Neuropharmacology of Addiction
Terms
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- Naltrexone
-
Used in Tx of Opioid Addiction
u Opioid Receptor Antagonist
-Blocks actions of drugs at u-opioid receptor in VTA
-blocks drugs' ability to increase DA levels
-Competitive antagonist
-->taking more of a drug can overcome affects - Clonidine
-
-Used to treat Opioid withdrawl
-a2 receptor agonist
-suppresses autonomic hyperactivity - Methadone
-
-Agonist
-Promotes tolerance to drug effects
Negative Affects
-Transfer of addiction
-May require lifetime Tx
-Termination may precipitate withdrawl - Acamprosate
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Glutamate receptor antagonist
-May block craving of drug - Disulfiram
-
Used in Tx of alcohol addiction
-Prevents breakdown of acetylaldehyde
-Causes acute toxicity in body
-Makes you feel awful
-Patient compliance may be low - Bupropion
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Anticraving Tx for Tobacco
Inhibits uptake of MAO
Decreases DA levels
Reduces nicotine craving - Alcohol
-
Action
-Hyperpolarizes GABA release on DA neurons
-Increases DA release
Withdrawl
-Hyperexcitable state
-Can last for up to 1 week
Treatment
-Long lasting sedative (Diazepam)
-Benozodiazepine (alcholics have higher abuse potential though)
Relapse Prevention
Aversion Therapy (Disulfiram)
Antagonist (Naltrexone)
Anticraving (Acamprosate) - Stimulant - Tobacoo
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Stimulates central nicotinic receptors
-Can increase DA levels in the nucleus acumbens
-May inhibit MAO
Detox
-Tx of withdrawl symptoms
-Nicotine replacement therapy
Relapse Prevention
-Agonist (Nicotine rplcment)
-Agonist/Antagonist (Better approach)
-Anticraving (Bupropion) -
Alcohol
Mechanism of Action -
Hyperpolarizes GABA neuron
-Increases DA in nucleus acumbens
-Increases amount of endogenous opioids -
Alcohol
Withdrawl Symptoms -
Anxiety, Insomnia, Hyperthermia, DTs=acute pyschosis
-Can last up to 1 week and can be fatal - Alcohol Addiction Tx
-
Long acting sedative (ie. Diazepam)
-Benzos are not so good b/c they are often abused by alcoholics
-Relapse Prevention
+Aversion (Disulfiram)
+Antagonist (Naltrexone)
+Anticraving (Acamprosate)