Neurobiological and Neurobehavioral Mechanisms of Chronic Alcohol Drinking
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Tolerance and Dependence
Tolerance and Dependence Drug Tolerance is a decrease in the effect of a drug as a consequence of repeated exposure. • Change over repeated exposures. • Different effects may show different tolerance. • Tolerance is reversible. Mechanisms of Tolerance • Pharmacokinetic Tolerance • Enzyme Induction Effects. • Pharmacodynamic Tolerance • NT depletion • Receptor Plasticity 1 Receptor Plasticity and Tolerance • Drugs that are NT agonists can cause receptor downregulation. • Drugs that are NT antagonists can cause receptor upregulation. Pharmacodynamic drug tolerance can also affect “normal” synaptic transmission. • Serious side-effect of drug use. Mechanisms of tolerance continued… Learned Tolerance - Learned behaviors compensate for drug effects. • Practice effects. • Reward and punishment . Context-Specific Tolerance • Stimuli in the environment (context) become able to counteract the effects of a drug. Pavlovian Conditioning • A neutral stimulus paired with a biologically relevant stimulus becomes able to elicit a response. Siegel et al. (1982) - Demonstrated that drug tolerance can be conditioned. 2 Group Control 15 injections of saline in distinctive room. High dose of heroin in distinctive room on Day 16. • Results: 96% died of overdose. Group Same 15 injections of heroin in distinctive room. Hig h dose o f hero in in dis tincti ve room on D ay 16 . • Results: 32% died of overdose. Group Different 15 injections of heroin in distinctive room. High dose of heroin in new room on Day 16. • Results: 64% died of overdose. Siegel’s Theory: • When an environment consistently predicts drug administration... • … the environment begins to elicit a “compensatory” response that is opposite to the drug’s effect. • The compensatory response counteracts the drug’s effect. -
AND DRUG' ABUSE' ( , \ I ., : for VOLUNTEER .AFTERCARE OFFICERS
=£q, G& ~. ~I o II g ~ L>- ".,-~..- ". 'PR'OBATIQN AND AFTERCA'RE SERVICE " rI ! ,~ i I!' 0 i! ,1 u I', :( ~ II' 1 r :.:" I I) 'tbLLECTED ,READINGS ,~ ~ - '., ,\ ON It, DR!J.GS ·AND DRUG' ABUSE' ( , \ i ., : FOR VOLUNTEER .AFTERCARE OFFICERS. ri ll, "' , 'I: o '.> .. , 4 . , . I:o..-__________:i-.._---... __ ~~ ___~;L __~ ______ fF PROBATION AND AFTERCARE SERVICE COLLECTED READUNGS ON DRUGS AND DRUG ABUSE FOR VOLUNTEER AFTERCARE OFFICERS 1977 a If' t «(, CONTENTS ARTICLE PAGE PART I - THE DRUG SCENE Speech by Dr Goh Keng Swee, Deputy Prime Minister and Minister of Defence, at the Launching of the NADAC Month at the National Theatre Or! Wedr!e~dev, 4th August 1976. 1 II Speech by Mr Chua Sian Chin, Minister for Home Affairs and Education at the Opening Ceremony of the First Meeting of ASEAN Drug Experts at the Crystal Ballroom, Hyatt Hotel, on Tuesday, 26th October 1976. 6 PART II - PREVENTIVE EDUCATION III The Objectives of Anti-Drug Abuse Education by Dr Tow Siang Hwa, Past President, Singapore Anti-Narcotics Association 8 .. PART III - DRUGS AND THEIR EFFECTS IV CommonlY Abused Drugs by Dr Yeow Teow Seng, Associate Profassor oi Pharmacology, University of Singapore 12 V The Non-Medical Uses of Dependence-Producing Drugs by Dr Leong Hon Koon 18 VI Psychiatric Aspects of Drug Abuse by Dr Paul W Ngui, Consultant Psychlatrist 23 VII Sad End to All Drug Trips by Dr Chao Tzu Cheng, Senior Forensic Pathologist, Ministry of Health 27 PART IV - SOCIAL CONSIDERATIONS OF DRUG ABUSE VIII Patterns & Social Consequences of Drug Abuse & the Rehabilitation of Drug Addict by K V Veloo, Chief Probation & Aftercare Officer 29 IX Social Factors of Drug Abuse by K V Veloo, Chief Probation & Aftercare Officer 34 f X Some Causes of Adolescent Problems , by S Vasoo, Deputy Director, Singapore Council of Social Service 39 " ,. -
Guaiana, G., Barbui, C., Caldwell, DM, Davies, SJC, Furukawa, TA
View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Explore Bristol Research Guaiana, G., Barbui, C., Caldwell, D. M., Davies, S. J. C., Furukawa, T. A., Imai, H., ... Cipriani, A. (2017). Antidepressants, benzodiazepines and azapirones for panic disorder in adults: a network meta-analysis. Cochrane Database of Systematic Reviews, 2017(7), [CD012729]. https://doi.org/10.1002/14651858.CD012729 Publisher's PDF, also known as Version of record Link to published version (if available): 10.1002/14651858.CD012729 Link to publication record in Explore Bristol Research PDF-document This is the final published version of the article (version of record). It first appeared online via Cochrane Library at https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD012729/full . Please refer to any applicable terms of use of the publisher. University of Bristol - Explore Bristol Research General rights This document is made available in accordance with publisher policies. Please cite only the published version using the reference above. Full terms of use are available: http://www.bristol.ac.uk/pure/about/ebr-terms Cochrane Database of Systematic Reviews Antidepressants, benzodiazepines and azapirones for panic disorder in adults: a network meta-analysis (Protocol) Guaiana G, Barbui C, Caldwell DM, Davies SJC, Furukawa TA, Imai H, Koesters M, Tajika A, Bighelli I, Pompoli A, Cipriani A Guaiana G, Barbui C, Caldwell DM, Davies SJC, Furukawa TA, Imai H, Koesters M, Tajika A, Bighelli I, Pompoli A, Cipriani A. Antidepressants, benzodiazepines and azapirones for panic disorder in adults: a network meta-analysis. Cochrane Database of Systematic Reviews 2017, Issue 7. -
How Psychoactive Drugs Affect Us
HOW PSYCHOACTIVE DRUGS AFFECT US Part II 7th February 2014 Ms. Cathy Ngarachu Physiological Responses to Drugs • Determines how drugs affect people and why it is difficult to control their levels of use. • They include: • Tolerance to Drug • Tissue Dependence • Psychological Dependence & Reward-reinforcing action of drugs • Withdrawal Tolerance • Results from the body’s attempt to eliminate a drug that it treats as a toxin • With continued drug use the body tries to neutralize the toxic effects by: • Requiring larger amounts of the drugs to achieve the original effects • Degree of effects depend on the : • Amount used • Duration of use • Frequency of use • Individual’s chemistry • State of mind Kinds of Tolerance • Dispositional Tolerance • Speeds up the metabolism to handle the drug in order to eliminate it • Example: Increases the amount of cytocells and mitochondria in the liver to neutralize the drug….. So it will take more of the drug to achieve the same level of intoxication Kinds of Tolerance • Pharmacodynamic Tolerance • Results from the desensitization of nerve cells to the action of the drug • Ex. The nerve cells become less sensitive and begin producing an antidote or antagonist to the drug, ie. The brain will generate more opiod receptor sites. Kinds of Tolerance • Behavioral Tolerance: • Brain adjustments that affect behavior • Someone who is high may make himself appear sober when threatened, then revert back to the high state • Reverse Tolerance • Person has greater sensitivity to the drug, after prolong use, and the body’s ability to metabolize the drug decreases. • Ex. A person who has drunk a 12-pack of beer daily for ten years, may find themselves drinking 3-4 beers to achieve the effect due to tissue damage of the liver and kidneys. -
GABA Receptors
D Reviews • BIOTREND Reviews • BIOTREND Reviews • BIOTREND Reviews • BIOTREND Reviews Review No.7 / 1-2011 GABA receptors Wolfgang Froestl , CNS & Chemistry Expert, AC Immune SA, PSE Building B - EPFL, CH-1015 Lausanne, Phone: +41 21 693 91 43, FAX: +41 21 693 91 20, E-mail: [email protected] GABA Activation of the GABA A receptor leads to an influx of chloride GABA ( -aminobutyric acid; Figure 1) is the most important and ions and to a hyperpolarization of the membrane. 16 subunits with γ most abundant inhibitory neurotransmitter in the mammalian molecular weights between 50 and 65 kD have been identified brain 1,2 , where it was first discovered in 1950 3-5 . It is a small achiral so far, 6 subunits, 3 subunits, 3 subunits, and the , , α β γ δ ε θ molecule with molecular weight of 103 g/mol and high water solu - and subunits 8,9 . π bility. At 25°C one gram of water can dissolve 1.3 grams of GABA. 2 Such a hydrophilic molecule (log P = -2.13, PSA = 63.3 Å ) cannot In the meantime all GABA A receptor binding sites have been eluci - cross the blood brain barrier. It is produced in the brain by decarb- dated in great detail. The GABA site is located at the interface oxylation of L-glutamic acid by the enzyme glutamic acid decarb- between and subunits. Benzodiazepines interact with subunit α β oxylase (GAD, EC 4.1.1.15). It is a neutral amino acid with pK = combinations ( ) ( ) , which is the most abundant combi - 1 α1 2 β2 2 γ2 4.23 and pK = 10.43. -
Neuroplasticity in the Mesolimbic System Induced by Sexual Experience and Subsequent Reward Abstinence
Western University Scholarship@Western Electronic Thesis and Dissertation Repository 6-21-2012 12:00 AM Neuroplasticity in the Mesolimbic System Induced by Sexual Experience and Subsequent Reward Abstinence Kyle Pitchers The University of Western Ontario Supervisor Lique M. Coolen The University of Western Ontario Graduate Program in Anatomy and Cell Biology A thesis submitted in partial fulfillment of the equirr ements for the degree in Doctor of Philosophy © Kyle Pitchers 2012 Follow this and additional works at: https://ir.lib.uwo.ca/etd Recommended Citation Pitchers, Kyle, "Neuroplasticity in the Mesolimbic System Induced by Sexual Experience and Subsequent Reward Abstinence" (2012). Electronic Thesis and Dissertation Repository. 592. https://ir.lib.uwo.ca/etd/592 This Dissertation/Thesis is brought to you for free and open access by Scholarship@Western. It has been accepted for inclusion in Electronic Thesis and Dissertation Repository by an authorized administrator of Scholarship@Western. For more information, please contact [email protected]. NEUROPLASTICITY IN THE MESOLIMBIC SYSTEM INDUCED BY SEXUAL EXPERIENCE AND SUBSEQUENT REWARD ABSTINENCE (Spine Title: Sex, Drugs and Neuroplasticity) (Thesis Format: Integrated Article) By Kyle Kevin Pitchers Graduate Program in Anatomy and Cell Biology A thesis submitted in partial fulfillment of the requirements for degree of Doctor of Philosophy The School of Graduate and Postdoctoral Studies The University of Western Ontario London, Ontario, Canada © Kyle K. Pitchers, 2012 THE UNIVERSITY -
Alprazolam Dependence Prevented by Substituting with the ß-Carboline
Proc. Natl. Acad. Sci. USA Vol. 94, pp. 2719–2723, March 1997 Pharmacology Alprazolam dependence prevented by substituting with the b-carboline abecarnil (benzodiazepinesywithdrawalytoleranceyreplacement therapy) GRAZIANO PINNA*, RUGGERO GALICI*, HERBERT H. SCHNEIDER,DAVID N. STEPHENS†, AND LECHOSLAW TURSKI‡ Research Laboratories of Schering AG, Mu¨llerstrasse 178, D-13342 Berlin, Germany Communicated by Jan Bures, Czech Academy of Sciences, Prague, Czech Republic, December 26, 1996 (received for review December 2, 1996) ABSTRACT Abrupt termination of the treatment of hu- although this view is not adequately supported by controlled mans with benzodiazepines (BDZs) leads to a rapid onset of human data (5). There are also no adequately controlled discontinuation syndrome characterized by anxiety, muscle animal experimental data that allow comparison of the risk of spasms, and occasionally convulsions. For this reason, it is producing dependence between BDZs with short and long recommended in clinical practice to reduce the dose of the half-lives (7). Similarly, there is scanty experimental data BDZs gradually at the end of treatment. Nevertheless, many demonstrating how to discontinue safely treatment with BDZs clinicians report signs of dependence even during gradual with short half-lives. reduction of doses (tapering) of the BDZs in a large propor- To address this issue we have employed newly developed tion of patients. Thus, there is considerable interest in dis- methods for electroencephalographic (EEG) monitoring of covering means of weaning patients away from BDZs without seizures, for electromyographic (EMG) monitoring of muscle the risk of discontinuation syndrome. In the present study, tone, and for detecting anxiety-like behavioral changes after mice withdrawn from chronic treatment with alprazolam discontinuation of long-term treatment with sedative drugs in showed anxiety, muscle rigidity, and seizures between days 1 mice (8) for controlled and standardized assessment of de- and 28 after termination of the treatment. -
Selective Serotonin Reuptake Inhibitors, Fluoxetine and Paroxetine, Attenuate the Expression of the Established Behavioral Sensitization Induced by Methamphetamine
Neuropsychopharmacology (2007) 32, 658–664 & 2007 Nature Publishing Group All rights reserved 0893-133X/07 $30.00 www.neuropsychopharmacology.org Selective Serotonin Reuptake Inhibitors, Fluoxetine and Paroxetine, Attenuate the Expression of the Established Behavioral Sensitization Induced by Methamphetamine 1 1 1 1 1 ,1 Yujiro Kaneko , Atsushi Kashiwa , Takashi Ito , Sumikazu Ishii , Asami Umino and Toru Nishikawa* 1 Section of Psychiatry and Behavioral Sciences, Tokyo Medical and Dental University Graduate School, Yushima, Bunkyo-ku, Tokyo, Japan To obtain an insight into the development of a new pharmacotherapy that prevents the treatment-resistant relapse of psychostimulant- induced psychosis and schizophrenia, we have investigated in the mouse the effects of selective serotonin reuptake inhibitors (SSRI), fluoxetine (FLX) and paroxetine (PRX), on the established sensitization induced by methamphetamine (MAP), a model of the relapse of these psychoses, because the modifications of the brain serotonergic transmission have been reported to antagonize the sensitization phenomenon. In agreement with previous reports, repeated MAP treatment (1.0 mg/kg a day, subcutaneously (s.c.)) for 10 days induced a long-lasting enhancement of the increasing effects of a challenge dose of MAP (0.24 mg/kg, s.c.) on motor activity on day 12 or 29 of withdrawal. The daily injection of FLX (10 mg/kg, s.c.) or PRX (8 mg/kg, s.c.) from 12 to 16 days of withdrawal of repeated MAP administration markedly attenuated the ability of the MAP pretreatment to augment the motor responses to the challenge dose of the stimulant 13 days after the SSRI injection. The repeated treatment with FLX or PRX alone failed to affect the motor stimulation following the challenge of saline and MAP 13 days later. -
Abecarnil/Allobarbital 959 Pharmacopoeias
Abecarnil/Allobarbital 959 Pharmacopoeias. In Eur. (see p.vii). acamprosate’s action including inhibition of neuronal hyper- maleate in the treatment of anxiety disorders, hiccups, and nau- Ph. Eur. 6.2 (Acamprosate Calcium). A white or almost white excitability by antagonising excitatory amino acids such as sea and vomiting. Acepromazine, as the base, has also been giv- powder. Freely soluble in water; practically insoluble in alcohol glutamate. en in preparations for the management of insomnia. and in dichloromethane. A 5% solution in water has a pH of 5.5 1. Wilde MI, Wagstaff AJ. Acamprosate: a review of its pharmacol- Preparations to 7.0. ogy and clinical potential in the management of alcohol depend- ence after detoxification. Drugs 1997; 53: 1038–53. Proprietary Preparations (details are given in Part 3) Adverse Effects 2. Anonymous. Acamprosate for alcohol dependence? Drug Ther Denm.: Plegicil; Turk.: Plegicil. The main adverse effect of acamprosate is dosage-related diar- Bull 1997; 35: 70–2. Multi-ingredient: Fr.: Noctran. rhoea; nausea, vomiting, and abdominal pain occur less frequent- 3. Mason BJ. Treatment of alcohol-dependent outpatients with acamprosate: a clinical review. J Clin Psychiatry 2001; 62 (suppl ly. Other adverse effects have included pruritus, and occasionally 20): 42–8. a maculopapular rash; bullous skin reactions have occurred rare- 4. Overman GP, et al. Acamprosate for the adjunctive treatment of Aceprometazine (rINN) ly. Depression and fluctuations in libido have also been reported. alcohol dependence. Ann Pharmacother 2003; 37: 1090–9. Hypersensitivity reactions including urticaria, angioedema, and 5. Anton RF, et al. Combined pharmacotherapies and behavioral 16-64 CB; Aceprometazina; Acéprométazine; Aceprometazi- anaphylaxis have been reported very rarely. -
ASAM National Practice Guideline for the Treatment of Opioid Use Disorder: 2020 Focused Update
The ASAM NATIONAL The ASAM National Practice Guideline 2020 Focused Update Guideline 2020 Focused National Practice The ASAM PRACTICE GUIDELINE For the Treatment of Opioid Use Disorder 2020 Focused Update Adopted by the ASAM Board of Directors December 18, 2019. © Copyright 2020. American Society of Addiction Medicine, Inc. All rights reserved. Permission to make digital or hard copies of this work for personal or classroom use is granted without fee provided that copies are not made or distributed for commercial, advertising or promotional purposes, and that copies bear this notice and the full citation on the fi rst page. Republication, systematic reproduction, posting in electronic form on servers, redistribution to lists, or other uses of this material, require prior specifi c written permission or license from the Society. American Society of Addiction Medicine 11400 Rockville Pike, Suite 200 Rockville, MD 20852 Phone: (301) 656-3920 Fax (301) 656-3815 E-mail: [email protected] www.asam.org CLINICAL PRACTICE GUIDELINE The ASAM National Practice Guideline for the Treatment of Opioid Use Disorder: 2020 Focused Update 2020 Focused Update Guideline Committee members Kyle Kampman, MD, Chair (alpha order): Daniel Langleben, MD Chinazo Cunningham, MD, MS, FASAM Ben Nordstrom, MD, PhD Mark J. Edlund, MD, PhD David Oslin, MD Marc Fishman, MD, DFASAM George Woody, MD Adam J. Gordon, MD, MPH, FACP, DFASAM Tricia Wright, MD, MS Hendre´e E. Jones, PhD Stephen Wyatt, DO Kyle M. Kampman, MD, FASAM, Chair 2015 ASAM Quality Improvement Council (alpha order): Daniel Langleben, MD John Femino, MD, FASAM Marjorie Meyer, MD Margaret Jarvis, MD, FASAM, Chair Sandra Springer, MD, FASAM Margaret Kotz, DO, FASAM George Woody, MD Sandrine Pirard, MD, MPH, PhD Tricia E. -
MRO Manual Before 2004
Note: This manual is essentially the same as the 1997 HHS Medical Review Officer (MRO) Manual except for changes related to the new Federal Custody and Control Form (CCF). The appendix has also been deleted since the new Federal Custody and Control Form is available as a separate file on the website. Medical Review Officer Manual for Federal Agency Workplace Drug Testing Programs for use with the new Federal Drug Testing Custody and Control Form (OMB Number 0930-0158, Exp Date: June 30, 2003) This manual applies to federal agency drug testing programs that come under Executive Order 12564 and the Department of Health and Human Services (HHS) Mandatory Guidelines. Table of Contents Chapter 1. The Medical Review Officer (MRO) ............................................................... 1 Chapter 2. Federal Drug Testing Custody and Control Form .......................................... 3 Chapter 3. The MRO Review Process ............................................................................ 3 A. Administrative Review of the CCF ........................................................................... 3 I. State Initiatives and Laws ....................................................................................... 15 Chapter 4. Specific Drug Class Issues .......................................................................... 15 A. Amphetamines ....................................................................................................... 15 B. Cocaine ................................................................................................................ -
WO 2015/072852 Al 21 May 2015 (21.05.2015) P O P C T
(12) INTERNATIONAL APPLICATION PUBLISHED UNDER THE PATENT COOPERATION TREATY (PCT) (19) World Intellectual Property Organization International Bureau (10) International Publication Number (43) International Publication Date WO 2015/072852 Al 21 May 2015 (21.05.2015) P O P C T (51) International Patent Classification: (81) Designated States (unless otherwise indicated, for every A61K 36/84 (2006.01) A61K 31/5513 (2006.01) kind of national protection available): AE, AG, AL, AM, A61K 31/045 (2006.01) A61P 31/22 (2006.01) AO, AT, AU, AZ, BA, BB, BG, BH, BN, BR, BW, BY, A61K 31/522 (2006.01) A61K 45/06 (2006.01) BZ, CA, CH, CL, CN, CO, CR, CU, CZ, DE, DK, DM, DO, DZ, EC, EE, EG, ES, FI, GB, GD, GE, GH, GM, GT, (21) International Application Number: HN, HR, HU, ID, IL, IN, IR, IS, JP, KE, KG, KN, KP, KR, PCT/NL20 14/050780 KZ, LA, LC, LK, LR, LS, LU, LY, MA, MD, ME, MG, (22) International Filing Date: MK, MN, MW, MX, MY, MZ, NA, NG, NI, NO, NZ, OM, 13 November 2014 (13.1 1.2014) PA, PE, PG, PH, PL, PT, QA, RO, RS, RU, RW, SA, SC, SD, SE, SG, SK, SL, SM, ST, SV, SY, TH, TJ, TM, TN, (25) Filing Language: English TR, TT, TZ, UA, UG, US, UZ, VC, VN, ZA, ZM, ZW. (26) Publication Language: English (84) Designated States (unless otherwise indicated, for every (30) Priority Data: kind of regional protection available): ARIPO (BW, GH, 61/903,430 13 November 2013 (13. 11.2013) US GM, KE, LR, LS, MW, MZ, NA, RW, SD, SL, ST, SZ, TZ, UG, ZM, ZW), Eurasian (AM, AZ, BY, KG, KZ, RU, (71) Applicant: RJG DEVELOPMENTS B.V.