Concomitant stress potentiates the preference for, and consumption of, ethanol induced by chronic pre-exposure to ethanol

Ethanol abuse is linked to several acute and chronic injuries that can lead to health problems. Ethanol addiction is one of the most severe diseases linked to the abuse of this drug. Symptoms of ethanol addiction include compulsive substance intake and withdrawal syndrome. Stress exposure has an important role in addictive behavior for many drugs of abuse (including ethanol), but the consequences of stress and ethanol in the organism when these factors are concomitant results in a complex interaction. We investigated the effects of concomitant, chronic administration of ethanol and stress exposure on the withdrawal and consumption of, as well as the preference for, ethanol in mice. Male Swiss mice (30-35 g, 8-10 per group) were exposed to an ethanol liquid diet as the only source of food for 15 days. In the final 5 days, they were exposed to forced swimming stress. Twelve hours after removal of the ethanol liquid diet, animals were evaluated for ethanol withdrawal by measuring anxiety-related behaviors and locomotor activity. Twenty-four hours after evaluation of ethanol withdrawal, they were evaluated for voluntary consumption of ethanol in a "three-bottle choice" paradigm. Mice exposed to chronic consumption of ethanol had decreased locomotor activity during withdrawal. Contrary to our expectations, a concomitant forced swimming stress did not aggravate ethanol withdrawal. Nevertheless, simultaneous ethanol administration and stress exposure increased voluntary consumption of ethanol, mainly solutions containing high concentrations of ethanol. These results showed that stressful situations during ethanol intake may aggravate specific addiction-related behaviors.

Cuantificación paramétrica de los cambios en la perfusión cerebral producidos por abstinencia y con activación neurocognitiva en dependientes de cocaína / Changes in cerebral perfusion caused by abstinence in cocaine-dependent patients

Introducción. Los sujetos dependientes de cocaína pueden presentar deterioro neurocognitivo y alteraciones conductuales con importantes implicancias sociales. En esos pacientes se han demostrado diversas anormalidades en la perfusión cerebral, especialmente en la corteza prefrontal. Esta región cortical está relacionada con funciones ejecutivas y con el control de impulsos. El Wisconsin Card Sorting Test (WCST) fue diseñado específicamente para activar la corteza prefrontal. Objetivo. En sujetos dependientes de cocaína, cuantificar cambios en la perfusion cerebral basal y post activación con WCST inducidos por la detoxificación. Método. Se estudió a 23 pacientes entre 24 y 49 años de edad (19 hombres) que cumplían criterios DSM-IV para dependencia de cocaína y con consumo reciente demostrado. En todos ellos se obtuvo SPECT de perfusión cerebral en condiciones de reposo al ingreso y tras 4 semanas de hospitalización con abstinencia controlada. En 19 sujetos se realizó además SPECT cerebral con activación usando WCST, al inicio y al final de la hospitalización. Para comparar estas cuatro condiciones se utilizó Statistical Parametric Mapping (SPM). Resultados. Al comparar la perfusión en condiciones de reposo inicial y al mes de abstinencia se observó mejoría significativa de múltiples áreas corticales especialmente en región parieto-occipital bilateral y corteza prefrontal izquierda.El análisis grupal no demostró activación de corteza prefrontal con WCST al ingreso a la terapia de detoxificación. Luego de 4 semanas de abstinencia estricta, se observó significativa activación post WCST de corteza prefrontal dorsolateral izquierda.Conclusiones. Un mes de abstinencia estricta de cocaína produce mejoría de la perfusión cerebral en pacientes dependientes. Post consumo reciente, no se demuestra activación a nivel prefrontal con el estímulo del WCST, la cual se observa luego de abstinencia, lo que indica mejoría neurocognitiva...

Introduction. Cocaine-dependent subjects might have socially disruptive behavior. Several regional cerebral blood flow (rCBF) abnormalities have been described in these patients, mainly in the prefrontal cortex, area related to executive functions and impulse control. Wisconsin Card Sorting Test (WCST) was specifically designed to activate this cortical area. Aim. To quantify rCBF and to assess prefrontal activation pre and post detoxification on cocaine-dependant subjects. Methods. We studied 23 patients who met DSM-IV criteria for cocaine dependency ranging from 24 - 49 years old (19 males), all with positive urine cocaine test. Baseline 99mTc-ECD brain perfusion SPECT was performed at admission and after 4 weeks of controlled in-hospital abstinence; in 19 patients SPECT was acquired also after WCST activation. Statistical Parametric Mapping (SPM) was used to compare SPECT studies on these 4 conditions. Results. rCBF of bilateral parieto-occipital area, left prefrontal cortex and multiple small cortical region improved after 4 weeks of cocaine detoxification. The group analysis did not show significant prefrontal cortex activation induced by WCST on admission. After 4 weeks of strict cocaine abstinence, WCST was able to induce left dorsolateral prefrontal cortex activation. Conclusions. A month of strict cocaine abstinence improved brain perfusion in dependant patients. After recent consumption, there was no prefrontal activation when using WCST, but this was observed after abstinence, supporting neurocognitive improvement. These findings may have clinical implications as potential predictors of therapy response.

Amor y adicción: comparación de las características neurales y conductuales: [revisión] / Love and addiction: comparison of the neural and behavioral characteristics: [review]

El amor es una experiencia placentera que se encuentra presente en todas las culturas y que posee una compleja base neurobiológica que la sustenta. El sistema neural del placer es fundamental para dicha experiencia y al contrario de lo que normalmente se piensa, el amor está ligado más con el sistema motivacional que con emociones. Los núcleos y los neurotransmisores que sintetizan la experiencia del amor son los mismos que sustentan la adicción a las drogas como la cocaína, las anfetaminas o la morfina. Además los síntomas por abstinencia del consumo de drogas y los que se generan cuando se termina una relación de pareja son casi los mismos.

The love is a pleasant experience that is present in all the culture and that possesses a complex base neurobiological that sustains her. The neural system of the pleasure is fundamental for the above mentioned experience and unlike what normally this one thinks the love tied more with the system motivational that with emotions. The nucleuses and the neurotransmitters that they synthesize during the experience of the love are the same that sustain the addiction the drugs as the cocaine, the amphetamines and the morphine. In addition the symptom for abstinence of the consumption of drugs and those who are generated when a relation of pair finishes are almost the same one.

Tratamiento del Síndrome de Retiro de Opiáceos: síndrome de retiro descrito como subjetivamente severo y objetivamente moderado / Drug therapy of opioid withdrawal

Si bien la dependencia a opiáceos es de baja frecuencia de aparición en nuestro medio, es importante conocer su manejo ya que requiere tratamiento farmacológico en la mayoría de los casos. En la actualidad, en nuestro país, se podría clasificar a las distintas poblaciones de pacientes capaces de presentar un síndrome de retiro a opiáceos en: pacientes sometidos a tratamiento crónico con opiáceos, pacientes internados en unidades de cuidados intensivos, neonato de madre adicta y pacientes adictos provenientes de la población en general o ligada al sistema de salud. Los programas de desintoxicación son caracterizados típicamente por un bajo índice de finalización del tratamiento y un alto índice de recaída. El síndrome de retiro a opiáceos es subjetivamente severo y objetivamente moderado y las metas de la terapia en el Síndrome de Retiro de Opiáceos son: evitar o reducir los síntomas objetivos y subjetivos de abstinencia; prevenir o tratar las complicaciones más serias; tratar las enfermedades psiquiátricas preexistentes o concurrentes; reducir la frecuencia o la severidad de las recaídas y rehabilitar a largo plazo.

Although the opiate dependence is of low frequency in our midst, it is important to know its management because it requires medical treatment in most cases. At present, in our country, we may classify the different patient populations able to submit an opioid withdrawal syndrome in patients undergoing chronic treatment with opioids, patients in intensive care units; neonatal mother addicted patients and addicts from the general population or linked to the health system. Detoxification programs are typically characterized by a low rate of completion of treatment and a high rate of relapse. The opioid withdrawal syndrome is objectively and subjectively severe and moderate and the goals of the therapy for the Opiates Withdrawal Syndrome are: to prevent or reduce the objective and subjective symptoms of abstinence; to prevent or treat its most serious complications; to treat preexisting or concurrent psychiatric disorders; to reduce the frequency or severity of relapses and to rehabilitate in the long term.

The Role of NMDA Receptor Antagonists in Nicotine Tolerance, Sensitization, and Physical Dependence: A Preclinical Review

Nicotine, the primary psychoactive component of tobacco products, produces diverse neurophysiological, motivational, and behavioral effects through several brain regions and neurochemical pathways. Various neurotransmitter systems have been explored to understand the mechanisms behind nicotine tolerance, dependence, and withdrawal. Recent evidence suggests that glutamate neurotransmission has an important role in this phenomenon. The aim of the present review is to discuss preclinical findings concerning the role of N-methyl-D-aspartate (NMDA) receptor neurotransmission in mediating the behavioral effects of nicotine, tolerance, sensitization, dependence, and withdrawal. Based on preclinical findings, it is hypothesized that NMDA receptors mediate the common adaptive processes that are involved in the development, maintenance, and expression of nicotine addiction. Modulation of glutamatergic neurotransmission with NMDA receptor antagonists may prove to be useful in alleviating the symptoms of nicotine abstinence and facilitate tobacco-smoking cessation.

[ comparative study on opium withdrawal of buprenorphine and clonidine]

Opium abuse and addiction is a worldwide problem and application of a method, both cost effective and with less side effect, to shorten the opioid detoxification period is on increasing demand. To compare the efficacy of Buprenorphine and Clonidine in treatment of opium withdrawal. This study was a randomized, double blind, parallel group, clinical trial performed on out-patients referred to either psychiatric ward at Amirkabir hospital or private clinics in 2005. The patients, initially divided into two groups of 38 members, were assessed for both the efficacy and side effects. Statistical analysis was performed using descriptive statistical tests, K[2] test, and also the correlation severity by relative risk analysis [R.R]. Thirty six [94.8%] subjects in Buprenorphine group and 32 [84.3%] in clonidine group completed the detoxification program, successfully. Relapses were observed in 2 and 6 cases of Buprenorphine and Clonidine groups, respectively. The difference was statistically insignificant [p= 0.13]. The side effects including hypotension, headache, sedation, dizziness, dry mouth, nausea, and constipation during the 10-day detoxification periods in Clonidine group was more severe and intolerable than in Buprenorphine group. Conversely, the sweating, as another side effect, was found to be more pronounced in Buprenorphine group than in Clonidine group. Buprenorphine and Clonidine showed similar effects in managing opium withdrawal, yet the withdrawal symptoms of opium was found to be more tolerable with Buprenorphine than Clonidine. Also, less side effects were observed with Buprenorphine

Bases neurofisiológicas da dependência do tabaco / Neurophysiological basis of tobacco dependence

A maioria dos estudos pré-clínicos e clínicos aponta a nicotina como o principal agente responsável pelo desenvolvimento da dependência ao tabaco. Muitos trabalhos têm demonstrado que as bases neurais da dependência à nicotina são semelhantes àquelas das outras drogas de abuso. A nicotina induz preferência condicionada por lugar e auto-administracão e, portanto, atua como reforcador positivo, esse efeito parece ser mediado pelo sistema dopaminérgico mesolímbico. A nicotina também induz à sensibilizacão comportamental que é provavelmente resultante de alteracões da expressão gênica do núcleo acumbens induzidas pela exposicão prolongada a essa substância. A suspensão do uso de nicotina resulta em síndrome de abstinência. As evidências indicam que esses sinais e sintomas sejam mediados por receptores colinérgicos nicotínicos centrais e periféricos. Outros neurotransmissores, como por exemplo a serotonina e os peptídeos opióides, também podem estar envolvidos na mediacão da dependência e síndrome de abstinência à nicotina. A revisão da literatura mostra a complexidade dos efeitos da nicotina no organismo. A integracão entre as abordagens comportamental, neuroquímica e molecular possibilitará a compreensão dos mecanismos neurais da dependência ao tabaco e fornecerá as bases para o desenvolvimento racional de agentes terapêuticos que possam ser utilizados para o tratamento da dependência e síndrome de abstinência ao tabaco.

Sindrome de abstinencia alcohólica / Alcoholic withdrawal syndrome

El Sindrome de abstinencia alcohólica es una de las mayores complicaciones vinculadas al alcoholismo. En esta revisión hacemos referencia a su fisiopatología, las diferentes presentaciones clínicas, desde las más leves en las que predominan las manifestaciones de hiperactividad adrenérgica a las formas más severas: la convulsión y el delirium tremens. Se describen los trastornos electrolíticos más frecuentemente encontrados. Hacemos hincapié en el manejo de estos pacientes, las medidas no farmacológicas y las farmacológicas, basándonos en el uso de la escala de CIWA-Ar para cuantificar la severidad del cuadro clínico y la oportunidad de tratamiento farmacológico

Caso clínico: psicosis asociada a uso de zipeprol / Clinical case: psychosis associated to use of zipeprol

Se presenta un caso de psicosis asociada con el uso de zipeprol. Hay una descripción de los aspectos clínicos y de los antecedentes familiares y personales, además de las características particulares del consumo de este fármaco

Adicción al ziprepol: tres casos clínicos / Ziprepol adiction: 3 clinical cases

Las adicciones o drogadependencias en la población joven de nuestro país se están transformando en un problema preocupante de salud mental. Al arsenal se sustancias adictivas más usadas se ha incorporado el ziprepol, jarabe antitusígeno. Su bajo costo lo hace fácilmente accesible entre adictos. En la presente comunicación se describen las manifestaciones neurológicas y psicopatológicas de 3 adictos a ziprepol, 2 hombres y una mujer

A study on withdrawal related haemodynamic response in chronic propranolol treated conscious rats.

Single dose of propranolol hydrochloride (5 mg/kg, i.p.) caused significant fall in heart rate (HR) but not in systolic blood pressure (SBP) in normotensive conscious rats. Multiple doses of propranolol (5 mg/kg, i.p., twice-a-day for 5 wk) caused significant fall in both HR and SBP at 2 wk and 4 wk in normotensive conscious rats. Sudden withdrawal of propranolol at 5 wk caused a significant blood pressure upswing and tachycardia between 12-24 h followed by normalization of both blood pressure and heart rate. The study documents a possible model of rebound hypertension in normotensive conscious rats.

Propranolol withdrawal and thyroid function in the rabbit

Propranolol without manifestations is now known to have strong correlation to thyroid hormones. Conflicting results are reported by different workers regarding the influence of sudden propranolol withdrawal on the different parameters related to thyroid functions. The present study was conducted on adult male rabbits to explore the effect of propranolol administration [30 mg/kg/day orally] for four weeks and its subsequent withdrawal on the pituitary thyroidaxis; namely, serum TSH, total T4, free T4, total T3 and free T3. The withdrawal period ranged from one day and extended up to 12 days. Total serum T3 was found to be significantly reduced following the prolonged daily oral administration of propranolol, while propranolol withdrawal led to a significant elevation of serum free T3 as compared with three and six days following drug cessation. These results emphasized the importance of free T3 in the production of propranolol withdrawal manifestations, while the nonsignificant changes of serum total T3 on propranolol withdrawal may be due to changes in serum protein binding capacity affecting total T3 but not free T3

A viagem de volta - parte 1 e 2 / The return trip - part 1 and 2

Parte 1 e 2: a história de uma dependente química que resolve buscar ajuda terapêutica quando presencia a morte por overdose de sua amiga. A descrença da família em sua possível recuperação representa um entrave durante o tratamento.Parte 2: os conflitos dentro do próprio grupo de terapia e os desafios da abstinência química rumo à recuperação, na tentativa de retormar a confiança dos outros e em si mesmo...