Psychotic Symptoms Associated with the use of Dopaminergic Drugs, in Patients with Cocaine Dependence or Abuse

Follow-Up of a Sample of Patients with Substance Use Disorder After Completing a Rehabilitation Program in a Continuous Care Unit in Eastern Province of Saudi Arabia, from 2012 to 2022: A Retrospective Study

Purpose

There has been limited research on Saudi patients with substance use disorders (SUDs) that has examined and assessed the psychotherapy modalities utilized in rehabilitation. Therefore, there is a need to evaluate rehabilitation programs in the continuous care unit of the Erada Complex for Mental Health, Eastern Province, Saudi Arabia.

Patients and Methods

The purpose of this study was to compare patients who finished the program with those who did not in order to determine the rate of re-admission and recurrence. Male patients (1160) aged >20 who had been diagnosed with SUDs were included in this retrospective cohort study. After ruling out mood, anxiety, psychosis, and other psychiatric disorders, they commenced a one-year rehabilitation program. Six months after leaving the facility, all participants who completed the program or not were re-admitted had relapses and underwent urine toxicological tests.

Results

Data analysis showed that 34.97% of patients completed the program, while 65.03% of patients did not complete the program. Within 6 months of follow-up after discharge, re-admission occurred in only 13.1% of patients that completed the program, but patients who did not complete the program had a readmission rate that reached 26.9% with statistical significance. In comparison between the two groups regarding relapse without needing admission, there was a significant difference between patients who completed the program (reached 14%) and those who did not complete the program (reached 28.9%). With a logistic regression model, the only significant predictor was completion of the program (the odds ratio was 0.42).

Conclusion

The present results in this study revealed that patients with substance use disorder who had finished the specific rehabilitation program in the continuous care unit had lower risk of relapse and re-admission. Further studies are needed to elucidate the importance of the rehabilitation programs in the management of substance use disorder.

Nanowired Delivery of Curcumin Attenuates Methamphetamine Neurotoxicity and Elevates Levels of Dopamine and Brain-Derived Neurotrophic Factor

Curcumin is a well-known antioxidant used as traditional medicine in China and India since ages to treat variety of inflammatory ailments as a food supplement. Curcumin has antitumor properties with neuroprotective effects in Alzheimer's disease. Curcumin elevates brain-derived neurotrophic factor (BDNF) and dopamine (DA) levels in the brain indicating its role in substance abuse. Methamphetamine (METH) is one of the most abused substances in the world that induces profound neurotoxicity by inducing breakdown of the blood-brain barrier (BBB), vasogenic edema and cellular injuries. However, influence of curcumin on METH-induced neurotoxicity is still not well investigated. In this investigation, METH neurotoxicity and neuroprotective effects of curcumin nanodelivery were examined in a rat model. METH (20 mg/kg, i.p.) neurotoxicity is evident 4 h after its administration exhibiting breakdown of BBB to Evans blue albumin in the cerebral cortex, hippocampus, cerebellum, thalamus and hypothalamus associated with vasogenic brain edema as seen measured using water content in all these regions. Nissl attaining exhibited profound neuronal injuries in the regions of BBB damage. Normal curcumin (50 mg/kg, i.v.) 30 min after METH administration was able to reduce BBB breakdown and brain edema partially in some of the above brain regions. However, TiO₂ nanowired delivery of curcumin (25 mg/kg, i.v.) significantly attenuated brain edema, neuronal injuries and the BBB leakage in all the brain areas. BDNF level showed a significant higher level in METH-treated rats as compared to saline-treated METH group. Significantly enhanced DA levels in METH-treated rats were also observed with nanowired delivery of curcumin. Normal curcumin was able to slightly elevate DA and BDNF levels in the selected brain regions. Taken together, our observations are the first to show that nanodelivery of curcumin induces superior neuroprotection in METH neurotoxicity probable by enhancing BDNF and DA levels in the brain, not reported earlier.