Flashcards in Lecture 35 - Emerging treatments for drug dependence: preclinical evaluation Deck (24):
What was the 2010 cost of drug and alcohol abuse to austrlia?
What is a good working definition of addiction?
a chronic relapsing disorder which consists of a compulsive pattern of drug seeking and drug taking behaviour
takes lace at the expense of other activities
persists despite adverse consequence
What parts of the brain are important in stress induced relapse?
Extended amygdala - central amygdala nucleus
What parts of the brain are important in Que (seeing a picture of beer) induced relapse?
What is the common pathway for que and stress induced relapse?
pre-frontal cortex -> nucleus accumbens core -> ventral pallidum
What kind of disorder is alcoholism and what are the factors ?
polymodal disorder - multiple causes
Gnenetic factors - still awaiting definitive marker gene
Environmental factors - peer pressure to self-medication of underlying psychological disturbance
Diagnosis is critical for selection of appropriate therapy
What are most alcoholism patientsbeing presscribed?
antidepressants - not to alleviate depression, but an attempt to reduce the abberant alcohol use
What are the problems with Disulfiram
ALDH inhibitor - needs high motivation and compliance - significant adverse side effects
what is Baclofen?
GABAb agonist - used in initial withdrawal period
Are antidepressants, Benzodiazepines useful clinically?
what is the problem with Naltrexone?
non-selective opioid receptor antagonist - tolerance an issue
CRF1 receptor antagonists are...
may have a clinically meaningful effect for alcohol - dependent patients with a high chance of consistent drinking
trials have had abstinence as end points - not realistic
How can you model drug seeking behavior?
- continual access
(does the drug stop people taking the drug when its available)
conditioned place preference
extinction (suddenly doesn't get the drug) / reinstatement (make the drug available) - "relapse"
What does naltrexone do clinically?
reduces responding for ethanol in primates and rodents
The Orexin-containing neurons are activated during...
cue-induced reinstatement to alcohol-seeking
What does CRF receptor antagonism stop?
the enhanced responding for alcohol observed in withdrawing dependent rats - ineffective in non-dependent rats3
What are the emerging treatments for smoking addiction?
Bupropion - amine uptake inhibitor
modafinil - amine uptake inhibitor
Mementine - partial NMDA R antagonist
Varenicline - partial agonist at nicotinic Rs
What are the emerging treatments for smoking addiction and have any been approved?
none have been approved
selegeline - MAO inhibitor
Venlafaxine - SNRI
What are the emerging treatments for cocaine addiction and have any been approved?
none have been approved
antidepressants are often used
What are the emerging treatments for opiates addiction and have any been approved?
What 3 things should effective therapeutic be?
safe, well-tolerated and efficacious
combination with Cognitive behavioral therapy and other behavioural strategies
What are the major issues with addiction-medication?