Effects of cortisol administration on craving in heroin addicts.

Heroin dependence is a severe and chronically relapsing substance use disorder with limited treatment options. Stress is known to increase craving and drug-taking behavior, but it is not known whether the stress hormone cortisol mediates these stress effects or whether cortisol may rather reduce craving, for example, by interfering with addiction memory. The aim of the present study was to determine the effects of cortisol administration on craving in heroin-dependent patients and to determine whether the effects depend on the daily dose of heroin consumption. We used a double-blind, placebo-controlled, cross-over study in 29 heroin-dependent patients in a stable heroin-assisted treatment setting. A single oral dose of 20 mg of cortisol or placebo was administered 105 min before the daily heroin administration. The primary outcome measure was cortisol-induced change in craving. Secondary measures included anxiety, anger and withdrawal symptoms. For the visual analog scale for craving, we found a significant interaction (P = 0.0027) between study medication and heroin-dose group (that is, daily low, medium or high dose of heroin). Cortisol administration reduced craving in patients receiving a low dose of heroin (before heroin administration: P = 0.0019; after heroin administration: P = 0.0074), but not in patients receiving a medium or high dose of heroin. In a picture-rating task with drug-related pictures, cortisol administration did not affect the ratings for the picture-characteristic craving in all the three heroin-dose groups. Cortisol also did not significantly affect secondary outcome measures. In conclusion, a single administration of cortisol leads to reduced craving in low-dose heroin addicts. The present findings might have important clinical implications with regard to understanding stress effects and regarding treatment of addiction.

Polybrominated diphenyl ether (PBDE) exposure in children: possible associations with cardiovascular and psychological functions.

BACKGROUND: Polybrominated diphenyl ethers (PBDE) have been used widely in consumer products and are currently found at detectable levels in the blood of humans and animals across the globe. In stark contrast to this widespread exposure to PBDEs, there is relatively little research on potential adverse health effects of exposure of children to these chemicals. OBJECTIVES: We performed this cross-sectional study to determine if blood PBDE levels (for 4 congeners) are associated with cardiovascular stress responses and psychological states in children. METHODS: Levels of 4 PBDE congeners (BDE-28, -47, -99, and -100) in whole blood were measured in children (N=43). These levels were analyzed in relation to cardiovascular disease risk factors, including cardiovascular responses to acute stress and relevant psychological variables, namely, hostility and depression. RESULTS: Higher levels of blood PBDEs were associated with significantly greater sympathetic activation during acute psychological stress and greater anger, as evidenced by significant associations with 3 different measures of this psychological variable. CONCLUSIONS: This study suggests an association between PBDE exposure and children's cardiovascular responses to stress as well as parental and self-reported anger in the child. These variables are particularly important as they may be of potential relevance to the future development of cardiovascular disease (CVD). Although intriguing, there is a need for further investigation and replication with a larger sample of children.

The temporal relationship between alcohol, marijuana, angry affect, and dating violence perpetration: A daily diary study with female college students.

Although a robust literature documents a positive association between alcohol and intimate partner violence (IPV), there is limited temporal research on this relation. Moreover, the role of marijuana in influencing IPV has been mixed. Thus, the primary aim of the current study was to examine the temporal relationship between alcohol and marijuana use and dating violence perpetration. A secondary aim was to examine whether angry affect moderated the temporal relation between alcohol and marijuana use and IPV perpetration. Participants were college women who had consumed alcohol in the previous month and were in a dating relationship (N = 173). For up to 90 consecutive days, women completed daily surveys that assessed their alcohol use, marijuana use, angry affect (anger, hostility, and irritation), and violence perpetration (psychological and physical). On alcohol use days, marijuana use days, and with increases in angry affect, the odds of psychological aggression increased. Only alcohol use days and increases in angry affect increased the odds of physical aggression. Moreover, the main effects of alcohol and marijuana use on aggression were moderated by angry affect. Alcohol was positively associated with psychological and physical aggression when angry affect was high, but was unrelated to aggression when angry affect was low. Marijuana use was associated with psychological aggression when angry affect was high. Findings advance our understanding of the proximal effect of alcohol and marijuana use on dating violence, including the potential moderating effect of angry affect on this relation.

Substituting dietary monounsaturated fat for saturated fat is associated with increased daily physical activity and resting energy expenditure and with changes in mood.

BACKGROUND: The Western diet increases risk of metabolic disease. OBJECTIVE: We determined whether lowering the ratio of saturated fatty acids to monounsaturated fatty acids in the Western diet would affect physical activity and energy expenditure. DESIGN: With the use of a balanced design, 2 cohorts of 18 and 14 young adults were enrolled in separate randomized, double-masked, crossover trials that compared a 3-wk high-palmitic acid diet (HPA; similar to the Western diet fat composition) to a low-palmitic acid and high-oleic acid diet (HOA; similar to the Mediterranean diet fat composition). All foods were provided by the investigators, and the palmitic acid (PA):oleic acid (OA) ratio was manipulated by adding different oil blends to the same foods. In both cohorts, we assessed physical activity (monitored continuously by using accelerometry) and resting energy expenditure (REE). To gain insight into a possible mood disturbance that might explain changes in physical activity, the Profile of Mood States (POMS) was administered in cohort 2. RESULTS: Physical activity was higher during the HOA than during the HPA in 15 of 17 subjects in cohort 1 (P = 0.008) (mean: 12% higher; P = 0.003) and in 12 of 12 subjects in the second, confirmatory cohort (P = 0.005) (mean: 15% higher; P = 0.003). When the HOA was compared with the HPA, REE measured during the fed state was 3% higher for cohort 1 (P < 0.01), and REE was 4.5% higher in the fasted state for cohort 2 (P = 0.04). POMS testing showed that the anger-hostility score was significantly higher during the HPA (P = 0.007). CONCLUSIONS: The replacement of dietary PA with OA was associated with increased physical activity and REE and less anger. Besides presumed effects on mitochondrial function (increased REE), the dietary PA:OA ratio appears to affect behavior. The second cohort was derived from a study that was registered at clinicaltrials.gov as R01DK082803.

Effect of desvenlafaxine on mood and climacteric symptoms in menopausal women with moderate to severe vasomotor symptoms.

OBJECTIVE: To assess effects of desvenlafaxine (administered as desvenlafaxine succinate) on secondary outcomes of mood, climacteric symptoms, and treatment satisfaction in postmenopausal women with moderate to severe menopausal vasomotor symptoms (VMS). METHODS: A 12-week, multicenter, double-blind, placebo-controlled trial was conducted in postmenopausal women with ≥ 50 moderate to severe hot flushes per week. Participants were randomly assigned to desvenlafaxine 100 mg/day, desvenlafaxine 150 mg/day, or placebo. Secondary outcome efficacy variables included Profile of Mood States (POMS), Greene Climacteric Scale (GCS), and Menopausal Symptoms Treatment Satisfaction Questionnaire (MS-TSQ) scores. Change from baseline in POMS total mood disturbance (TMD) score and subdomain scores were evaluated using analysis of covariance, adjusting for treatment and study site as factors and baseline score. GCS total and subdomain scores were analyzed similarly. Treatment satisfaction was analyzed using the row mean score test. RESULTS: A total of 458 women were enrolled. At week 12, desvenlafaxine 100 mg/day significantly improved POMS TMD scores (p <0.001) and four of six POMS subdomains compared with placebo (all p ≤ 0.005). Women taking desvenlafaxine 100 mg/day experienced significantly greater improvement in GCS total scores (p <0.001) and five of six subdomains (all p ≤ 0.029) compared with placebo. Treatment with desvenlafaxine 100 mg/day resulted in significantly greater treatment satisfaction overall and in six of seven additional MS-TSQ items (all p ≤0.042). Desvenlafaxine 150-mg/day results were similar. CONCLUSIONS: Desvenlafaxine treatment improved mood and climacteric symptoms in postmenopausal women with moderate to severe VMS compared with placebo, and more women were satisfied with desvenlafaxine treatment than with placebo.

Emotional suppression tendencies as predictors of symptoms, mood, and coping appraisals during AC chemotherapy for breast cancer treatment.

Tendencies to suppress negative emotions have been shown to predict adjustment to cancer and cancer progression. We examined whether emotional suppression, in terms of both general and emotion-specific tendencies, predict symptom reports, mood states, and coping appraisals during adriamycin/doxorubicin, cyclophosphamide/cytoxan chemotherapy for breast cancer. Forty participants completed a measure yielding scores for anxiety suppression, anger suppression, depression suppression, and total emotional suppression. They then reported their experiences of 34 physical symptoms, mood, and coping efficacy on a daily basis for the duration of treatment (84 days). Mixed model analyses revealed that emotional suppression predicted lower reports of symptoms that are vague, well-known, and potentially embarrassing side effects of chemotherapy (e.g., fatigue and constipation). Emotional suppression and particularly anger suppression predicted higher reports of symptoms relating to immune function and cardiovascular arousal (e.g., mouth sores and heart palpitations) and with appraisals of poorer coping. The three suppression tendencies exhibited distinctive patterns of relationships with symptoms, mood, and coping appraisals, suggesting that anxiety suppression, anger suppression, and depression suppression have partially independent relationships with symptomatic and mood processes. The findings highlight the potential importance of emotional suppression for understanding symptom and coping responses during chemotherapy.

Gene and gene by sex associations with initial sensitivity to nicotine in nonsmokers.

Genetic variation may influence initial sensitivity to nicotine (i.e. during early tobacco exposure), perhaps helping to explain differential vulnerability to nicotine dependence. This study explored associations of functional candidate gene polymorphisms with initial sensitivity to nicotine in 101 young adult nonsmokers of European ancestry. Nicotine (0, 5, 10 microg/kg) was administered through nasal spray followed by mood, nicotine reward (e.g. 'liking') and perception (e.g. 'feel effects') measures, physiological responses, sensory processing (prepulse inhibition of startle), and performance tasks. Nicotine reinforcement was assessed in a separate session using a nicotine versus placebo spray choice procedure. For the dopamine D4 receptor [DRD4 variable number of tandem repeats (VNTR)], presence of the 7-repeat allele was associated with greater aversive responses to nicotine (decreases in 'vigor', positive affect, and rapid information processing; increased cortisol) and reduced nicotine choice. Individuals with at least one DRD4 7-repeat allele also reported increased 'feel effects' and greater startle response, but in men only. Other genetic associations were also observed in men but not women, such as greater 'feel effects' and anger, and reduced fatigue, in the dopamine D2 receptor (DRD2 C957T single nucleotide polymorphism) TT versus CT or CC genotypes. Very few or no significant associations were seen for the DRD2/ANKK1 TaqIA polymorphism, the serotonin transporter promoter VNTR or 5HTTLPR (SLC6A4), the dopamine transporter 3' VNTR (SLC6A3), and the mu opioid receptor A118G single nucleotide polymorphism (mu opioid receptor polymorphism 1). Although these results are preliminary, this study is the first to suggest that genetic polymorphisms related to function in the dopamine D4, and perhaps D2, receptor may modulate initial sensitivity to nicotine before the onset of dependence and may do so differentially between men and women.

Increase in anger symptoms after smoking cessation predicts relapse.

Smokers tend to increase their cigarette consumption during angry states. We sought to determine whether increases in post-quit anger symptoms predict relapse among smokers who had received 8-weeks of smoking cessation treatment (21 mg nicotine patch+smoking cessation counseling). The 15-item state anger assessment [from Spielberger, C., 1999. STAXI-2: the state trait anger expression inventory professional manual, Odessa, FL] was administered at pre-treatment (2 weeks before the target quit date; TQD) and 1 week after the TQD. Abstinence at 8-weeks post-quit was biochemically verified using carbon monoxide. Smokers who reported increases in pre- to post-quit state anger levels (n=117) were significantly more likely to relapse by 8-weeks after treatment as compared to smokers whose anger did not change or decreased after quitting (n=130) (OR=1.06; CI=1.01-1.10; p=0.01). Furthermore, smokers with increased post-quit anger relapsed almost twice as quickly than those who did not have an increase in post-quit anger symptoms (HR=1.98; CI: 1.32-2.96; p=0.001). These data suggest that anger may be an important withdrawal symptom that influences liability to relapse. Future studies are needed to evaluate treatment strategies that effectively help smokers reduce and manage post-quit anger.

The anabolic androgenic steroid, nandrolone decanoate, increases the density of Fos-like immunoreactive neurons in limbic regions of guinea-pig brain.

The increased abuse of anabolic androgenic steroids is a major concern because of physiological and psychological side-effects. In some individuals they induce dramatic behavioural changes such as increased aggression, anxiety and depression. The mechanisms behind these behavioural changes are still poorly understood. In order to obtain information on the brain regions affected by anabolic androgenic steroids, the distribution of neurons containing c-Fos, the protein product of the immediate early gene c-fos, and Fos-related antigens was studied following chronic treatment of guinea-pigs with a high dose of nandrolone decanoate (15 mg/kg i.m. daily for 14 days). The behaviour of the guinea-pigs was monitored for 1 h each day. Animals treated with nandrolone exhibited a significantly greater incidence of biting behaviour during the 14 day treatment period than vehicle-treated animals. A significantly greater density of c-Fos and Fos-related antigen-positive neurons was found in the central nucleus of the amygdala, and of Fos-related antigen-positive neurons in the frontal cortex, the shell of the nucleus accumbens and the supraoptic nucleus in nandrolone-treated animals than in vehicle controls. Therefore, nandrolone induced Fos in brain regions involved in stress, behavioural responses and reward. The increased Fos expression in these limbic brain regions is of particular interest in relation to the behavioural changes reported in humans who abuse anabolic androgenic steroids and the abuse potential of these drugs.

Nicotine reduces the frequency of anger reports in smokers and nonsmokers with high but not low hostility: an ambulatory study.

Two studies were conducted to determine the anger-attenuating effects of nicotine as a function of trait hostility. The 1st study examined the effects of nicotine on diary ratings of anger during a 24-hr period in a natural setting in 30 smokers and 30 nonsmokers. Participants took part in 2 monitoring sessions involving the administration of a nicotine patch and a placebo patch. Participants were categorized as high or low on trait hostility on the basis of their scores on the Cook-Medley Hostility scale. Administration of the nicotine patch, compared with the placebo patch, resulted in a significant reduction in diary reports of anger from 24% to 13% in high-hostile participants. In low-hostile participants, nicotine had no effect on reports of anger during the day. The anger-palliative effects of nicotine were greatest among participants more frequently reporting anger on the placebo-patch day. These effects were independent of smoking status and gender. The 2nd study, which was restricted to high-hostile smokers (n = 19) and nonsmokers (n = 23), found that, compared with a placebo patch, administration of nicotine resulted in significant reductions in reports of anger in smokers and nonsmokers. The results of these 2 studies clearly link nicotine to reduced reports of anger in high-hostile individuals.

Oral contraceptive use: implications for cognitive and emotional functioning.

This study investigated the role of oral contraception use versus nonuse as a moderator variable differentially influencing cognitive-emotional processes. Seventy-six healthy women (29 users and 47 nonusers; 18 to 48 years old), completed the State-Trait Anger Expression Inventory, the Clinical Analysis Questionnaire, the Rotter Scale of locus of control, the Daily Hassles Scale, and a Repertory Grid. A subsample (N = 33) also volunteered for a blood draw. Hormonal levels of progesterone and estrogen mostly were unrelated to cognitive and emotional measures, and contraindicated the "chemical suppression" proposition. Alternatively, when cognitive-emotional functioning was examined separately for users and nonusers, cognitive factors including the appraisal of stress, loci of control, and self-integration were implicated with specific patterns of negative affect and much more so for users than for nonusers. For the most part, oral contraceptive use versus nonuse seemed to influence the saliency rather than the nature of cognitive-emotional patterns. Discussion focused on oral contraceptive use as a moderator variable and the need for longitudinal research to clarify the evolving, biopsychosocial influence of hormonal regulatory treatment.

Premedication with oral midazolam for voiding cystourethrography in children: safety and efficacy.

OBJECTIVE: Midazolam is a relatively short-acting water-soluble benzodiazepine that provides anxiolysis and anterograde amnesia and can be given orally with few adverse effects. We evaluated the benefit and safety of oral midazolam for sedation of young children during voiding cystourethrography or nuclear cystography. SUBJECTS AND METHODS: For 3.5 years, a highly selected group of 98 children, ages 23 months to 9 years (mean, 4 years), were given oral midazolam 0.6 mg/kg 20-30 min before cystourethrography or nuclear cystography. These children either had been frightened by a previous catheterization (39%) or seemed particularly frightened during an examination of their genitals in the office (61%). A control group of 25 children, similar in age to the study group, did not receive midazolam before cystourethrography. Parents were interviewed to assess their child's recollection of the procedure. Voiding dynamics were assessed by evaluating the postvoiding radiograph. RESULTS: Of the midazolam-treated patients, 60% had no recollection of the study, and 31% remembered part or all of the study but did not have a negative experience. No significant change in vital signs or oxygen saturation was observed in any child. In the control group, 24 (96%) of 25 children remembered the cystographic examination (p < .01). Behavioral side effects occurred in 12% of the children receiving midazolam and consisted primarily of combative behavior as the medication was wearing off. Ninety-five percent of the parents indicated that they would want their child to have midazolam again if the cystography needed to be repeated. Of the children receiving midazolam, 76% had little or no residual urine after voiding, compared with 72% of the control group (no significant difference). CONCLUSION: In children who have been or are likely to be excessively frightened during cystourethrography or nuclear cystography, midazolam usually provides satisfactory amnesia and anxiolysis with few side effects or adverse impact on voiding dynamics.

Psychometric evidence that mercury from silver dental fillings may be an etiological factor in depression, excessive anger, and anxiety.

Scores on the Beck Depression Inventory were compared for 25 women who had silver dental fillings (amalgams) and for 23 women without amalgams. Women with amalgams had significantly higher scores and reported more symptoms of fatigue and insomnia. Anger scores from the State-Trait Anger Expression Inventory showed that the women with amalgams had statistically significantly higher mean scores on expressing anger without provocation and experiencing more intense angry feelings. The women without amalgams scored significantly higher on controlling anger, which suggested they invested more energy in monitoring and preventing the experience and expression of anger. Anxiety scores from the State-Trait Anxiety Inventory showed the women with amalgams scored significantly less pleasant, satisfied, happy, secure, and steady, and had a more difficult time making decisions. They had significantly higher Trait Anxiety scores. The women with amalgams also had significantly higher levels of mercury in the oral cavity before and after chewing gum. The study suggests that amalgam mercury may be an etiological factor in depression, excessive anger, and anxiety because mercury can produce such symptoms perhaps by affecting the neurotransmitters in the brain.

Cucumis colocynthis / Cucumis colocynthis

El medicamento se prepara con los frutos desecados. El glucósido colocynthina es el principal componente y su función es ecxitar la musculatura intestinal (purgante drástico). El tropismo tisular y terapéutico se observa en: 1) plexos nerviosos lumbo-abdominales y sacro; 2) nervio trigémino; 3) nervio ciático; 4) ovarios-útero; 5) articulaciones; 6) riñones. Se adapta a pacientes con dificultades materiales o espirituales, que se hacen muy irritables con gran intolerancia al dolor. Reumáticos-gotosos irritables y susceptibles. Lo más importante es saber el tipo de vida que lleva el paciente (Kent). Celosos que se hacen irritables. Dolores violentísimos que hacen doblar en dos la parte afectada con agitación y transpiración. Pueden aparecer después de cólera, enojo, indignación o alimentos fríos, calman por la presión fuerte y aplicaciones calientes. A pesar de la agitación el enfermo queda postrado, débil. Puede llegar al desmayo y no quiere a nadie a su lado porque todo lo encoleriza. Adaptado a cólicos abdominales, renales, dismenorreas violentísimas, ciáticas (principalmente izquierda) y neuralgia del trigémino (rama infraorbital). Sinonimia: colocynthis, citrullus colocynthis, colocynthis fructu rotundo minor, colocynthis vulgaris

Septal rage: mitigation by pre-surgical treatment with p-chlorophenylalamine.

Destruction of the septum leads to a well known hyperirritability syndrome. However, the intensity of this syndrome is modifiable by certain presurgical treatments. Injections, prior to surgery of para-chlorophenylalanine (PCPA) for two days or insulin for five days has no effect on septal rage. However, injections of PCPA five days prior to surgery leads to a marked reduction in septal hyperirritability.