1
|
Akinluyi ET, Edem EE, Dakoru KM, Nnodim CJ, Oladipupo MA, Adeoluwa OA, Obisesan AO, Ben-Azu B, Adebayo OG. Psychobiotic interventions attenuate chronic alcohol use-mediated exacerbation of posttraumatic stress disorder in rats: the role of gut-liver axis response. J Complement Integr Med 2023; 20:92-105. [PMID: 36537043 DOI: 10.1515/jcim-2022-0353] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 11/29/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVES The incidence of co-occurring alcohol-use disorder (AUD) and post-traumatic stress disorder (PTSD) is high, and the presence of one disorder aggravates the severity of the other. Emerging evidence shows the neuroprotective and anti-inflammation functions of psychobiotics. Hence, the study explored the effects of probiotics and synbiotic inulin on the gut- and liver-oxidative and inflammatory biomarkers in chronic alcohol exacerbation of PTSD symptoms in rats. METHODS Young adult rats were administered 10% ethanol in a two-bottle choice test for six weeks and were subjected to single prolonged stress. Probiotics and synbiotic intervention followed this. Markers of oxido-inflammatory stress, liver functions, intestinal (faecal) metabolites, occludin expression, and histopathology of the ileum and liver were evaluated. RESULTS Chronic alcohol drinking and PTSD increased oxido-inflammatory stress, markers of hepatic damage, and reduced faecal metabolites, which were attenuated by probiotic and synbiotic interventions. Furthermore, reduced immunoexpression of gut and liver occludin, with loss of barrier integrity, viable hepatocytes, congestive portal area, and shortened villi and crypt depth, were observed. Probiotic and synbiotic interventions mitigated these effects. CONCLUSIONS The study demonstrates that psychobiotics mitigate the detrimental effects of co-occurring chronic alcohol intake in the context of PTSD.
Collapse
Affiliation(s)
- Elizabeth T Akinluyi
- Neuropharmacology Unit, Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, Afe Babalola University, Ado- Ekiti, Nigeria
| | - Edem E Edem
- Neuroscience Unit, Department of Human Anatomy, College of Medicine and Health Sciences, Afe Babalola University, Ado- Ekiti, Nigeria
| | - Kelvin M Dakoru
- Neuropharmacology Unit, Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, Afe Babalola University, Ado- Ekiti, Nigeria
| | - Chinaza J Nnodim
- Neuropharmacology Unit, Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, Afe Babalola University, Ado- Ekiti, Nigeria
| | - Michael A Oladipupo
- Neuropharmacology Unit, Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, Afe Babalola University, Ado- Ekiti, Nigeria
| | - Olusegun A Adeoluwa
- Neuropharmacology Unit, Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, Afe Babalola University, Ado- Ekiti, Nigeria
| | - Abiola O Obisesan
- Department of Pharmaceutical Microbiology, College of Pharmacy, Afe Babalola University, Ado-Ekiti, Nigeria
| | - Benneth Ben-Azu
- Department of Pharmacology and Therapeutics, Faculty of Basic Medical Sciences, College of Health Sciences, Delta State University, Abraka, Delta State, Nigeria
| | - Olusegun G Adebayo
- Neurophysiology Unit, Department of Physiology, Faculty of Basic Medical Sciences, PAMO University of Medical Sciences, Port Harcourt, Rivers State, Nigeria
| |
Collapse
|
2
|
Park A, Tran T, Gutierrez L, Stojanik CJ, Plyler J, Thompson GA, Bohm RA, Scheuerman EA, Smith DP, Atkinson NS. Alcohol-induced aggression in Drosophila. Addict Biol 2021; 26:e13045. [PMID: 34044470 DOI: 10.1111/adb.13045] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/16/2021] [Accepted: 03/31/2021] [Indexed: 11/28/2022]
Abstract
Alcohol-induced aggression is a destructive and widespread phenomenon associated with violence and sexual assault. However, little is understood concerning its mechanistic origin. We have developed a Drosophila melanogaster model to genetically dissect and understand the phenomenon of sexually dimorphic alcohol-induced aggression. Males with blood alcohol levels of 0.04-mg/ml BAC were less aggressive than alcohol-naive males, but when the BAC had dropped to ~0.015 mg/ml, the alcohol-treated males showed an increase in aggression toward other males. This aggression-promoting treatment is referred to as the post-ethanol aggression (PEA) treatment. Females do not show increased aggression after the same treatment. PEA-treated males also spend less time courting and attempt to copulate earlier than alcohol-naive flies. PEA treatment induces expression of the FruM transcription factor (encoded by a male-specific transcript from the fruitless gene), whereas sedating doses of alcohol reduce FruM expression and reduce male aggression. Transgenic suppression of FruM induction also prevents alcohol-induced aggression. In male flies, alcohol-induced aggression is dependent on the male isoform of the fruitless transcription factor (FruM). Low-dose alcohol induces FruM expression and promotes aggression, whereas higher doses of alcohol suppress FruM and suppress aggression.
Collapse
Affiliation(s)
- Annie Park
- Department of Neuroscience and Waggoner Center for Alcohol and Addiction Research The University of Texas at Austin Austin Texas USA
- Centre for Neural Circuits and Behaviour The University of Oxford Oxford UK
| | - Tracy Tran
- Department of Neuroscience and Waggoner Center for Alcohol and Addiction Research The University of Texas at Austin Austin Texas USA
| | - Linda Gutierrez
- Department of Neuroscience and Waggoner Center for Alcohol and Addiction Research The University of Texas at Austin Austin Texas USA
| | - Christopher J. Stojanik
- Department of Neuroscience and Waggoner Center for Alcohol and Addiction Research The University of Texas at Austin Austin Texas USA
| | - Julian Plyler
- Department of Neuroscience and Waggoner Center for Alcohol and Addiction Research The University of Texas at Austin Austin Texas USA
| | - Grace A. Thompson
- Department of Neuroscience and Waggoner Center for Alcohol and Addiction Research The University of Texas at Austin Austin Texas USA
| | - Rudolf A. Bohm
- Department of Biological and Health Sciences Texas A&M University‐Kingsville Kingsville Texas USA
| | - Elizabeth A. Scheuerman
- Department of Pharmacology and Neuroscience University of Texas Southwestern Medical Center Dallas Texas USA
| | - Dean P. Smith
- Department of Pharmacology and Neuroscience University of Texas Southwestern Medical Center Dallas Texas USA
| | - Nigel S. Atkinson
- Department of Neuroscience and Waggoner Center for Alcohol and Addiction Research The University of Texas at Austin Austin Texas USA
| |
Collapse
|
3
|
Moon TJ, Mathias CW, Mullen J, Karns-Wright TE, Hill-Kapturczak N, Roache JD, Dougherty DM. Social Support and the Rehabilitation of Alcohol-Impaired Drivers: Drinking Motives as Moderators. Health Commun 2021; 36:540-550. [PMID: 32091242 PMCID: PMC7483183 DOI: 10.1080/10410236.2020.1731914] [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] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Alcohol-impaired driving is a common and costly public health problem associated with alcohol misuse. This investigation aims to understand the role of social support and drinking motives in motivating alcohol-impaired drivers to reduce alcohol use. One hundred nineteen participants with a history of driving-while-intoxicated arrest were recruited from either a correctional treatment facility (n = 59) or the community (n = 60) and asked about their motivation to change alcohol use. Motivation to change was tested in relationships with two types of social support (i.e. Abstinence-Specific Social Support and General Social Support) and drinking motives (Coping, Enhancement, and Social Motives). The results showed: (1) only Abstinence-Specific Social Support was positively associated with motivation to change; (2) Coping and Social Motives had a negative association with motivation to change; (3) the impact of Abstinence-Specific Social Support on motivation to change was greater among those with a stronger Enhancement Motives. In other words, those who drink primarily for pleasure showed a greater increase in motivation to change when more Abstinence-Specific Social Support is available, compared to those with lower Enhancement Motives. The findings of this investigation contribute to our knowledge of the roles of communication in the rehabilitation of alcohol-impaired drivers.
Collapse
Affiliation(s)
- Tae-Joon Moon
- Department of Psychiatry, The University of Texas Health Science Center at San Antonio
| | - Charles W. Mathias
- Department of Psychiatry, The University of Texas Health Science Center at San Antonio
| | - Jillian Mullen
- Department of Psychiatry, The University of Texas Health Science Center at San Antonio
| | - Tara E. Karns-Wright
- Department of Psychiatry, The University of Texas Health Science Center at San Antonio
| | | | - John D. Roache
- Department of Psychiatry, The University of Texas Health Science Center at San Antonio
| | - Donald M. Dougherty
- Department of Psychiatry, The University of Texas Health Science Center at San Antonio
| |
Collapse
|
4
|
Bajaj JS, Sikaroodi M, Fagan A, Heuman D, Gilles H, Gavis EA, Fuchs M, Gonzalez-Maeso J, Nizam S, Gillevet PM, Wade JB. Posttraumatic stress disorder is associated with altered gut microbiota that modulates cognitive performance in veterans with cirrhosis. Am J Physiol Gastrointest Liver Physiol 2019; 317:G661-G669. [PMID: 31460790 PMCID: PMC6879889 DOI: 10.1152/ajpgi.00194.2019] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 08/12/2019] [Accepted: 08/18/2019] [Indexed: 02/07/2023]
Abstract
Posttraumatic stress disorder (PTSD) is associated with cirrhosis in veterans, and therapeutic results are suboptimal. An altered gut-liver-brain axis exists in cirrhosis due to hepatic encephalopathy (HE), but the added impact of PTSD is unclear. The aim of this study was to define linkages between gut microbiota and cognition in cirrhosis with/without PTSD. Cirrhotic veterans (with/without prior HE) underwent cognitive testing [PHES, inhibitory control test (ICT), and block design test (BDT)], serum lipopolysaccharide-binding protein (LBP) and stool collection for 16S rRNA microbiota composition, and predicted function analysis (PiCRUST). PTSD was diagnosed using DSM-V criteria. Correlation networks between microbiota and cognition were created. Patients with/without PTSD and with/without HE were compared. Ninety-three combat-exposed male veterans [ (58 yr, MELD 11, 34% HE, 31% combat-PTSD (42 no-HE/PTSD, 19 PTSD-only, 22 HE-only, 10 PTSD+HE)] were included. PTSD patients had similar demographics, alcohol history, MELD, but worse ICT/BDT, and higher antidepressant use and LBP levels. Microbial diversity was lower in PTSD (2.1 ± 0.5 vs. 2.5 ± 0.5, P = 0.03) but unaffected by alcohol/antidepressant use. PTSD (P = 0.02) and MELD (P < 0.001) predicted diversity on regression. PTSD patients showed higher pathobionts (Enterococcus and Escherichia/Shigella) and lower autochthonous genera belonging to Lachnospiraceaeae and Ruminococcaceae regardless of HE. Enterococcus was correlated with poor cognition, while the opposite was true for autochthonous taxa regardless of PTSD/HE. Escherichia/Shigella was only linked with poor cognition in PTSD patients. Gut-brain axis-associated microbiota functionality was altered in PTSD. In male cirrhotic veterans, combat-related PTSD is associated with cognitive impairment, lower microbial diversity, higher pathobionts, and lower autochthonous taxa composition and altered gut-brain axis functionality compared with non-PTSD combat-exposed patients. Cognition was differentially linked to gut microbiota, which could represent a new therapeutic target.NEW & NOTEWORTHY Posttraumatic stress disorder (PTSD) in veterans with cirrhosis was associated with poor cognitive performance. This was associated with lower gut microbial diversity in PTSD with higher pathobionts belonging to Enterococcus and Escherichia/Shigella and lower beneficial taxa belonging to Lachnospiraceaeae and Ruminococcaceae, with functional alterations despite accounting for prior hepatic encephalopathy, psychoactive drug use, or model for end-stage liver disease score. Given the suboptimal response to current therapies for PTSD, targeting the gut microbiota could benefit the altered gut-brain axis in these patients.
Collapse
Affiliation(s)
- Jasmohan S Bajaj
- Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University Medical Center, Richmond, Virginia
- McGuire Veterans Affairs Medical Center, Richmond, Virginia
| | | | - Andrew Fagan
- Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University Medical Center, Richmond, Virginia
- McGuire Veterans Affairs Medical Center, Richmond, Virginia
| | - Douglas Heuman
- Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University Medical Center, Richmond, Virginia
- McGuire Veterans Affairs Medical Center, Richmond, Virginia
| | - HoChong Gilles
- Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University Medical Center, Richmond, Virginia
- McGuire Veterans Affairs Medical Center, Richmond, Virginia
| | - Edith A Gavis
- Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University Medical Center, Richmond, Virginia
- McGuire Veterans Affairs Medical Center, Richmond, Virginia
| | - Michael Fuchs
- Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University Medical Center, Richmond, Virginia
- McGuire Veterans Affairs Medical Center, Richmond, Virginia
| | - Javier Gonzalez-Maeso
- Department of Physiology and Biophysics, Virginia Commonwealth University, Richmond, Virginia
| | - Shahzor Nizam
- Microbiome Analysis Center, George Mason University, Manassas, Virginia
| | | | - James B Wade
- Department of Psychiatry, Virginia Commonwealth University Medical Center, Richmond, Virginia
| |
Collapse
|
5
|
Luquiens A, Rolland B, Pelletier S, Alarcon R, Donnadieu-Rigole H, Benyamina A, Nalpas B, Perney P. Role of Patient Sex in Early Recovery from Alcohol-Related Cognitive Impairment: Women Penalized. J Clin Med 2019; 8:E790. [PMID: 31167412 DOI: 10.3390/jcm8060790] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 05/13/2019] [Accepted: 05/31/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The objective was to explore the role of patient sex in cognitive recovery and to identify predictive factors for non-recovery in alcohol use disorder (AUD). METHODS All patients with AUD admitted to a residential addictions treatment center were systematically assessed at admission and after 6 weeks of abstinence in a controlled environment. The inclusion criteria were that patients were admitted for AUD with baseline alcohol-related cognitive impairment (baseline total Montreal Cognitive Assessment (MoCA) score < 26) and reassessed at 6 weeks (n = 395). A logistic regression model was built to determine the influence of sex on recovery status (MoCA < or ≥ 26) taking into account the interaction effect of sex with alcohol consumption on cognitive function. RESULTS The mean age was 50.10 years (SD = 9.79), and 27.41% were women. At baseline, the mean MoCA scores were 21.36 (SD = 3.04). Participants who did not achieve recovery (59.3% of women vs 53.8% of men) had lower total MoCA scores at baseline. The 2 factors that was significantly and independently associated with non-recovery and with a non-zero coefficient was being a woman and initial MoCA score (respective adjusted odds ratios (AOR) = 1.5 and 0.96, p-values < 0.05). CONCLUSIONS These results could influence the time required in a controlled environment to maintain abstinence and the duration of in-care for women.
Collapse
|
6
|
Miller M, Orwat D, Rahimi G, Mintzer J. A retrospective, population-based cohort study of driving under the influence, Alzheimer's disease diagnosis, and survival. Int Psychogeriatr 2019; 31:571-7. [PMID: 30303050 DOI: 10.1017/S1041610218001151] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
UNLABELLED ABSTRACTIntroduction:The relationship between Alzheimer's Disease (AD) and alcohol addiction is poorly characterized. Arrests for driving under the influence (DUI) can serve as a proxy for alcohol addiction. Therefore, the potential association between DUI and AD could be helpful in understanding the relationship between alcohol abuse and AD. MATERIALS AND METHODS A retrospective, population-based cohort study using state health and law enforcement data was performed. The study cross-referenced 141,281 South Carolina Alzheimer's Disease Registry cases with state law enforcement data. RESULTS Of the 2,882 registry cases (1.4%) found to have a history of at least one DUI arrest, cases were predominantly White (58.7%) and male (77.4%). Results showed a correlation coefficient of 0.7 (p < 0.0001) between the age of first DUI arrest and the age of AD diagnosis. A dose-response relationship between the number of DUIs and age of AD onset was found to exist, where those with a history of DUI arrest were diagnosed an average of 9.1 years earlier, with a further 1.8 years earlier age at diagnosis in those with two or more arrests for DUI. A history of DUI arrest was also found to be negatively associated with survival after diagnosis, with a 10% decreased life expectancy in those with a DUI arrest history. CONCLUSIONS Driving under the influence, a potential indicator of alcohol addiction, is associated with an earlier onset of AD registry diagnosis and shortened survival after diagnosis. This study contributes to the growing body of evidence suggesting that some cases of AD are alcohol related and, possibly, postponable or preventable.
Collapse
|
7
|
Rautiainen E, Ryynänen OP, Laatikainen T. Care outcomes and alcohol-related treatment utilisation profiles of patients with alcohol-use disorder: A prospective cohort study using electronic health records. Nordisk Alkohol Nark 2018; 35:329-343. [PMID: 32934536 PMCID: PMC7434146 DOI: 10.1177/1455072518783972] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 05/22/2018] [Indexed: 11/16/2022] Open
Abstract
Background: We examined the probabilities of longitudinal care outcomes of working-aged
patients with alcohol-use disorder (AUD) and their alcohol-related treatment
utilisation patterns across the healthcare services, by using linked
electronic health records. Methods: A random sample (n = 396) of patients with alcohol-related
visits to healthcare services in 2011–2012 was collected retrospectively
from the electronic health record data in the North Karelia region of
Finland and followed prospectively in time until the end of 2016. Data on
care outcomes and alcohol-related healthcare use were gathered from the
electronic health records. Three outcome groups were identified: (1) dead,
(2) present AUD, and (3) remission. Group differences in alcohol-related
health service use were compared. Results: At the end of the follow-up period, an increased mortality rate of 22.9% was
observed, and 18.4% had achieved stable remission, while for the majority
(56%), the AUD remained. Most of those in remission had contact with either
specialised AUD services or mental health services. Conversely, the majority
of those who had died had no contact with specialised AUD services during
the follow-up period. Conclusions: The electronic-health-record-based register analysis captured mainly
individuals with advanced forms of AUD. An excess mortality rate and other
negative health consequences were observed. Training providers to identify
and treat earlier the less severe forms of AUD could have major benefit to
patients and also reduce health system costs.
Collapse
|
8
|
Abstract
Alcohol use disorder generates devastating social, medical and economic burdens, making it a major global health issue. The persistent nature of memories associated with intoxication experiences often induces cravings and triggers relapse in recovering individuals. Despite recent advances, the neural and molecular mechanisms underlying these memories are complex and not well understood. This makes finding effective pharmacological targets challenging. The investigation of persistent alcohol-associated memories in the fruit fly, Drosophila melanogaster, presents a unique opportunity to gain a comprehensive understanding of the memories for ethanol reward at the level of genes, molecules, neurons and circuits. Here we characterize the dose-dependent nature of ethanol on the expression of memory for an intoxication experience. We report that the concentration of ethanol, number of ethanol exposures, length of ethanol exposures, and timing between ethanol exposures are critical in determining whether ethanol is perceived as aversive or appetitive, and in how long the memory for the intoxicating properties of ethanol last. Our study highlights that fruit flies display both acute and persistent memories for ethanol-conditioned odor cues, and that a combination of parameters that determine the intoxication state of the fly influence the seemingly complex retention and expression of memories associated with intoxication. Our thorough behavioral characterization provides the opportunity to interrogate the biological underpinnings of these observed preference differences in future studies.
Collapse
Affiliation(s)
- Kavin M Nunez
- Molecular Pharmacology and Physiology Graduate Program, Brown University, Providence, RI, United States
| | - Reza Azanchi
- Department of Neuroscience, Brown University, Providence, RI, United States
| | - Karla R Kaun
- Department of Neuroscience, Brown University, Providence, RI, United States
| |
Collapse
|
9
|
Gimeno C, Dorado ML, Roncero C, Szerman N, Vega P, Balanzá-Martínez V, Alvarez FJ. Treatment of Comorbid Alcohol Dependence and Anxiety Disorder: Review of the Scientific Evidence and Recommendations for Treatment. Front Psychiatry 2017; 8:173. [PMID: 29018367 PMCID: PMC5614930 DOI: 10.3389/fpsyt.2017.00173] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 09/04/2017] [Indexed: 01/11/2023] Open
Abstract
Patients with alcohol-use disorders (AUDs) have a high prevalence of anxiety disorders (AnxDs). "Co-occurring disorders" refers to the coexistence of an AUD and/or drug related disorders with another non-addictive psychiatric disorder. The aim of this study was to assess the effectiveness of psychopharmacological treatments and psychotherapy in patients with AUD and AnxD and to propose recommendations for the treatment of patients with comorbid AnxDs and AUDs. Randomized clinical trials, meta-analyses, and clinical guidelines were retrieved from PubMed, Embase, and Cochrane databases. Paroxetine was found to be effective in social anxiety patients with alcohol dependence. Selective serotonin reuptake inhibitors (SSRIs), especially sertraline, showed effective results in posttraumatic stress disorder and in comorbid AnxD-AUD. However, SSRIs should be used with caution when patients are actively drinking because they may increase alcohol consumption. Buspirone, gabapentin, and pregabalin were found to be effective in comorbid AnxD-AUD. The treatment of dual AnxDs should start as early as possible. Since AUDs and AnxDs can reinforce each other, treatments targeting both pathologies can be effective. Women suffer from higher levels of stress and AnxDs than men, and they are also more vulnerable to maintaining alcohol consumption levels. Further research is needed in this comorbid patient population, including the study of different types of patients and gender perspectives.
Collapse
Affiliation(s)
- Carmen Gimeno
- Unit for Addictive Behaviours, Conselleria de Sanitat, Alicante, Spain
- Sociedad Española de Patología Dual, Madrid, Spain
| | - Marisa Luisa Dorado
- Sociedad Española de Patología Dual, Madrid, Spain
- Unit for Addictive Behaviors of Guillen de Castro, Conselleria de Sanitat, Valencia, Spain
| | - Carlos Roncero
- Sociedad Española de Patología Dual, Madrid, Spain
- Addiction and Dual Diagnosis Unit, Psychiatric Service, Hospital Vall Hebron-ASPB, CIBERSAM, Psychiatric Department, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Nestor Szerman
- Sociedad Española de Patología Dual, Madrid, Spain
- Salud Mental Retiro, Hospital General Universitario Gregorio Marañon, Madrid, Spain
| | - Pablo Vega
- Sociedad Española de Patología Dual, Madrid, Spain
- Instituto de Adicciones, Madrid, Spain
| | - Vicent Balanzá-Martínez
- Service of Psychiatry, La Fe University and Polytechnic Hospital, Department of Medicine, Medical School, University of Valencia, CIBERSAM, International Society for Nutritional Psychiatry Research (ISNPR), Valencia, Spain
| | - F. Javier Alvarez
- Sociedad Española de Patología Dual, Madrid, Spain
- Pharmacology, Faculty of Medicine, University of Valladolid, Valladolid, Spain
- CEIC/CEIm, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| |
Collapse
|
10
|
Sawicka M, Tracy DK. Naltrexone efficacy in treating alcohol-use disorder in individuals with comorbid psychosis: a systematic review. Ther Adv Psychopharmacol 2017; 7:211-224. [PMID: 28959434 PMCID: PMC5593217 DOI: 10.1177/2045125317709975] [Citation(s) in RCA: 9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 02/23/2017] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Psychotic illnesses, such as schizophrenia, are typically enduring and disabling conditions, impacting individual, family, and societal outcomes. Individuals with these face greater vulnerabilities in developing alcohol-use disorder (AUD). Furthermore, the nature of psychoses, often manifesting with paranoia, cognitive impairment, a lack of insight, sub-optimal treatment adherence, and stigma from others, means that they can pose unique treatment challenges when these two conditions comorbidly occur. These challenges mean that the standard literature on the effectiveness of the opioid antagonist naltrexone in AUD does not necessarily translate to this vulnerable population. METHODS Following PRISMA guidelines, we herein systematically reviewed the evidence for naltrexone in individuals with both psychosis and AUD. Overall, there is a paucity of research in this important area, with only nine reports meeting search criteria, only four of which were randomized control trials. Studies compared naltrexone with: placebo, another pharmaceutical agent, or upon changes to baseline drinking behaviour. One study evaluated the long-acting injectable formulation of this drug. RESULTS Most studies, including the methodologically more robust ones, supported naltrexone's effectiveness over placebo in terms of reduction in drinking days and numbers of drinks consumed on such days in this cohort. Work comparing naltrexone to other pharmaceutical interventions showed approximate equivalence with disulfiram, and modest superiority over acamprosate. CONCLUSIONS On this limited evidence base, this review endorses the use of naltrexone as both safe and effective in those with both psychotic illnesses and AUD. Several key issues remain to be elucidated. Critically, study designs meant that they were limited to individuals with good engagement with services, and levels of adherence were attained that are unlikely to be replicated in this cohort in real-world settings. Finally, effects of specific psychosis symptomatology, not least paranoia and insight, upon naltrexone use, and the reverse directional potential of 'double dysphoria' from an opioid antagonist remain largely unexplored.
Collapse
Affiliation(s)
- Martyna Sawicka
- Cognition, Schizophrenia and Imaging Laboratory, Department of Psychosis Studies, The Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Derek K Tracy
- Consultant Psychiatrist, The Memorial Hospital, Woolwich, London SE18 3RG, UK
| |
Collapse
|
11
|
Sulkunen P. Comment on Rehm and Room. Nordisk Alkohol Nark 2017; 34:353-355. [PMID: 32934496 PMCID: PMC7450829 DOI: 10.1177/1455072517729786] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 08/15/2017] [Indexed: 12/02/2022] Open
|
12
|
Hellum R, Jensen S, Nielsen A. Is training in creative writing a feasible treatment adjunct for clients suffering from chronic alcohol-use disorder? Nordisk Alkohol Nark 2017; 34:299-313. [PMID: 32934493 PMCID: PMC7450834 DOI: 10.1177/1455072517696507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 01/09/2017] [Accepted: 02/08/2017] [Indexed: 11/29/2022] Open
Abstract
Introduction: If and how various ways of expressing oneself creatively might help heal and resolve mental problems is a question that has been discussed for decades. Creative writing is typically used as an add-on to traditional therapy rather than being an integrated part of the therapy. There is a lack of research into the effect of implementing creative writing as an add-on to therapy for alcohol dependence. The aim of this study was to introduce creative writing to chronic alcohol-dependent clients. Method: A creative writing course was held as a pilot study with six workshops each lasting two hours. Six clients recruited from a harm reduction unit in a Danish alcohol treatment centre and suffering from chronic alcohol-use disorder participated in the workshops. The workshops were led by two professional authors experienced in teaching creative writing. At the end we conducted three interviews: one with the clients, one with the therapist and one with the authors. The interviews were analysed with a focus on the clients’ perspective. Findings: In the analysis, we found that writing can give the clients a lower self-esteem, make them fear failure, and it can be too private. We also found that writing can increase the clients’ self-confidence and unity in the group, give them new nuances of life, stimulate their brain, give zest for life, and improve relations between clients and care providers. Further, we identified a few points of importance to be added to the organization of the workshops. Conclusion: We found that clients suffering from alcohol-use disorder participating in creative writing profited from increased self-confidence, a sense of unity, were better able to appreciate the nuances of life, experienced stimulating brain activity, had more zest for life, and that the intervention improved relations between clients and care providers.
Collapse
|
13
|
Zastrozhin MS, Brodyansky VM, Skryabin VY, Grishina EA, Ivashchenko DV, Ryzhikova KA, Savchenko LM, Kibitov AO, Bryun EA, Sychev DA. Pharmacodynamic genetic polymorphisms affect adverse drug reactions of haloperidol in patients with alcohol-use disorder. Pharmgenomics Pers Med 2017; 10:209-215. [PMID: 28744152 PMCID: PMC5511016 DOI: 10.2147/pgpm.s140700] [Citation(s) in RCA: 7] [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] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background Antipsychotic action of haloperidol is due to blockade of D2 receptors in the mesolimbic dopamine pathway, while the adverse drug reactions are associated with striatal D2 receptor blockade. Contradictory data concerning the effects of genetic polymorphisms of genes encoding these receptors and associated structures (catechol-O-methyltransferase [COMT], glycine transporter and gene encoding the density of D2 receptors on the neuronal membrane) are described. Objective The objectives of this study were to evaluate the correlation between DRD2, SLC6A3 (DAT) and COMT genetic polymorphisms and to investigate their effect on the development of adverse drug reactions in patients with alcohol-use disorder who received haloperidol. Patients and methods The study included 64 male patients (average age 41.38 ± 10.14 years, median age 40 years, lower quintile [LQ] 35 years, upper quintile [UQ] 49 years). Bio-Rad CFX Manager™ software and “SNP-Screen” sets of “Syntol” (Russia) were used to determine polymorphisms rs4680, rs1800497, rs1124493, rs2242592, rs2298826 and rs2863170. In every “SNP-Screen” set, two allele-specific hybridizations were used, which allowed to determine two alleles of studied polymorphism separately on two fluorescence channels. Results Results of this study detected a statistically significant difference in the adverse drug reaction intensity in patients receiving haloperidol with genotypes 9/10 and 10/10 of polymorphic marker SLC6A3 rs28363170. In patients receiving haloperidol in tablets, the increases in the UKU Side-Effect Rating Scale (UKU) score of 9.96 ± 2.24 (10/10) versus 13 ± 2.37 (9/10; p < 0.001) and in the Simpson-Angus Scale (SAS) score of 5.04 ± 1.59 (10/10) versus 6.41 ± 1.33 (9/10; p = 0.006) were revealed. Conclusion Polymorphism of the SCL6A3 gene can affect the safety of haloperidol, and this should be taken into account during the choice of drug and its dosage regimen.
Collapse
Affiliation(s)
- Mikhail Sergeevich Zastrozhin
- Department of Addictology, Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation, Moscow, Russia.,Moscow Research and Practical Centre on Addictions of the Moscow Department of Healthcare, Center for the Prevention of Dependent Behavior, Moscow, Russia
| | - Vadim Markovich Brodyansky
- Federal Medical Research Centre of Psychiatry and Addictology, Laboratory of Molecular Genetics, Moscow, Russia
| | - Valentin Yurievich Skryabin
- Moscow Research and Practical Centre on Addictions of the Moscow Department of Healthcare, Department of Addictology, Moscow, Russia
| | - Elena Anatolievna Grishina
- Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation, Research Centre, Moscow, Russia
| | - Dmitry Vladimirovich Ivashchenko
- Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation, Research Centre, Moscow, Russia
| | - Kristina Anatolievna Ryzhikova
- Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation, Research Centre, Moscow, Russia
| | - Ludmila Mikhaylovna Savchenko
- Department of Addictology, Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Alexander Olegovich Kibitov
- Federal Medical Research Centre of Psychiatry and Addictology, Laboratory of Molecular Genetics, Moscow, Russia
| | - Evgeny Alekseevich Bryun
- Department of Addictology, Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation, Moscow, Russia.,Moscow Research and Practical Centre on Addictions of the Moscow Department of Healthcare, Department of Addictology, Moscow, Russia
| | - Dmitry Alekseevich Sychev
- Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation, Department of Clinical Pharmacology and Therapy, Moscow, Russia
| |
Collapse
|
14
|
Yip SW, Morie KP, Xu J, Constable RT, Malison RT, Carroll KM, Potenza MN. Shared microstructural features of behavioral and substance addictions revealed in areas of crossing fibers. Biol Psychiatry Cogn Neurosci Neuroimaging 2017; 2:188-95. [PMID: 28367515 DOI: 10.1016/j.bpsc.2016.03.001] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Similarities between behavioral and substance addictions exist. However, direct neurobiological comparison between addictive disorders is rare. Determination of disorder-specificity (or lack thereof) of alterations within white-matter microstructures will advance understanding of the pathophysiology of addictions. METHODS We compared white-matter microstructural features between individuals with gambling disorder (GD; n=38), cocaine-use disorder (CUD; n=38) and healthy comparison (HC; n=38) participants, as assessed using diffusion-weighted magnetic resonance imaging (dMRI). To provide a more precise estimate of diffusion within regions of complex architecture (e.g., cortico-limbic tracts), analyses were conducted using a crossing-fiber model incorporating local-orientation modeling (tbss_x). Anisotropy estimates for primary and secondary fiber orientations were compared using ANOVAs corrected for multiple comparisons across space using threshold-free cluster enhancement (pFWE<.05). RESULTS A main effect of group on anisotropy of secondary fiber orientations within the left internal capsule, corona radiata, forceps major and posterior thalamic radiation, involving reduced anisotropy among GD and CUD participants in comparison to HC participants. No differences in anisotropy measures were found between GD and CUD individuals. CONCLUSIONS This is the first study to compare diffusion indices directly between behavioral and substance addictions and the largest dMRI study of GD. Our findings indicate similar white-matter microstructural alterations across addictions that cannot be attributed solely to exposure to drugs or alcohol and thus may be a vulnerability mechanism for addictive disorders.
Collapse
|
15
|
Kohno M, Dennis LE, McCready H, Hoffman WF. Executive Control and Striatal Resting-State Network Interact with Risk Factors to Influence Treatment Outcomes in Alcohol-Use Disorder. Front Psychiatry 2017; 8:182. [PMID: 28993741 PMCID: PMC5622290 DOI: 10.3389/fpsyt.2017.00182] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [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: 07/24/2017] [Accepted: 09/11/2017] [Indexed: 12/20/2022] Open
Abstract
Alterations within mesocorticolimbic terminal regions commonly occur with alcohol use disorder (AUD). As pathological drug-seeking behavior may arise as a consequence of alcohol-induced neuroadaptations, it is critical to understand how such changes increase the likelihood of relapse. This report examined resting-state functional connectivity (RSFC) using both a seed-based and model-free approach in individuals in treatment for AUD and how dysregulation of network connectivity contributes to treatment outcomes. In order to provide a mechanism by which neural networks promote relapse, interactive effects of mesocorticolimbic connectivity and AUD risk factors in treatment completers and non-completers were examined. AUD group showed stronger RSFC between striatum, insula, and anterior cingulate cortex than controls. Within the AUD group, non-completers compared to completers showed enhanced RSFC between (1) striatum-insula, (2) executive control network (ECN)-amygdala, and (3) basal ganglia/salience network and striatum, precuneus, and insula. Completers showed enhanced RSFC between striatum-right dorsolateral prefrontal cortex. Furthermore, completers and non-completers differed in relationships between RSFC and relapse risk factors, where non-completers exhibited positive associations between craving intensity and RSFC of striatum-insula and ECN-amygdala. These findings provide evidence for interactions between corticolimbic connectivity in AUD and craving and establish an important link between network connectivity and dynamic risk factors that contribute to relapse. Results demonstrate that relapse vulnerability is attributed to craving dysregulation manifested by enhanced connectivity in striato-limbic regions and diminished corticostriatal connectivity.
Collapse
Affiliation(s)
- Milky Kohno
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, United States.,Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR, United States.,Methamphetamine Abuse Research Center, Portland, OR, United States
| | - Laura E Dennis
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, United States.,Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR, United States.,Methamphetamine Abuse Research Center, Portland, OR, United States
| | - Holly McCready
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, United States.,Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR, United States.,Methamphetamine Abuse Research Center, Portland, OR, United States
| | - William F Hoffman
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, United States.,Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR, United States.,Methamphetamine Abuse Research Center, Portland, OR, United States.,Mental Health and Clinical Neurosciences Division, Portland, OR, United States.,Research Service Veterans Affairs Portland Healthcare System, Portland, OR, United States
| |
Collapse
|
16
|
Panksepp JB, Rodriguez ED, Ryabinin AE. Sweetened ethanol drinking during social isolation: enhanced intake, resistance to genetic heterogeneity and the emergence of a distinctive drinking pattern in adolescent mice. Genes Brain Behav 2016; 16:369-383. [PMID: 27706910 DOI: 10.1111/gbb.12346] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 09/14/2016] [Accepted: 09/26/2016] [Indexed: 01/15/2023]
Abstract
With its ease of availability during adolescence, sweetened ethanol ('alcopops') is consumed within many contexts. We asked here whether genetically based differences in social motivation are associated with how the adolescent social environment impacts voluntary ethanol intake. Mice with previously described differences in sociability (BALB/cJ, C57BL/6J, FVB/NJ and MSM/MsJ strains) were weaned into isolation or same-sex pairs (postnatal day, PD, 21), and then given continuous access to two fluids on PDs 34-45: one containing water and the other containing an ascending series of saccharin-sweetened ethanol (3-6-10%). Prior to the introduction of ethanol (PDs 30-33), increased water and food intake was detected in some of the isolation-reared groups, and controls indicated that isolated mice also consumed more 'saccharin-only' solution. Voluntary drinking of 'ethanol-only' was also higher in a subset of the isolated groups on PDs 46-49. However, sweetened ethanol intake was increased in all isolated strain × sex combinations irrespective of genotype. Surprisingly, blood ethanol concentration (BEC) was not different between these isolate and socially housed groups 4 h into the dark phase. Using lickometer-based measures of intake in FVB mice, we identified that a predominance of increased drinking during isolation transpired outside of the typical circadian consumption peak, occurring ≈8.5 h into the dark phase, with an associated difference in BEC. These findings collectively indicate that isolate housing leads to increased consumption of rewarding substances in adolescent mice independent of their genotype, and that for ethanol this may be because of when individuals drink during the circadian cycle.
Collapse
Affiliation(s)
- J B Panksepp
- Department of Behavioral Neuroscience, Oregon Health and Science University, Portland, OR, USA
| | - E D Rodriguez
- Department of Behavioral Neuroscience, Oregon Health and Science University, Portland, OR, USA
| | - A E Ryabinin
- Department of Behavioral Neuroscience, Oregon Health and Science University, Portland, OR, USA
| |
Collapse
|