg oral CBD or placebo (PBO), in a randomised order. Abstinence was biologically verified. Participants were assessed on go/no-go, delay discounting, prose recall and N-back (0-back, 1-back, 2-back) tasks. The effects of CBD on delay discounting, prose recall and the N-back (correct responses, maintenance or manipulation) were null, confirmed by a Bayesian analysis, which found evidence for the null hypothesis. Contrary to our predictions, CBD increased commission errors on the go/no-go task. In conclusion, a single 800 mg dose of CBD does not improve verbal or spatial working memory, or impulsivity during tobacco abstinence.
Collapse
Affiliation(s)
- C Hindocha
- Clinical Psychopharmacology Unit, University College London, WC1E 7HB, London, United Kingdom.
| | - T P Freeman
- Clinical Psychopharmacology Unit, University College London, WC1E 7HB, London, United Kingdom.,National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8BB, United Kingdom
| | - M Grabski
- Clinical Psychopharmacology Unit, University College London, WC1E 7HB, London, United Kingdom.,School of Experimental Psychology, University of Bristol, 12a Priory Road, BS81TU, Bristol, United Kingdom
| | - H Crudgington
- Clinical Psychopharmacology Unit, University College London, WC1E 7HB, London, United Kingdom
| | - A C Davies
- Clinical Psychopharmacology Unit, University College London, WC1E 7HB, London, United Kingdom
| | | | - R K Das
- Clinical Psychopharmacology Unit, University College London, WC1E 7HB, London, United Kingdom
| | - W Lawn
- Clinical Psychopharmacology Unit, University College London, WC1E 7HB, London, United Kingdom
| | - C J A Morgan
- Clinical Psychopharmacology Unit, University College London, WC1E 7HB, London, United Kingdom.,Psychopharmacology and Addiction Research Centre, University of Exeter, Devon, UK
| | - H V Curran
- Clinical Psychopharmacology Unit, University College London, WC1E 7HB, London, United Kingdom
| |
Collapse
|
18
|
Hindocha C, Freeman TP, Grabski M, Stroud JB, Crudgington H, Davies AC, Das RK, Lawn W, Morgan CJA, Curran HV. Cannabidiol reverses attentional bias to cigarette cues in a human experimental model of tobacco withdrawal. Addiction 2018; 113:1696-1705. [PMID: 29714034 PMCID: PMC6099309 DOI: 10.1111/add.14243] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 01/15/2018] [Accepted: 04/06/2018] [Indexed: 01/01/2023]
Abstract
BACKGROUND AND AIMS Cannabidiol (CBD), a non-intoxicating cannabinoid found in cannabis, may be a promising novel smoking cessation treatment due to its anxiolytic properties, minimal side effects and research showing that it may modify drug cue salience. We used an experimental medicine approach with dependent cigarette smokers to investigate if (1) overnight nicotine abstinence, compared with satiety, will produce greater attentional bias (AB), higher pleasantness ratings of cigarette-related stimuli and increased craving and withdrawal; and (2) CBD in comparison to placebo, would attenuate AB, pleasantness of cigarette-related stimuli, craving and withdrawal and not produce any side effects. DESIGN Randomized, double-blind cross-over study with a fixed satiated session followed by two overnight abstinent sessions. SETTING UK laboratory. PARTICIPANTS Thirty non-treatment-seeking, dependent cigarette smokers recruited from the community. INTERVENTION AND COMPARATOR 800 mg oral CBD, or matched placebo (PBO) in a counterbalanced order MEASUREMENTS: AB to pictorial tobacco cues was recorded using a visual probe task and an explicit rating task. Withdrawal, craving, side effects, heart rate and blood pressure were assessed repeatedly. FINDINGS When participants received PBO, tobacco abstinence increased AB (P = 0.001, d = 0.789) compared with satiety. However, CBD reversed this effect, such that automatic AB was directed away from cigarette cues (P = 0.007, d = 0.704) and no longer differed from satiety (P = 0.82). Compared with PBO, CBD also reduced explicit pleasantness of cigarette images (P = 0.011; d = 0.514). Craving (Bayes factor = 7.08) and withdrawal (Bayes factor = 6.95) were unaffected by CBD, but greater in abstinence compared with satiety. Systolic blood pressure decreased under CBD during abstinence. CONCLUSIONS A single 800-mg oral dose of cannabidiol reduced the salience and pleasantness of cigarette cues, compared with placebo, after overnight cigarette abstinence in dependent smokers. Cannabidiol did not influence tobacco craving or withdrawal or any subjectively rated side effects.
Collapse
Affiliation(s)
- Chandni Hindocha
- Clinical Psychopharmacology UnitUniversity College LondonLondonUK
| | - Tom P. Freeman
- Clinical Psychopharmacology UnitUniversity College LondonLondonUK
- National Addiction Centre, Institute of PsychiatryPsychology and Neuroscience, King's College LondonLondonUK
| | - Meryem Grabski
- Clinical Psychopharmacology UnitUniversity College LondonLondonUK
- School of Experimental PsychologyUniversity of BristolBristolUK
| | - Jack B. Stroud
- Clinical Psychopharmacology UnitUniversity College LondonLondonUK
| | | | - Alan C. Davies
- Clinical Psychopharmacology UnitUniversity College LondonLondonUK
| | - Ravi K. Das
- Clinical Psychopharmacology UnitUniversity College LondonLondonUK
| | - William Lawn
- Clinical Psychopharmacology UnitUniversity College LondonLondonUK
| | - Celia J. A. Morgan
- Clinical Psychopharmacology UnitUniversity College LondonLondonUK
- Psychopharmacology and Addiction Research CentreUniversity of ExeterExeterUK
| | | |
Collapse
|
19
|
Lawn W, Hallak JE, Crippa JA, Dos Santos R, Porffy L, Barratt MJ, Ferris JA, Winstock AR, Morgan CJA. Author Correction: Well-being, problematic alcohol consumption and acute subjective drug effects in past-year ayahuasca users: a large, international, self-selecting online survey. Sci Rep 2018; 8:4059. [PMID: 29497055 PMCID: PMC5832875 DOI: 10.1038/s41598-018-21666-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Will Lawn
- Clinical Psychopharmacology Unit, University College London, London, UK. .,Psychopharmacology and Addiction Research Centre, University of Exeter, Exeter, UK.
| | - Jaime E Hallak
- Department of Psychiatry, University of Sao Paolo, Ribero, Preto, Brazil
| | - Jose A Crippa
- Department of Psychiatry, University of Sao Paolo, Ribero, Preto, Brazil
| | - Rafael Dos Santos
- Department of Psychiatry, University of Sao Paolo, Ribero, Preto, Brazil
| | - Lilla Porffy
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Monica J Barratt
- Drug Policy Modelling Program, National Drug and Alcohol Research Centre, UNSW, Sydney, NSW, Australia.,National Drug Research Institute, Faculty of Health Sciences, Curtin University, Perth, WA, Australia.,Behaviours and Health Risks Program, Burnet Institute, Melbourne, VIC, Australia
| | - Jason A Ferris
- Institute for Social Science Research, University of Queensland, St Lucia, Australia
| | | | - Celia J A Morgan
- Clinical Psychopharmacology Unit, University College London, London, UK.,Psychopharmacology and Addiction Research Centre, University of Exeter, Exeter, UK
| |
Collapse
|
20
|
Ivan Ezquerra-Romano I, Lawn W, Krupitsky E, Morgan CJA. Ketamine for the treatment of addiction: Evidence and potential mechanisms. Neuropharmacology 2018; 142:72-82. [PMID: 29339294 DOI: 10.1016/j.neuropharm.2018.01.017] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Revised: 01/08/2018] [Accepted: 01/11/2018] [Indexed: 12/14/2022]
Abstract
Ketamine is a dissociative anaesthetic drug which acts on the central nervous system chiefly through antagonism of the n-methyl-d-aspartate (NMDA) receptor. Recently, ketamine has attracted attention as a rapid-acting anti-depressant but other studies have also reported its efficacy in reducing problematic alcohol and drug use. This review explores the preclinical and clinical research into ketamine's ability to treat addiction. Despite methodological limitations and the relative infancy of the field, results thus far are promising. Ketamine has been shown to effectively prolong abstinence from alcohol and heroin in detoxified alcoholics and heroin dependent individuals, respectively. Moreover, ketamine reduced craving for and self-administration of cocaine in non-treatment seeking cocaine users. However, further randomised controlled trials are urgently needed to confirm ketamine's efficacy. Possible mechanisms by which ketamine may work within addiction include: enhancement of neuroplasticity and neurogenesis, disruption of relevant functional neural networks, treating depressive symptoms, blocking reconsolidation of drug-related memories, provoking mystical experiences and enhancing psychological therapy efficacy. Identifying the mechanisms by which ketamine exerts its therapeutic effects in addiction, from the many possible candidates, is crucial for advancing this treatment and may have broader implications understanding other psychedelic therapies. In conclusion, ketamine shows great promise as a treatment for various addictions, but well-controlled research is urgently needed. This article is part of the Special Issue entitled 'Psychedelics: New Doors, Altered Perceptions'.
Collapse
Affiliation(s)
- I Ivan Ezquerra-Romano
- Department of Neuroscience, Physiology and Pharmacology, University College London, Gower Street, London, UK
| | - W Lawn
- Clinical Psychopharmacology Unit, University College London, Gower Street, London, UK
| | - E Krupitsky
- St.-Petersburg Pavlov State Medical University and Bekhterev Research Psychoneurological Institute, St. Petersburg, Russia
| | - C J A Morgan
- Clinical Psychopharmacology Unit, University College London, Gower Street, London, UK; Psychopharmacology and Addiction Research Centre, University of Exeter, Exeter, UK.
| |
Collapse
|
21
|
Freeman TP, Pope RA, Wall MB, Bisby JA, Luijten M, Hindocha C, Mokrysz C, Lawn W, Moss A, Bloomfield MAP, Morgan CJA, Nutt DJ, Curran HV. Cannabis Dampens the Effects of Music in Brain Regions Sensitive to Reward and Emotion. Int J Neuropsychopharmacol 2018; 21:21-32. [PMID: 29025134 PMCID: PMC5795345 DOI: 10.1093/ijnp/pyx082] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Despite the current shift towards permissive cannabis policies, few studies have investigated the pleasurable effects users seek. Here, we investigate the effects of cannabis on listening to music, a rewarding activity that frequently occurs in the context of recreational cannabis use. We additionally tested how these effects are influenced by cannabidiol, which may offset cannabis-related harms. METHODS Across 3 sessions, 16 cannabis users inhaled cannabis with cannabidiol, cannabis without cannabidiol, and placebo. We compared their response to music relative to control excerpts of scrambled sound during functional Magnetic Resonance Imaging within regions identified in a meta-analysis of music-evoked reward and emotion. All results were False Discovery Rate corrected (P<.05). RESULTS Compared with placebo, cannabis without cannabidiol dampened response to music in bilateral auditory cortex (right: P=.005, left: P=.008), right hippocampus/parahippocampal gyrus (P=.025), right amygdala (P=.025), and right ventral striatum (P=.033). Across all sessions, the effects of music in this ventral striatal region correlated with pleasure ratings (P=.002) and increased functional connectivity with auditory cortex (right: P< .001, left: P< .001), supporting its involvement in music reward. Functional connectivity between right ventral striatum and auditory cortex was increased by cannabidiol (right: P=.003, left: P=.030), and cannabis with cannabidiol did not differ from placebo on any functional Magnetic Resonance Imaging measures. Both types of cannabis increased ratings of wanting to listen to music (P<.002) and enhanced sound perception (P<.001). CONCLUSIONS Cannabis dampens the effects of music in brain regions sensitive to reward and emotion. These effects were offset by a key cannabis constituent, cannabidol.
Collapse
Affiliation(s)
- Tom P Freeman
- Clinical Psychopharmacology Unit, University College London, United Kingdom.,National Addiction Centre, King's College London, United Kingdom
| | - Rebecca A Pope
- Clinical Psychopharmacology Unit, University College London, United Kingdom
| | - Matthew B Wall
- Clinical Psychopharmacology Unit, University College London, United Kingdom.,Imanova Centre for Imaging Sciences, Imperial College London, Hammersmith Hospital, London, United Kingdom.,Neuropsychopharmacology Unit, Division of Brain Sciences, Imperial College London, London, United Kingdom
| | - James A Bisby
- Institute of Cognitive Neuroscience, University College London, United Kingdom
| | - Maartje Luijten
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Chandni Hindocha
- Clinical Psychopharmacology Unit, University College London, United Kingdom
| | - Claire Mokrysz
- Clinical Psychopharmacology Unit, University College London, United Kingdom
| | - Will Lawn
- Clinical Psychopharmacology Unit, University College London, United Kingdom
| | - Abigail Moss
- Clinical Psychopharmacology Unit, University College London, United Kingdom
| | - Michael A P Bloomfield
- Psychiatric Imaging Group, Medical Research Council Clinical Sciences Centre, Hammersmith Hospital, London, United Kingdom.,Division of Psychiatry, University College London, United Kingdom
| | - Celia J A Morgan
- Clinical Psychopharmacology Unit, University College London, United Kingdom.,Department of Psychology, University of Exeter, United Kingdom
| | - David J Nutt
- Neuropsychopharmacology Unit, Division of Brain Sciences, Imperial College London, London, United Kingdom
| | - H Valerie Curran
- Clinical Psychopharmacology Unit, University College London, United Kingdom
| |
Collapse
|
22
|
Carlyle M, Dumay N, Roberts K, McAndrew A, Stevens T, Lawn W, Morgan CJA. Improved memory for information learnt before alcohol use in social drinkers tested in a naturalistic setting. Sci Rep 2017; 7:6213. [PMID: 28740085 PMCID: PMC5524957 DOI: 10.1038/s41598-017-06305-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 06/09/2017] [Indexed: 01/08/2023] Open
Abstract
Alcohol is known to facilitate memory if given after learning information in the laboratory; we aimed to investigate whether this effect can be found when alcohol is consumed in a naturalistic setting. Eighty-eight social drinkers were randomly allocated to either an alcohol self-dosing or a sober condition. The study assessed both retrograde facilitation and alcohol induced memory impairment using two independent tasks. In the retrograde task, participants learnt information in their own homes, and then consumed alcohol ad libitum. Participants then undertook an anterograde memory task of alcohol impairment when intoxicated. Both memory tasks were completed again the following day. Mean amount of alcohol consumed was 82.59 grams over the evening. For the retrograde task, as predicted, both conditions exhibited similar performance on the memory task immediately following learning (before intoxication) yet performance was better when tested the morning after encoding in the alcohol condition only. The anterograde task did not reveal significant differences in memory performance post-drinking. Units of alcohol drunk were positively correlated with the amount of retrograde facilitation the following morning. These findings demonstrate the retrograde facilitation effect in a naturalistic setting, and found it to be related to the self-administered grams of alcohol.
Collapse
Affiliation(s)
- Molly Carlyle
- Psychopharmacology and Addiction Research Centre (PARC), University of Exeter, Exeter, UK
| | - Nicolas Dumay
- Psychopharmacology and Addiction Research Centre (PARC), University of Exeter, Exeter, UK.,BCBL, Basque Center on Cognition, Brain and Language, Donostia-San Sebastián, Spain
| | - Karen Roberts
- Psychopharmacology and Addiction Research Centre (PARC), University of Exeter, Exeter, UK
| | - Amy McAndrew
- Psychopharmacology and Addiction Research Centre (PARC), University of Exeter, Exeter, UK
| | - Tobias Stevens
- Psychopharmacology and Addiction Research Centre (PARC), University of Exeter, Exeter, UK
| | - Will Lawn
- Psychopharmacology and Addiction Research Centre (PARC), University of Exeter, Exeter, UK.,Clinical Psychopharmacology Unit, University College London, London, UK
| | - Celia J A Morgan
- Psychopharmacology and Addiction Research Centre (PARC), University of Exeter, Exeter, UK.
| |
Collapse
|
23
|
McAndrew A, Lawn W, Stevens T, Porffy L, Brandner B, Morgan CJA. A proof-of-concept investigation into ketamine as a pharmacological treatment for alcohol dependence: study protocol for a randomised controlled trial. Trials 2017; 18:159. [PMID: 28372596 PMCID: PMC5379743 DOI: 10.1186/s13063-017-1895-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 03/12/2017] [Indexed: 12/12/2022] Open
Abstract
Background Worldwide, alcohol abuse is a burgeoning problem. Abstinence is key to allow recovery of physical and mental health as well as quality of life, but treatment for alcohol dependence is associated with high relapse rates. Preliminary data have suggested that a combined repeated ketamine and psychological therapy programme may be effective in reducing relapse in severe alcohol use disorder. This non-commercial proof-of-concept trial is aimed at making a preliminary assessment of the effectiveness of this combined treatment in this patient group. Methods/design This is a phase II, randomised, double-blind, placebo-controlled, parallel-group clinical trial taking place in two sites in the UK: the South West of England and London. Ninety-six recently detoxified alcoholics, with comorbid depressive symptoms, will be randomised to one of four treatment arms. Patients will receive either three sessions of ketamine (0.8 mg/kg administered intravenously (IV) over 40 minutes) or placebo (50 ml saline 0.9% IV over 40 minutes) plus either seven sessions of manualised psychological therapy or an alcohol education control. Patients will be assessed at 3 and 6 months on a range of psychological and biological variables. The primary endpoints are (1) relapse rates at 6 months and (2) percentage days abstinent at 6 months. Secondary endpoints include 3 and 6 month percentage days abstinence, tolerability (indicated by dropout), adverse events, depressive symptoms, craving and quality of life. Discussion This study will provide important information on a new combined psychological and pharmacological intervention aimed at reducing relapse rates in alcoholics. The findings would have broad application given the worldwide prevalence of alcoholism and its associated medical, psychological and social problems. Trial registration ClinicalTrials.gov, NCT02649231. Registered on 5 January 2016. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-1895-6) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Amy McAndrew
- Psychopharmacology and Addiction Research Centre (PARC), College of Life and Environmental Science, University of Exeter, Washington Singer Building, Perry Road, Exeter, EX4 4QG, UK.
| | - Will Lawn
- Clinical Psychopharmacology Unit, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Tobias Stevens
- Psychopharmacology and Addiction Research Centre (PARC), College of Life and Environmental Science, University of Exeter, Washington Singer Building, Perry Road, Exeter, EX4 4QG, UK
| | - Lilla Porffy
- Clinical Psychopharmacology Unit, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Brigitta Brandner
- Anaesthetics Department, Podium 3, maple Link corridor, Unviersity College Hospital, 235 Euston Road, London, NW1 2BU, UK
| | - Celia J A Morgan
- Psychopharmacology and Addiction Research Centre (PARC), College of Life and Environmental Science, University of Exeter, Washington Singer Building, Perry Road, Exeter, EX4 4QG, UK
| |
Collapse
|
24
|
Abstract
In an increasing number of states and countries, cannabis now stands poised to join alcohol and tobacco as a legal drug. Quantifying the relative adverse and beneficial effects of cannabis and its constituent cannabinoids should therefore be prioritized. Whereas newspaper headlines have focused on links between cannabis and psychosis, less attention has been paid to the much more common problem of cannabis addiction. Certain cognitive changes have also been attributed to cannabis use, although their causality and longevity are fiercely debated. Identifying why some individuals are more vulnerable than others to the adverse effects of cannabis is now of paramount importance to public health. Here, we review the current state of knowledge about such vulnerability factors, the variations in types of cannabis, and the relationship between these and cognition and addiction.
Collapse
Affiliation(s)
- H Valerie Curran
- Clinical Psychopharmacology Unit, University College London, Gower Street, London WC1E 6BT, UK
| | - Tom P Freeman
- Clinical Psychopharmacology Unit, University College London, Gower Street, London WC1E 6BT, UK
| | - Claire Mokrysz
- Clinical Psychopharmacology Unit, University College London, Gower Street, London WC1E 6BT, UK
| | - David A Lewis
- Department of Psychiatry, University of Pittsburgh, 3811 O'Hara Street, Pittsburgh, Pennsylvania 15213, USA
| | - Celia J A Morgan
- Clinical Psychopharmacology Unit, University College London, Gower Street, London WC1E 6BT, UK.,Psychopharmacology and Addiction Research Centre, University of Exeter, Perry Road, Exeter EX4 4QG, UK
| | - Loren H Parsons
- The Scripps Research Institute, 10550 N. Torrey Pines Road, SP30-2001, La Jolla, California 92037, USA
| |
Collapse
|
25
|
Lawn W, Freeman TP, Hindocha C, Mokrysz C, Das RK, Morgan CJA, Curran HV. The effects of nicotine dependence and acute abstinence on the processing of drug and non-drug rewards. Psychopharmacology (Berl) 2015; 232:2503-17. [PMID: 25757672 DOI: 10.1007/s00213-015-3883-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 02/06/2015] [Indexed: 10/23/2022]
Abstract
RATIONALE Drug addiction may be characterised by a hypersensitivity to drug rewards and a hyposensitivity to non-drug rewards. This imbalance may become further polarised during acute abstinence. OBJECTIVES (i) Examine the differences between dependent and occasional smokers in choices for, motivation for and self-reported wanting and liking of cigarette and non-drug rewards. (ii) Examine the effects of 12-h nicotine abstinence on these metrics. METHODS Dependent (n = 20) and occasional, non-dependent smokers (n = 20) were tested after ad libitum smoking and ≥12-h of nicotine abstinence. A novel task was developed (Drug, Reward and Motivation-Choice (DReaM-Choice)) in which different rewards (cigarettes, music and chocolate) could be won. In each trial, participants chose between two rewards and then could earn the chosen reward via repeated button-pressing. Participants subsequently 'consumed' and rated subjective liking of the rewards they had won. RESULTS Compared with occasional smokers, dependent smokers made more choices for (p < 0.001), pressed more for (p = 0.046) and reported more wanting (p = 0.007) and liking (p < 0.001) of cigarettes, and also made fewer choices for chocolate (p = 0.005). There were no differences between the groups on button-pressing for chocolate or music. However, the balance between drug and non-drug reward processing was different between the groups across all metrics. Twelve-hour nicotine abstinence led to more cigarette choices (p < 0.001) and fewer music choices (p = 0.042) in both groups. CONCLUSIONS Nicotine dependence was associated with a hypersensitivity to cigarette rewards, but we found little evidence indicating a hyposensitivity to non-drug rewards. Our findings question the moderating influence of dependence on how acute nicotine abstinence affects reward processing.
Collapse
Affiliation(s)
- W Lawn
- Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, University College London, Gower Street, London, WC1E 6BT, UK,
| | | | | | | | | | | | | |
Collapse
|
26
|
Stewart LH, Ferguson B, Morgan CJA, Swaboda N, Jones L, Fenton R, Wall MB, Curran HV. Effects of ecstasy on cooperative behaviour and perception of trustworthiness: a naturalistic study. J Psychopharmacol 2014; 28:1001-8. [PMID: 25122044 DOI: 10.1177/0269881114544775] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Acute recreational use of 3,4-methylenedioxymethamphetamine (MDMA; 'ecstasy') can promote pro-social effects which may alter interpersonal perceptions. AIMS To explore such effects, this study investigated whether acute recreational use of ecstasy was associated with changes in individual perception of trustworthiness of people's faces and co-operative behaviours. METHOD An independent group, repeated measures design was used in which 17 ecstasy users were tested on the night of drug use (day 0) and again three days later (day 3); 22 controls were tested on parallel days. On each day, participants rated the trustworthiness of 66 faces, carried out three co-operative behaviour tasks (public good; dictator; ultimatum game) and completed mood self-ratings. RESULTS Acute ecstasy use was associated with increased face trustworthiness ratings and increased cooperative behaviour on the dictator and ultimatum games; on day 3 there were no group differences on any task. Self-ratings showed the standard acute ecstasy effects (euphoria, energy, jaw clenching) with negative effects (less empathy, compassion, more distrust, hostility) emerging on day 3. CONCLUSIONS Our findings of increased perceived trustworthiness and co-operative behaviours following use of ecstasy suggest that a single dose of the drug enhances aspects of empathy. This may in turn contribute to its popularity as a recreational drug and potentially to its enhancement of the therapeutic alliance in psychotherapy.
Collapse
Affiliation(s)
- L H Stewart
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - B Ferguson
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - C J A Morgan
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - N Swaboda
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - L Jones
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - R Fenton
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - M B Wall
- Imanova Centre for Imaging Sciences, London, UK Division of Brain Sciences, Imperial College London, London, UK
| | - H V Curran
- Clinical Psychopharmacology Unit, University College London, London, UK
| |
Collapse
|
27
|
Freeman TP, Morgan CJA, Hindocha C, Schafer G, Das RK, Curran HV. Just say 'know': how do cannabinoid concentrations influence users' estimates of cannabis potency and the amount they roll in joints? Addiction 2014; 109:1686-94. [PMID: 24894801 DOI: 10.1111/add.12634] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Revised: 04/09/2014] [Accepted: 05/29/2014] [Indexed: 11/30/2022]
Abstract
AIMS (1) To determine whether measured concentrations of delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) in individuals' own cannabis predict their estimates of drug potency and actual titration; and (2) to ascertain if these effects are influenced by frequency of use and cannabis type. DESIGN Cross-sectional, naturalistic. SETTING Participants' own homes. PARTICIPANTS A total of 247 cannabis users in the United Kingdom: 152 'recreational' (1-24 days/month) and 95 'daily' (≥25 days/month). METHODS Participants rated their own cannabis for its potency (1-10) and type ('resin', 'herbal', 'skunk') before smoking it in front of the researcher. The amount of cannabis (g) used in their joints was recorded and an additional sample was analysed for THC and CBD concentrations (%). FINDINGS THC concentrations were related negatively to the amount of cannabis used [unstandardized regression coefficient: b = -0.009, 95% confidence interval (CI) = -0.017, -0.002]. Potency estimates were predicted by increasing THC (b = 0.055, 95% CI = 0.020, 0.090) and decreasing CBD (b = -0.160, 95% CI = -0.284, -0.062), and both of these associations were mediated by cannabis type (THC: b = 0.018, 95% CI = 0.006, 0.037; CBD: b = -0.105, 95% CI = -0.198, -0.028). Potency estimates were more reflective of THC as frequency of use increased (b = 0.004, 95% CI = 0.001, 0.007) and were 7.3 times more so in daily (partial r = 0.381) than recreational users (r = 0.052). CONCLUSIONS When using their own cannabis in a naturalistic setting, people titrate the amount they roll in joints according to concentrations of delta-9-tetrahydrocannabinol (THC) but not cannabidiol (CBD). Recreational users thus show poor understanding of cannabis potency.
Collapse
Affiliation(s)
- Tom P Freeman
- Clinical Psychopharmacology Unit, University College London, London, UK
| | | | | | | | | | | |
Collapse
|
28
|
Abstract
BACKGROUND No study has examined ketamine users' psychiatric morbidity using structured diagnostic instruments. The aim of this study was thus to determine the psychiatric comorbidity of community-based ketamine users using the Structured Clinical Interview for DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition), Axis I Disorders (SCID). METHODS A convenience sample of 200 frequent ketamine users was recruited from community organizations in Hong Kong. Participants were screened with the Severity of Dependence Scale (SDS), Beck Depression Inventory (BDI), Anxiety subscale of the Hospital Anxiety Depression Scale (HADSA), and SCID psychotic symptoms. Those who scored above the threshold (cutoff point of 8/9 on the BDI and 4/5 on HADSA) or displayed evidence of psychotic symptoms were referred for a structured clinical interview conducted by a psychiatrist. RESULTS One hundred and seventy participants scored above the cutoff point on 1 or more of the scales, and 115 participants attended the SCID interview. Fifty-one of these 115 participants received a psychiatric diagnosis of 1 or more comorbidities for the month preceding the interview. Mood disorders accounted for 80.4% of the diagnoses, anxiety disorders for 33.3%, and psychotic disorders for 7.8%. CONCLUSIONS Female gender and history of psychiatric/psychological clinic attendance were significantly associated with comorbid psychiatric disorders, whereas ketamine dependence had a borderline association.
Collapse
Affiliation(s)
- Wai Kwong Tang
- a Department of Psychiatry , Chinese University of Hong Kong , Hong Kong SAR , China
| | | | | | | | | | | |
Collapse
|
29
|
Bloomfield MAP, Morgan CJA, Egerton A, Kapur S, Curran HV, Howes OD. Dopaminergic function in cannabis users and its relationship to cannabis-induced psychotic symptoms. Biol Psychiatry 2014; 75:470-8. [PMID: 23820822 DOI: 10.1016/j.biopsych.2013.05.027] [Citation(s) in RCA: 149] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2012] [Revised: 05/17/2013] [Accepted: 05/23/2013] [Indexed: 12/30/2022]
Abstract
BACKGROUND Cannabis is the most widely used illicit drug globally, and users are at increased risk of mental illnesses including psychotic disorders such as schizophrenia. Substance dependence and schizophrenia are both associated with dopaminergic dysfunction. It has been proposed, although never directly tested, that the link between cannabis use and schizophrenia is mediated by altered dopaminergic function. METHODS We compared dopamine synthesis capacity in 19 regular cannabis users who experienced psychotic-like symptoms when they consumed cannabis with 19 nonuser sex- and age-matched control subjects. Dopamine synthesis capacity (indexed as the influx rate constant [Formula: see text] ) was measured with positron emission tomography and 3,4-dihydroxy-6-[(18)F]-fluoro-l-phenylalanine ([(18)F]-DOPA). RESULTS Cannabis users had reduced dopamine synthesis capacity in the striatum (effect size: .85; t36 = 2.54, p = .016) and its associative (effect size: .85; t36 = 2.54, p = .015) and limbic subdivisions (effect size: .74; t36 = 2.23, p = .032) compared with control subjects. The group difference in dopamine synthesis capacity in cannabis users compared with control subjects was driven by those users meeting cannabis abuse or dependence criteria. Dopamine synthesis capacity was negatively associated with higher levels of cannabis use (r = -.77, p < .001) and positively associated with age of onset of cannabis use (r = .51, p = .027) but was not associated with cannabis-induced psychotic-like symptoms (r = .32, p = .19). CONCLUSIONS These findings indicate that chronic cannabis use is associated with reduced dopamine synthesis capacity and question the hypothesis that cannabis increases the risk of psychotic disorders by inducing the same dopaminergic alterations seen in schizophrenia.
Collapse
Affiliation(s)
- Michael A P Bloomfield
- Psychiatric Imaging Group, Medical Research Council Clinical Sciences Centre, Institute of Clinical Sciences, Hammersmith Hospital, Imperial College London; Department of Psychosis Studies, Institute of Psychiatry, King's College London (King's Health Partners), London, United Kingdom
| | - Celia J A Morgan
- Clinical Psychopharmacology Unit, Division of Psychology and Language Sciences, University College London
| | - Alice Egerton
- Psychiatric Imaging Group, Medical Research Council Clinical Sciences Centre, Institute of Clinical Sciences, Hammersmith Hospital, Imperial College London; Department of Psychosis Studies, Institute of Psychiatry, King's College London (King's Health Partners), London, United Kingdom
| | - Shitij Kapur
- Department of Psychosis Studies, Institute of Psychiatry, King's College London (King's Health Partners), London, United Kingdom
| | - H Valerie Curran
- Clinical Psychopharmacology Unit, Division of Psychology and Language Sciences, University College London
| | - Oliver D Howes
- Psychiatric Imaging Group, Medical Research Council Clinical Sciences Centre, Institute of Clinical Sciences, Hammersmith Hospital, Imperial College London; Department of Psychosis Studies, Institute of Psychiatry, King's College London (King's Health Partners), London, United Kingdom.
| |
Collapse
|
30
|
Morgan CJA, Dodds CM, Furby H, Pepper F, Fam J, Freeman TP, Hughes E, Doeller C, King J, Howes O, Stone JM. Long-Term Heavy Ketamine Use is Associated with Spatial Memory Impairment and Altered Hippocampal Activation. Front Psychiatry 2014; 5:149. [PMID: 25538631 PMCID: PMC4255515 DOI: 10.3389/fpsyt.2014.00149] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Accepted: 10/12/2014] [Indexed: 11/13/2022] Open
Abstract
Ketamine, a non-competitive N-methyl-d-aspartate receptor antagonist, is rising in popularity as a drug of abuse. Preliminary evidence suggests that chronic, heavy ketamine use may have profound effects on spatial memory but the mechanism of these deficits is as yet unclear. This study aimed to examine the neural mechanism by which heavy ketamine use impairs spatial memory processing. In a sample of 11 frequent ketamine users and 15 poly-drug controls, matched for IQ, age, years in education. We used fMRI utilizing an ROI approach to examine the neural activity of three regions known to support successful navigation; the hippocampus, parahippocampal gyrus, and the caudate nucleus during a virtual reality task of spatial memory. Frequent ketamine users displayed spatial memory deficits, accompanied by and related to, reduced activation in both the right hippocampus and left parahippocampal gyrus during navigation from memory, and in the left caudate during memory updating, compared to controls. Ketamine users also exhibited schizotypal and dissociative symptoms that were related to hippocampal activation. Impairments in spatial memory observed in ketamine users are related to changes in medial temporal lobe activation. Disrupted medial temporal lobe function may be a consequence of chronic ketamine abuse and may relate to schizophrenia-like symptomatology observed in ketamine users.
Collapse
Affiliation(s)
- Celia J A Morgan
- Centre for Clinical Psychopharmacology, University of Exeter , Exeter , UK ; Clinical Psychopharmacology Unit UCL, University College London , London , UK
| | - Chris M Dodds
- Centre for Clinical Psychopharmacology, University of Exeter , Exeter , UK
| | - Hannah Furby
- Neuroimaging Sciences, Cardiff University , Cardiff , UK
| | - Fiona Pepper
- Institute of Psychiatry, Kings College London , London , UK
| | - Johnson Fam
- Department of Experimental Medicine, Imperial College London , London , UK
| | - Tom P Freeman
- Clinical Psychopharmacology Unit UCL, University College London , London , UK
| | - Emer Hughes
- Department of Experimental Medicine, Imperial College London , London , UK
| | - Christian Doeller
- Donders Institute for Brain, Cognition and Behaviour , Nijmegen , Netherlands
| | - John King
- Clinical Psychopharmacology Unit UCL, University College London , London , UK
| | - Oliver Howes
- Department of Experimental Medicine, Imperial College London , London , UK
| | - James M Stone
- Institute of Psychiatry, Kings College London , London , UK ; Department of Experimental Medicine, Imperial College London , London , UK
| |
Collapse
|
31
|
Morgan CJA, Das RK, Joye A, Curran HV, Kamboj SK. Cannabidiol reduces cigarette consumption in tobacco smokers: preliminary findings. Addict Behav 2013; 38:2433-6. [PMID: 23685330 DOI: 10.1016/j.addbeh.2013.03.011] [Citation(s) in RCA: 118] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2012] [Revised: 01/29/2013] [Accepted: 03/25/2013] [Indexed: 11/19/2022]
Abstract
The role of the endocannabinoid system in nicotine addiction is being increasingly acknowledged. We conducted a pilot, randomised double blind placebo controlled study set out to assess the impact of the ad-hoc use of cannabidiol (CBD) in smokers who wished to stop smoking. 24 smokers were randomised to receive an inhaler of CBD (n=12) or placebo (n=12) for one week, they were instructed to use the inhaler when they felt the urge to smoke. Over the treatment week, placebo treated smokers showed no differences in number of cigarettes smoked. In contrast, those treated with CBD significantly reduced the number of cigarettes smoked by ~40% during treatment. Results also indicated some maintenance of this effect at follow-up. These preliminary data, combined with the strong preclinical rationale for use of this compound, suggest CBD to be a potential treatment for nicotine addiction that warrants further exploration.
Collapse
Affiliation(s)
- Celia J A Morgan
- Clinical Psychopharmacology Unit, University College London, London, UK.
| | | | | | | | | |
Collapse
|
32
|
Morgan CJA, Noronha LA, Muetzelfeldt M, Feilding A, Fielding A, Curran HV. Harms and benefits associated with psychoactive drugs: findings of an international survey of active drug users. J Psychopharmacol 2013; 27:497-506. [PMID: 23438502 PMCID: PMC4107777 DOI: 10.1177/0269881113477744] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
There have been several recent efforts in the UK and the Netherlands to describe the harms of psychoactive substances based on ratings of either experts or drug users. This study aimed to assess the perceived benefits as well as harms of widely used recreational drugs, both licit and illicit, in an international sample of drug users. The survey was hosted at https://www.internationaldrugsurvey.org/ and was available in three languages. Residents reported their experience of 15 commonly used drugs or drug classes; regular users then rated their harms and benefits. In all, 5791 individuals from over 40 countries completed the survey, although the majority were from English speaking countries. Rankings of drugs differed across 10 categories of perceived benefits. Skunk and herbal cannabis were ranked consistently beneficial, whilst alcohol and tobacco fell below many classified drugs. There was no correlation at all between users' harm ranking of drugs and their classification in schedules of the USA or ABC system in the UK. Prescription analgesics, alcohol and tobacco were ranked within the top 10 most harmful drugs. These findings suggest that neither the UK nor US classification systems act to inform users of the harms of psychoactive substances. It is hoped the results might inform health professionals and educators of what are considered to be both the harms and benefits of psychoactive substances to young people.
Collapse
|
33
|
Morgan CJA, Page E, Schaefer C, Chatten K, Manocha A, Gulati S, Curran HV, Brandner B, Leweke FM. Cerebrospinal fluid anandamide levels, cannabis use and psychotic-like symptoms. Br J Psychiatry 2013; 202:381-2. [PMID: 23580381 DOI: 10.1192/bjp.bp.112.121178] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Anandamide is a ligand of the endocannabinoid system. Animals show a depletion following repeated Δ(9)-tetrahydrocannabinol (THC) administration but the effect of cannabis use on central nervous system levels of endocannabinoids has not been previously examined in humans. Cerebrospinal fluid (CSF) levels of the endocannabinoids anandamide, 2-arachidonoylglycerol (2-AG) and related lipids were tested in 33 volunteers (20 cannabis users). Lower levels of CSF anandamide and higher levels of 2-AG in serum were observed in frequent compared with infrequent cannabis users. Levels of CSF anandamide were negatively correlated with persisting psychotic symptoms when drug-free. Higher levels of anandamide are associated with a lower risk of psychotic symptoms following cannabis use.
Collapse
|
34
|
Freeman TP, Morgan CJA, Pepper F, Howes OD, Stone JM, Curran HV. Associative blocking to reward-predicting cues is attenuated in ketamine users but can be modulated by images associated with drug use. Psychopharmacology (Berl) 2013; 225:41-50. [PMID: 22829431 DOI: 10.1007/s00213-012-2791-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2012] [Accepted: 06/21/2012] [Indexed: 10/28/2022]
Abstract
RATIONALE Blocking is an associative learning process that is attenuated in schizophrenia, can be modulated by cue salience and is accompanied by changes in selective attention. Repeated exposure to ketamine can model aspects of schizophrenia, and frequent users selectively attend to images of the drug. OBJECTIVES This study aimed to establish whether (1) ketamine users show attenuated blocking to reward-predicting cues and (2) drug cues can modulate blocking and cause overshadowing of neutral cues that are equally predictive of reward in these individuals. METHODS Ketamine users (n = 18) and polydrug controls (n = 16) were assessed on the Drug Cue Reward Prediction Error Task, which indexes blocking and overshadowing to neutral and drug-related cues following Pavlovian reward conditioning. Schizotypy, depression, drug history and ketamine dependence were also assessed. RESULTS Compared to controls, ketamine users showed elevated delusional, schizotypal and depressive symptoms, and a reduction in blocking as evidenced by higher accuracy to blocked cues. Drug-related cues were resistant to blocking and seen as more important for earning money by ketamine users compared to controls. Both groups showed overshadowing of neutral cues by drug cues, and ketamine users gave both of these cues higher importance ratings than controls. CONCLUSIONS These findings provide the first evidence that (1) glutamatergic perturbation is linked to a reduction in blocking and (2) blocking can be modulated by the presence of drug-related cues. The ability of drug cues to bias selective learning about 'alternative rewards' has implications for contingency management based addiction treatments.
Collapse
Affiliation(s)
- Tom P Freeman
- Clinical Psychopharmacology Unit, University College London, London, UK.
| | | | | | | | | | | |
Collapse
|
35
|
Battistella S, Constantinou N, Morgan CJA, Davis P, O'Ryan D, Curran HV. Semantic priming and verbal learning in current opiate users, ex-users and non-user controls. Hum Psychopharmacol 2012; 27:499-506. [PMID: 22996617 DOI: 10.1002/hup.2255] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Despite a growing interest in memory functions of chronic drug users, investigation of semantic and episodic memory in opiate users is limited, and findings of studies have been inconsistent. The present study aimed to assess semantic memory and episodic memory for both drug-related and neutral stimuli in current and ex-users of opiates. METHODS Using an independent group design, we assessed semantic priming and verbal learning in 16 current opiate users on a methadone maintenance programme, 16 ex-opiate users in rehabilitation programmes and 16 healthy controls. The groups were matched on verbal IQ, age and employment status. RESULTS We found that current and ex-users showed intact automatic and controlled semantic priming. Ex-users who had been abstinent for an average of 19 months showed a verbal learning impairment compared with controls. Both current and ex-users were impaired in recalling semantically unrelated words but unimpaired in recalling semantically related words. CONCLUSION The findings suggest a relative lack of spontaneous use of mnemonic strategies and imply that highly structured information would help opiate-using clients in treatment.
Collapse
Affiliation(s)
- Stefania Battistella
- Clinical Psychopharmacology Unit, Clinical Health Psychology, University College London, London, UK
| | | | | | | | | | | |
Collapse
|
36
|
Morgan CJA, Duffin S, Hunt S, Monaghan L, Mason O, Curran HV. Neurocognitive function and schizophrenia-proneness in individuals dependent on ketamine, on high potency cannabis ('skunk') or on cocaine. Pharmacopsychiatry 2012; 45:269-74. [PMID: 22511328 DOI: 10.1055/s-0032-1306310] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND Ketamine, psychostimulants and cannabis have all been associated with psychotic phenomena but no study has directly compared users of these drugs. AIMS The aim of this study was to assess schizophrenia proneness and neurocognitive function in individuals dependent upon ketamine, cannabis and cocaine. METHOD 130 volunteers - 29 'skunk' users, 22 cocaine users, 21 ketamine users, along with 28 'recreational' poly-drug users and 30 drug-naïve controls - were assessed on the Schizophrenia Proneness Instrument, Adult version (SPI-A). They were specifically asked to rate symptoms when not under the acute influence of a psychoactive drug. RESULTS Ketamine and skunk users manifested the greatest attentional and cognitive disturbances. The symptom profile of the dependent ketamine users was very similar to that of prodromal individuals who transitioned to psychosis. CONCLUSIONS Given the recent rapid rise in use of high potency cannabis and of ketamine, these findings are important and clinicians should be careful to rule out the effects of persistent drug use, especially in users of ketamine or skunk, when assessing an individual's risk of psychosis. A longitudinal study is needed to differentiate which basic symptoms persist following abstention from ketamine and skunk.
Collapse
Affiliation(s)
- C J A Morgan
- Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, University College London, London, U.K
| | | | | | | | | | | |
Collapse
|
37
|
Freeman TP, Morgan CJA, Vaughn-Jones J, Hussain N, Karimi K, Curran HV. Cognitive and subjective effects of mephedrone and factors influencing use of a 'new legal high'. Addiction 2012; 107:792-800. [PMID: 22257011 DOI: 10.1111/j.1360-0443.2011.03719.x] [Citation(s) in RCA: 88] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIMS Use of the stimulant drug mephedrone increased dramatically in 2009, and it is still available in the United Kingdom after being controlled in April 2010. This study aimed to assess mephedrone's acute cognitive and subjective effects. DESIGN A mixed within- and between-subjects design compared 20 mephedrone users, first while intoxicated (T1) and secondly drug free (T2); and 20 controls twice when drug free (T1 and T2). SETTINGS Participants' own homes. PARTICIPANTS Healthy adults recruited from the community. MEASUREMENTS Subjective effects, episodic and working memory, phonological and semantic fluency, psychomotor speed and executive control at were assessed at T1 and T2. Trait schizotypy, depression, changes in mephedrone use since the ban and attitudes influencing use of a hypothetical new legal high were indexed at T2 only. FINDINGS Compared with controls, mephedrone users had generally impaired prose recall (P = 0.037) and higher scores in schizotypy (P < 0.001) and depression (P = 0.01). Mephedrone acutely primed a marked 'wanting' for the drug (P < 0.001), induced stimulant-like effects, impaired working memory (P < 0.001) and enhanced psychomotor speed (P = 0.024). Impulsivity in mephedrone users correlated with the number of hours in an average (nearly 8 hour) mephedrone session (r = 0.6). Users would be drawn to use a new legal high if it were pure, had no long/short term harms, and was positively rated by friends or on the internet. CONCLUSIONS Mephedrone impairs working memory acutely, induces stimulant-like effects in users and is associated with binge use. Factors that influence users' attitudes to new drugs might help to predict future trends in use of the many new psychoactive substances emerging on the internet.
Collapse
Affiliation(s)
- Tom P Freeman
- Clinical Psychopharmacology Unit, Clinical Health Psychology, University College London, UK.
| | | | | | | | | | | |
Collapse
|
38
|
Morgan CJA, Gardener C, Schafer G, Swan S, Demarchi C, Freeman TP, Warrington P, Rupasinghe I, Ramoutar A, Tan N, Wingham G, Lewis S, Curran HV. Sub-chronic impact of cannabinoids in street cannabis on cognition, psychotic-like symptoms and psychological well-being. Psychol Med 2012; 42:391-400. [PMID: 21798112 DOI: 10.1017/s0033291711001322] [Citation(s) in RCA: 128] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Cannabis varies considerably in levels of its two major constituent cannabinoids - (delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD). Recently, we found evidence that those who smoked cannabis containing detectable levels of CBD had fewer psychotic-like symptoms than those whose cannabis had no CBD. The present study aimed, first, to replicate those findings and, second, to determine whether protective effects of CBD may extend to other harms of cannabis, such as memory impairment and reduced psychological well-being. METHOD A total of 120 current cannabis smokers, 66 daily users and 54 recreational users were classified into groups according to whether analysis of their hair revealed the presence or absence of CBD and high versus low levels of THC. All were assessed on measures of psychosis-like symptoms, memory (prose recall; source memory) and depression/anxiety. RESULTS Lower psychosis-like symptoms were found in those whose hair had CBD compared with those without. However, this was seen only in recreational users, who had higher levels of THC in their hair. Higher THC levels in hair were associated with increased depression and anxiety. Prose recall and source memory were poorer in daily users with high THC levels in hair while recognition memory was better in individuals with CBD present in hair. CONCLUSIONS CBD attenuates the psychotic-like effects of cannabis over time in recreational users. Higher THC negatively impacts on memory and psychological well-being. These findings raise concerns for the harms stemming from use of varieties such as 'skunk' (sensimillia), which lack any CBD but currently dominate the supply of cannabis in many countries.
Collapse
Affiliation(s)
- C J A Morgan
- Clinical Psychopharmacology Unit, UCL, Gower Street, London WC1E 6BT, UK
| | - C Gardener
- Clinical Psychopharmacology Unit, UCL, Gower Street, London WC1E 6BT, UK
| | - G Schafer
- Clinical Psychopharmacology Unit, UCL, Gower Street, London WC1E 6BT, UK
| | - S Swan
- Clinical Psychopharmacology Unit, UCL, Gower Street, London WC1E 6BT, UK
| | - C Demarchi
- Clinical Psychopharmacology Unit, UCL, Gower Street, London WC1E 6BT, UK
| | - T P Freeman
- Clinical Psychopharmacology Unit, UCL, Gower Street, London WC1E 6BT, UK
| | - P Warrington
- Clinical Psychopharmacology Unit, UCL, Gower Street, London WC1E 6BT, UK
| | - I Rupasinghe
- Clinical Psychopharmacology Unit, UCL, Gower Street, London WC1E 6BT, UK
| | - A Ramoutar
- Clinical Psychopharmacology Unit, UCL, Gower Street, London WC1E 6BT, UK
| | - N Tan
- Clinical Psychopharmacology Unit, UCL, Gower Street, London WC1E 6BT, UK
| | - G Wingham
- Clinical Psychopharmacology Unit, UCL, Gower Street, London WC1E 6BT, UK
| | - S Lewis
- Clinical Psychopharmacology Unit, UCL, Gower Street, London WC1E 6BT, UK
| | - H V Curran
- Clinical Psychopharmacology Unit, UCL, Gower Street, London WC1E 6BT, UK
| |
Collapse
|
39
|
Schafer G, Feilding A, Morgan CJA, Agathangelou M, Freeman TP, Valerie Curran H. Investigating the interaction between schizotypy, divergent thinking and cannabis use. Conscious Cogn 2012; 21:292-8. [PMID: 22230356 PMCID: PMC3657189 DOI: 10.1016/j.concog.2011.11.009] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2011] [Revised: 10/29/2011] [Accepted: 11/27/2011] [Indexed: 11/29/2022]
Abstract
Cannabis acutely increases schizotypy and chronic use is associated with elevated rates of psychosis. Creative individuals have higher levels of schizotypy, however links between cannabis use, schizotypy and creativity have not been investigated. We investigated the effects of cannabis smoked naturalistically on schizotypy and divergent thinking, a measure of creativity. One hundred and sixty cannabis users were tested on 1 day when sober and another day when intoxicated with cannabis. State and trait measures of both schizotypy and creativity were administered. Quartile splits compared those lowest (n = 47) and highest (n = 43) in trait creativity. Cannabis increased verbal fluency in low creatives to the same level as that of high creatives. Cannabis increased state psychosis-like symptoms in both groups and the high creativity group were significantly higher in trait schizotypy, but this does not appear to be linked to the verbal fluency change. Acute cannabis use increases divergent thinking as indexed by verbal fluency in low creatives.
Collapse
Affiliation(s)
- Gráinne Schafer
- Clinical Psychopharmacology Unit, Research Department of Clinical, Health and Educational Psychology, University College London, Gower Street, London WC1E 6BT, United Kingdom.
| | | | | | | | | | | |
Collapse
|
40
|
Abstract
AIMS Ketamine remains an important medicine in both specialist anaesthesia and aspects of pain management. At the same time, its use as a recreational drug has spread in many parts of the world during the past few years. There are now increasing concerns about the harmful physical and psychological consequences of repeated misuse of this drug. The aim of this review was to survey and integrate the research literature on physical, psychological and social harms of both acute and chronic ketamine use. METHOD The literature on ketamine was systematically searched and findings were classified into the matrix of Nutt et al.'s (2007) rational scale for assessing the harms of psychoactive substances. RESULTS A major physical harm is ketamine induced ulcerative cystitis which, although its aetiology is unclear, seems particularly associated with chronic, frequent use of the drug. Frequent, daily use is also associated with neurocognitive impairment and, most robustly, deficits in working and episodic memory. Recent studies suggest certain neurological abnormalities which may underpin these cognitive effects. Many frequent users are concerned about addiction and report trying but failing to stop using ketamine. CONCLUSIONS The implications of these findings are drawn out for treatment of ketamine-induced ulcerative cystitis in which interventions from urologists and from addiction specialists should be coordinated. Neurocognitive impairment in frequent users can impact negatively upon achievement in education and at work, and also compound addiction problems. Prevention and harm minimization campaigns are needed to alert young people to these harmful and potentially chronic effects of ketamine.
Collapse
Affiliation(s)
- Celia J A Morgan
- Clinical Psychopharmacology Unit, Clinical Health Psychology, University College London, London, UK
| | | | | |
Collapse
|
41
|
Freeman TP, Morgan CJA, Beesley T, Curran HV. Drug cue induced overshadowing: selective disruption of natural reward processing by cigarette cues amongst abstinent but not satiated smokers. Psychol Med 2012; 42:161-171. [PMID: 21733292 DOI: 10.1017/s0033291711001139] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Addicts show both reward processing deficits and increased salience attribution to drug cues. However, no study to date has demonstrated that salience attribution to drug cues can directly modulate inferences of reward value to non-drug cues. Associative learning depends on salience: a more salient predictor of an outcome will 'overshadow' a less salient predictor of the same outcome. Similarly, blocking, a demonstration that learning depends on prediction error, can be influenced by the salience of the cues employed. METHOD This study investigated whether salient drug cues might interact with neutral cues predicting financial reward in an associative learning task indexing blocking and overshadowing in satiated smokers (n=24), abstaining smokers (n=24) and non-smoking controls (n=24). Attentional bias towards drug cues, craving and expired CO were also indexed. RESULTS Abstaining smokers showed drug cue induced overshadowing, attributing higher reward value to drug cues than to neutral cues that were equally predictive of reward. Overshadowing was positively correlated with expired CO levels, which, in turn, were correlated with craving in abstainers. An automatic attentional bias towards cigarette cues was found in abstainers only. CONCLUSIONS These findings provide the first evidence that drug cues interact with reward processing in a drug dependent population.
Collapse
Affiliation(s)
- T P Freeman
- Clinical Psychopharmacology Unit, Clinical Health Psychology, University College London, London, UK
| | | | | | | |
Collapse
|
42
|
Abstract
Studies of the chronic effects of MDMA, or 'ecstasy', in humans have been largely inconsistent. We explored whether study-level characteristics are associated with the effect size estimate reported. We based our analyses on the recent systematic review by Rogers and colleagues, focusing on those meta-analyses within this report where there was a relatively large number of studies contributing to each individual meta-analysis. Linear regression was used to investigate the association between study level variables and effect size estimate, weighted by the inverse of the SE of the effect size estimate, with cluster correction for studies which contributed multiple estimates. This indicated an association between effect size estimate and both user group, with smaller estimates among studies recruiting former users compared with those recruiting current users, and control group, with smaller estimates among studies recruiting polydrug user controls compared with those recruiting drug-naïve controls. In addition, increasing year of publication was associated with reduced effect size estimate, and there was a trend level association with prevalence of ecstasy use, reflecting smaller estimates among studies conducted in countries with higher prevalence of ecstasy use. Our data suggest a number of study-level characteristics which appear to influence individual study effect size estimates. These should be considered when designing future studies, and also when interpreting the ecstasy literature as a whole.
Collapse
Affiliation(s)
- Eleanor M Taylor
- School of Experimental Psychology, University of Bristol, Bristol, UK
| | | | | | | |
Collapse
|
43
|
Kamboj SK, Massey-Chase R, Rodney L, Das R, Almahdi B, Curran HV, Morgan CJA. Changes in cue reactivity and attentional bias following experimental cue exposure and response prevention: a laboratory study of the effects of D-cycloserine in heavy drinkers. Psychopharmacology (Berl) 2011; 217:25-37. [PMID: 21455709 DOI: 10.1007/s00213-011-2254-z] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2010] [Accepted: 03/01/2011] [Indexed: 11/28/2022]
Abstract
RATIONALE The effects of D-cycloserine (DCS) in animal models of anxiety disorders and addiction indicate a role for N-methyl D-aspartate (NMDA) receptors in extinction learning. Exposure/response prevention treatments for anxiety disorders in humans are enhanced by DCS, suggesting a promising co-therapy regime, mediated by NMDA receptors. Exposure/response prevention may also be effective in problematic drinkers, and DCS might enhance habituation to cues in these individuals. Since heavy drinkers show ostensible conditioned responses to alcohol cues, habituation following exposure/response prevention should be evident in these drinkers, with DCS enhancing this effect. OBJECTIVES The objective of this study is to investigate the effect of DCS on exposure/response prevention in heavy drinkers. METHODS In a randomised, double-blind, placebo-controlled study, heavy social drinkers recruited from the community received either DCS (125 mg; n = 19) or placebo (n = 17) 1 h prior to each of two sessions of exposure/response prevention. Cue reactivity and attentional bias were assessed during these two sessions and at a third follow-up session. Between-session drinking behaviour was recorded. RESULTS Robust cue reactivity and attentional bias to alcohol cues was evident, as expected of heavy drinkers. Within- and between-session habituation of cue reactivity, as well as a reduction in attentional bias to alcohol cues over time was found. However, there was no evidence of greater habituation in the DCS group. Subtle stimulant effects (increased subjective contentedness and euphoria) which were unrelated to exposure/response prevention were found following DCS. CONCLUSIONS DCS does not appear to enhance habituation of alcohol cue reactivity in heavy non-dependent drinkers. Its utility in enhancing treatments based on exposure/response prevention in dependent drinkers or drug users remains open.
Collapse
Affiliation(s)
- Sunjeev K Kamboj
- Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, University College London, Gower Street, London WC1E6BT, UK.
| | | | | | | | | | | | | |
Collapse
|
44
|
Carroll EMA, Kamboj SK, Conroy L, Tookman A, Williams ACDC, Jones L, Morgan CJA, Curran HV. Facial affect processing in patients receiving opioid treatment in palliative care: preferential processing of threat in pain catastrophizers. J Pain Symptom Manage 2011; 41:975-85. [PMID: 21251795 DOI: 10.1016/j.jpainsymman.2010.08.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2010] [Revised: 08/28/2010] [Accepted: 09/03/2010] [Indexed: 11/20/2022]
Abstract
CONTEXT As a multidimensional phenomenon, pain is influenced by various psychological factors. One such factor is catastrophizing, which is associated with higher pain intensity and emotional distress in cancer and noncancer pain. One possibility is that catastrophizing represents a general cognitive style that preferentially supports the processing of negative affective stimuli. Such preferential processing of threat--toward negative facial expressions, for example--is seen in emotional disorders and is sensitive to pharmacological treatment. Whether pharmacological (analgesic) treatment might also influence the processing of threat in pain patients is currently unclear. OBJECTIVES This study investigates the effects catastrophizing on processing of facial affect in those receiving an acute opioid dose. METHODS In a double-blind crossover design, the performance of 20 palliative care patients after their usual dose of immediate-release opioid was compared with their performance following matched-placebo administration on a facial affect recognition (i.e., speed and accuracy) and threat-pain estimation task (i.e., ratings of pain intensity). The influence of catastrophizing was examined by splitting the sample according to their score on the Pain Catastrophizing Scale (PCS). RESULTS Opioid administration had no effect on facial affect processing compared with placebo. However, the main finding was that enhanced processing of fear, sadness, and disgust was found only in patients who scored highly on the PCS. There was no difference in performance between the two PCS groups on the other emotions (i.e., happiness, surprise, and anger). CONCLUSION These findings suggest that catastrophizing is associated with an affective information-processing bias in patients with severe pain conditions.
Collapse
Affiliation(s)
- Erin M A Carroll
- Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
| | | | | | | | | | | | | | | |
Collapse
|
45
|
Platt B, Kamboj S, Morgan CJA, Curran HV. Processing dynamic facial affect in frequent cannabis-users: evidence of deficits in the speed of identifying emotional expressions. Drug Alcohol Depend 2010; 112:27-32. [PMID: 21036306 DOI: 10.1016/j.drugalcdep.2010.05.004] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2009] [Revised: 05/01/2010] [Accepted: 05/04/2010] [Indexed: 11/30/2022]
Abstract
BACKGROUND While heavy cannabis-users seem to show various cognitive impairments, it remains unclear whether they also experience significant deficits in affective functioning. Evidence of such deficits may contribute to our understanding of the interpersonal difficulties in cannabis-users, and the link between cannabis-use and psychological disorders (Moore et al., 2007). METHOD Emotion recognition performance of heavy cannabis-users and non-using controls was compared. A measure of emotion recognition was used in which participants identified facial expressions as they changed from neutral (open-mouth) to gradually more intense expressions of sadness, neutral, anger or happiness (open or closed mouth). Reaction times and accuracy were recorded as the facial expressions changed. Participants also completed measures of 'theory of mind,' depression and impulsivity. RESULTS Cannabis-users were significantly slower than controls at identifying all three emotional expressions. There was no difference between groups in identifying facial expressions changing from open-mouth neutral expressions to closed-mouth neutral expressions suggesting that differences in emotion recognition were not due to a general slowing of reaction times. Cannabis-users were also significantly more liberal in their response criterion for recognising sadness. CONCLUSION Heavy cannabis-use may be associated with affect recognition deficits. In particular, a greater intensity of emotion expression was required before identification of positive and negative emotions. This was found using stimuli which simulated dynamic changes in emotion expression, and in turn, suggests that cannabis-users may experience generalised problems in decoding basic emotions during social interactions. The implications of these findings are discussed for vulnerability to psychological and interpersonal difficulties in cannabis-users.
Collapse
Affiliation(s)
- Bradley Platt
- Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, University College London, Gower Street, London, UK.
| | | | | | | |
Collapse
|
46
|
Morgan CJA, Schafer G, Freeman TP, Curran HV. Impact of cannabidiol on the acute memory and psychotomimetic effects of smoked cannabis: naturalistic study: naturalistic study [corrected]. Br J Psychiatry 2010; 197:285-90. [PMID: 20884951 DOI: 10.1192/bjp.bp.110.077503] [Citation(s) in RCA: 217] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND The two main constituents of cannabis, cannabidiol and Δ(9)-tetrahydrocannabinol (THC), have opposing effects both pharmacologically and behaviourally when administered in the laboratory. Street cannabis is known to contain varying levels of each cannabinoid. AIMS To study how the varying levels of cannabidiol and THC have an impact on the acute effects of the drug in naturalistic settings. METHOD Cannabis users (n = 134) were tested 7 days apart on measures of memory and psychotomimetic symptoms, once while they were drug free and once while acutely intoxicated by their own chosen smoked cannabis. Using an unprecedented methodology, a sample of cannabis (as well as saliva) was collected from each user and analysed for levels of cannabinoids. On the basis of highest and lowest cannabidiol content of cannabis, two groups of individuals were directly compared. RESULTS Groups did not differ in the THC content of the cannabis they smoked. Unlike the marked impairment in prose recall of individuals who smoked cannabis low in cannabidiol, participants smoking cannabis high in cannabidiol showed no memory impairment. Cannabidiol content did not affect psychotomimetic symptoms, which were elevated in both groups when intoxicated. CONCLUSIONS The antagonistic effects of cannabidiol at the CB(1) receptor are probably responsible for its profile in smoked cannabis, attenuating the memory-impairing effects of THC. In terms of harm reduction, users should be made aware of the higher risk of memory impairment associated with smoking low-cannabidiol strains of cannabis like 'skunk' and encouraged to use strains containing higher levels of cannabidiol.
Collapse
Affiliation(s)
- Celia J A Morgan
- Clinical Psychopharmacology Unit, University College London, Gower St, London WC1E 6BT, UK
| | | | | | | |
Collapse
|
47
|
Constantinou N, Morgan CJA, Battistella S, O'Ryan D, Davis P, Curran HV. Attentional bias, inhibitory control and acute stress in current and former opiate addicts. Drug Alcohol Depend 2010; 109:220-5. [PMID: 20172662 DOI: 10.1016/j.drugalcdep.2010.01.012] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2009] [Revised: 01/13/2010] [Accepted: 01/13/2010] [Indexed: 11/18/2022]
Abstract
BACKGROUND Drug dependence is associated with both attentional biases to drug-related cues and inhibitory control deficits. Although acute stress is known to increase craving, it is not known whether this effect is mediated via changes in attentional bias and inhibitory control. OBJECTIVES To examine the effect of a mild stressor on inhibitory control, attentional bias and craving in current opiate users (methadone maintained), ex-users (currently abstinent) and non-users (healthy controls). METHOD Forty-eight participants (16 in each group) were exposed to both stress and non-stress conditions, after which inhibitory control and attentional bias was assessed using a Go-No-go and dot probe task respectively. Subjective ratings of stress levels and drug craving were repeatedly monitored. RESULTS Current opiate users had significantly higher cravings ratings than both other groups at all times, and their craving tended to increase following the stress task. Current users had a greater attentional bias towards drug-related stimuli than the ex-users. Interestingly, ex-users showed a bias away from drug-related stimuli in the stress condition and this correlated positively with their length of abstinence. On the Go/No-go task, all groups had fewer false alarms in the stress condition. CONCLUSIONS These results indicate that successful treatment is associated with a bias away from drugs, and that this bias may be protective against the effects of stress.
Collapse
|
48
|
Morgan CJA, Rothwell E, Atkinson H, Mason O, Curran HV. Hyper-priming in cannabis users: a naturalistic study of the effects of cannabis on semantic memory function. Psychiatry Res 2010; 176:213-8. [PMID: 20122742 DOI: 10.1016/j.psychres.2008.09.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2007] [Revised: 03/13/2008] [Accepted: 09/09/2008] [Indexed: 11/30/2022]
Abstract
Psychotic symptoms have theoretically been linked to semantic memory impairments in patients with schizophrenia. Little is known of the effects of cannabis, the world's most popular illicit drug, on semantic memory and whether they are linked to the psychotomimetic states elicited by the drug. Thirty-six cannabis users were tested whilst under the influence of cannabis. They were then tested again when not intoxicated and compared with 38 non-drug using controls. Semantic memory was assessed using a semantic priming task with a long and short stimulus onset asynchrony (SOA) to differentiate automatic and controlled processing. Under the influence of cannabis, users showed increases in both automatic semantic priming and schizotypal symptoms compared with controls. When abstinent, cannabis users exhibited hyper-priming at long SOAs. Cannabis users did not differ from controls in either trait schizotypy or state schizotypy when not intoxicated. Acute cannabis use increases schizotypyal symptoms and may increase automatic semantic priming in recreational users of this drug. When drug-free, cannabis users did not differ from controls in schizotypy but did show hyper-priming at the long SOA. The acute increase in automatic semantic priming may be one factor contributing to the psychotomimetic effects of cannabis.
Collapse
Affiliation(s)
- Celia J A Morgan
- Clinical Psychopharmacology Unit, Sub-Department of Clinical Health Psychology, University College London, Gower St, London, WC1E 6BT, United Kingdom.
| | | | | | | | | |
Collapse
|
49
|
Abstract
Nutt and colleagues' 'rational' scale to assess the harms of commonly used drugs was based on ratings by a panel of experts. This survey aimed to assess drug users' views of the harms of drugs using the same scale. As users' drug choices are not solely based on harms, we additionally assessed perceived benefits. The survey was hosted at http://www.nationaldrugsurvey.org. UK residents reported their experience of 20 commonly used substances; those with direct experience of a substance rated its physical, dependence-related and social harms as well as benefits. A total of 1501 users completed the survey. There was no correlation between the classification of the 20 drugs under the Misuse of Drugs Act and ranking of harms by users. Despite being unclassified substances, alcohol, solvents and tobacco were rated within the top ten most harmful drugs. There was a remarkably high correlation (r = 0.896) overall between rankings by users' and by experts. Ecstasy, cannabis and LSD were ranked highest by users on both acute and chronic benefits. These findings imply that users are relatively well informed about the harms associated with the drugs they use. They also suggest that the current UK legal classification system is not acting to inform users of the harms of psychoactive substances.
Collapse
Affiliation(s)
- Celia J A Morgan
- Clinical Psychopharmacology Unit, University College London, London, UK.
| | | | | | | | | |
Collapse
|
50
|
Paraskevaides T, Morgan CJA, Leitz JR, Bisby JA, Rendell PG, Curran HV. Drinking and future thinking: acute effects of alcohol on prospective memory and future simulation. Psychopharmacology (Berl) 2010; 208:301-8. [PMID: 19967530 DOI: 10.1007/s00213-009-1731-0] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2009] [Accepted: 11/11/2009] [Indexed: 10/20/2022]
Abstract
BACKGROUND It has recently been shown that acute alcohol globally impairs 'prospective memory' (PM)-remembering to do something in the future (Leitz et al. in Psychopharmacology 205:379-387, 2009). In healthy, sober individuals, simulating future events at encoding enhances PM performance. AIMS We therefore aimed to determine if future event simulation could attenuate the impairing effects of acute alcohol on PM. METHODS Using a double-blind independent group design, 32 healthy volunteers were administered a 0.6-g/kg dose of ethanol or matched placebo. PM performance was assessed using a behavioural task, the 'Virtual Week', which was adapted to enable future event simulation in both remote and recent contexts. Episodic memory was indexed with a source memory task and planning with the Tower of London task. RESULTS We replicated the finding of Leitz et al. that acute alcohol consumption impairs prospective memory for event-based tasks. Future event simulation significantly improved PM performance on these tasks and eliminated the PM deficit caused by acute alcohol consumption. CONCLUSIONS This is the first evidence that future event simulation can overcome alcohol-induced deficits in prospective memory and may have important clinical implications for the rehabilitation of chronic alcohol users.
Collapse
Affiliation(s)
- Theadora Paraskevaides
- Clinical Psychopharmacology Unit, Research Department of Clinical, Health and Educational Psychology, University College London, Gower St., London, WC1E 6BT, UK
| | | | | | | | | | | |
Collapse
|