scholarly journals Schizophrenia and drug addiction comorbidity: recent advances in our understanding of behavioural susceptibility and neural mechanisms

2020 ◽  
Vol 2 ◽  
pp. e10
Author(s):  
Victoria Menne ◽  
Rose Chesworth
Keyword(s):  
Substance Abuse ◽  
Drug Addiction ◽  
Drug Exposure ◽  
Drugs Of Abuse ◽  
The Self ◽  
Self Medication ◽  
Receptor System ◽  
Drug Classes ◽  
Abused Drugs ◽  
Schizophrenia Susceptibility

Schizophrenia is a severe psychiatric disorder which is worsened substantially by substance abuse/addiction. Substance abuse affects nearly 50% of individuals with schizophrenia, extends across several drug classes (e.g. nicotine, cannabinoids, ethanol, psychostimulants) and worsens overall functioning of patients. Prominent theories explaining schizophrenia and addiction comorbidity include the primary addiction hypothesis (i.e. schizophrenia susceptibility primes drug reward circuits, increasing drug addiction risk following drug exposure), the two-hit hypothesis (i.e. drug abuse and other genetic and/or environmental risk factors contribute to schizophrenia development) and the self-medication hypothesis (i.e. drug use alleviates schizophrenia symptoms). Animal models can be used to evaluate the utility and validity of these theories. Since this literature was last reviewed by Ng and colleagues in 2013 [Neurosci Biobehav Rev, 37(5)], significant advances have been made to our understanding of schizophrenia and substance abuse comorbidity. Here we review advances in the field since 2013, focussing on two key questions: 1) Does schizophrenia susceptibility increase susceptibility to drug addiction (assessing the primary addiction hypothesis), and 2) Do abused drugs exacerbate or ameliorate schizophrenia symptoms (assessing the two-hit hypothesis and the self-medication hypothesis). We addressed these questions using data from several schizophrenia preclinical models (e.g. genetic, lesion, neurodevelopmental, pharmacological) across drug classes (e.g. nicotine, cannabinoids, ethanol, psychostimulants). We conclude that addiction-like behaviour is present in several preclinical schizophrenia models, and drugs of abuse can exacerbate but also ameliorate schizophrenia-relevant behaviours. These behavioural changes are associated with altered receptor system function (e.g. dopaminergic, glutamatergic, GABAergic) critically implicated in schizophrenia and addiction pathology.

Adolescent Substance Abuse, Transgenerational Consequences and Epigenetics

2021 ◽  
Vol 19 ◽  
Author(s):  
Hamed Salmanzadeh ◽  
Mohammad Ahmadi-Soleimani ◽  
Maryam Azadi ◽  
Robert F. Halliwell ◽  
Hossein Azizi
Keyword(s):  
Substance Abuse ◽  
Clinical Studies ◽  
Critical Period ◽  
Drug Exposure ◽  
Drugs Of Abuse ◽  
Transitional Period ◽  
Drug Actions ◽  
And Behavior ◽  
Human Brains

: Adolescence is the transitional period between childhood and adulthood and a critical period in brain development. Adolescence in humans is also associated with increased expression of risk-taking behaviors. Epidemiological and clinical studies, for example, show a surge of drug abuse and raise the hypothesis that the adolescent brain undergoes critical changes resulting in diminished control. Determining how substance abuse during this critical period might cause long-term neurobiological changes in cognition and behavior is therefore critically important. The present work aims to provide an evaluation of the transgenerational and multi- generational phenotypes derived from parent animals exposed to drugs of abuse only during their adolescence. Specifically, we will consider changes found following administration of cannabinoids, nicotine, alcohol and opiates. In addition, epigenetic modifications of the genome following drug exposure will be discussed as emerging evidence of the underlying adverse transgenerational effects. Notwithstanding, much of the new data discussed here is from animal models, indicating that future clinical studies are much needed to better understand the neurobiological consequences and mechanisms of drug actions on the human brains’ development and maturation.

scholarly journals The Paradoxical Effect Hypothesis of Abused Drugs in a Rat Model of Chronic Morphine Administration

2021 ◽  
Vol 10 (15) ◽  
pp. 3197
Author(s):  
Yinghao Yu ◽  
Alan Bohan He ◽  
Michelle Liou ◽  
Chenyin Ou ◽  
Anna Kozłowska ◽  
...  
Keyword(s):  
Drug Addiction ◽  
Basolateral Amygdala ◽  
Neural Substrates ◽  
Plasma Corticosterone ◽  
High Plasma ◽  
Paradoxical Effect ◽  
Chronic Morphine ◽  
Morphine Administration ◽  
Abused Drugs ◽  
Effect Hypothesis

A growing body of studies has recently shown that abused drugs could simultaneously induce the paradoxical effect in reward and aversion to influence drug addiction. However, whether morphine induces reward and aversion, and which neural substrates are involved in morphine’s reward and aversion remains unclear. The present study first examined which doses of morphine can simultaneously produce reward in conditioned place preference (CPP) and aversion in conditioned taste aversion (CTA) in rats. Furthermore, the aversive dose of morphine was determined. Moreover, using the aversive dose of 10 mg/kg morphine tested plasma corticosterone (CORT) levels and examined which neural substrates were involved in the aversive morphine-induced CTA on conditioning, extinction, and reinstatement. Further, we analyzed c-Fos and p-ERK expression to demonstrate the paradoxical effect—reward and aversion and nonhomeostasis or disturbance by morphine-induced CTA. The results showed that a dose of more than 20 mg/kg morphine simultaneously induced reward in CPP and aversion in CTA. A dose of 10 mg/kg morphine only induced the aversive CTA, and it produced higher plasma CORT levels in conditioning and reacquisition but not extinction. High plasma CORT secretions by 10 mg/kg morphine-induced CTA most likely resulted from stress-related aversion but were not a rewarding property of morphine. For assessments of c-Fos and p-ERK expression, the cingulate cortex 1 (Cg1), prelimbic cortex (PrL), infralimbic cortex (IL), basolateral amygdala (BLA), nucleus accumbens (NAc), and dentate gyrus (DG) were involved in the morphine-induced CTA, and resulted from the aversive effect of morphine on conditioning and reinstatement. The c-Fos data showed fewer neural substrates (e.g., PrL, IL, and LH) on extinction to be hyperactive. In the context of previous drug addiction data, the evidence suggests that morphine injections may induce hyperactivity in many neural substrates, which mediate reward and/or aversion due to disturbance and nonhomeostasis in the brain. The results support the paradoxical effect hypothesis of abused drugs. Insight from the findings could be used in the clinical treatment of drug addiction.

scholarly journals Clinical Aspects of Substance Abuse in Persons with Schizophrenia

2003 ◽  
Vol 48 (1) ◽  
pp. 14-21 ◽  
Author(s):  
Juan C Negrete
Keyword(s):  
Substance Abuse ◽  
Current Knowledge ◽  
Psychiatric Service ◽  
Psychosocial Interventions ◽  
Clinical Aspects ◽  
Continuing Care ◽  
Self Medication ◽  
Integrated Therapy ◽  
Therapy Services ◽  
Persons With Schizophrenia

Objective: To review the current knowledge on the problem of psychoactive substance abuse by persons with schizophrenia, with particular attention to issues of direct relevance to clinical practice. Method: The author examined the literature from the last 2 decades and data from studies in which he was involved. Results: Schizophrenia sufferers show an elevated liability for substance abuse. Such comorbidity may derive from self-medication attempts, a common neuropathology for addiction and schizophrenia, the psychotogenic properties of certain drugs, or the influence of environmental factors. Among schizophrenia patients receiving treatment, substance misuse is associated with more severe symptoms and poorer therapeutic response. The presence of a chronic psychosis impedes treatment of the substance problem in traditional, nonpsychiatric addiction programs. Better outcomes are observed in integrated therapy services, where patients receive appropriate care for both conditions. Conclusion: Dual-pathology patients need comprehensive care with appropriate pharmacotherapy and psychosocial interventions. This treatment can be best provided within the context of a continuing care psychiatric service.

An Evaluation of the Measurement of Drugs of Abuse by Commercial and In-House Horizontal Thin Layer Chromatography

1993 ◽  
Vol 30 (2) ◽  
pp. 163-168 ◽  
Author(s):  
K Wolff ◽  
M J Sanderson ◽  
A W M Hay ◽  
I Barnes
Keyword(s):  
Thin Layer ◽  
Thin Layer Chromatography ◽  
Drug Addiction ◽  
Drugs Of Abuse ◽  
Routine Screening ◽  
Suitable Method ◽  
Screening Service ◽  
Laboratory Methods ◽  
Opioid Drugs ◽  
Layer Chromatography

We have compared an in-house horizontal thin layer chromatography (TLC) method with a commercial TLC screening kit (Toxi-Lab) to find the most suitable method for screening urine for opioid drugs. The in-house TLC procedure is cheaper and more efficient than the commercial TLC method and is ideal as a confirmatory method when used in conjunction with other established laboratory methods. The in-house TLC method is useful for one-off requests and is able to differentiate between small quantities (0·1–0·5 mg/L) of the different, commonly abused opioids and their metabolites, which means that it is well suited for use at a local Drug Addiction Unit as a routine screening service.

scholarly journals The self-medication practice in primary dysmenorrhea among pharmacy students-a cross-sectional questionnaire study

2019 ◽  
Vol 1 (4) ◽  
pp. 97-100
Author(s):  
Sunitha Sunitha ◽  
Dhanya Dharman ◽  
Deepa Manohar ◽  
Shaiju S Daran ◽  
Vismaya Annie Vinod ◽  
...  
Keyword(s):  
Negative Impact ◽  
The Self ◽  
Pharmacy Students ◽  
Questionnaire Study ◽  
Primary Dysmenorrhea ◽  
Self Medication ◽  
Cross Sectional ◽  
Medical Practitioners ◽  
Medication Practice ◽  
Validated Questionnaire

Primary dysmenorrhea is one of the most common gynecological problems among adolescent females which interferes with daily activities, affecting their physical and emotional aspects and has a negative impact on the quality of life. The pain is usually in the pelvis or lower abdomen. Self-medication for primary dysmenorrhea is a very common practice. The aim of this study was to observe and evaluate self-medication practice in primary dysmenorrhea among pharmacy students. This is a cross-sectional questionnaire study to be conducted among 50 females of age group between 18-25 of pharmacy college. The self-medication practice and features of dysmenorrhea were to be assessed with a 15 pre-validated questionnaire and the data is analyzed using descriptive statistics. A total of 50 students participated in this study in which 81.8% had regular periods. Dysmenorrhea was experienced in 79.6% with mild (30.4%),moderate(23.9%) and with severe(28.3%) dysmennohea. In this study 64.3% preferred self-medication pattern. The majority were Pharm.D students. The most commonly used drug was Meftal spas (mephenamic acid+dicyclomine) and for 96.8% the treatment was found to be effective. Among the 50 students, 57.6% have experienced ADR , majority with decreased blood flow. The Self-medication practice in dysmenorrhea was more among pharmacy students probably due to the knowledge of drugs, better awareness and greater access to drug information during their curriculum. This highlights the importance of creating awareness among students to consume drugs only in severe discomfort after prescription by the registered medical practitioners.

scholarly journals Prevalence and Factors Related to Self-Medication for COVID-19 Prevention in the Elderly

Salmand ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. 112-127
Author(s):  
Narjes Heshmatifar ◽  
◽  
Arezoo Davarinia Motlagh Quchan ◽  
Zohreh Mohammadzadeh Tabrizi ◽  
Leila Moayed ◽  
...  
Keyword(s):  
Significant Relationship ◽  
Insurance Coverage ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Emotional Reactions ◽  
The Self ◽  
Self Medication ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Major Factors

Objectives: The Coronavirus Disease 2019 (COVID-19) crisis and health outcomes are among the major human social events of the 21st century. The unknown nature of the disease and the fear of contagion have caused emotional reactions, including the self-consumption of drugs in the elderly. Therefore, this study investigated factors affecting the self-consumption of drugs for COVID-19 prevention in the elderly. Methods & Materials: This descriptive and cross-sectional study was performed on 342 elderly in Sabzevar City, Iran, in 2020. The research units were selected as clusters from 16 health centers. The necessary data were collected by an online self-medication questionnaire. Data analysis was performed in SPSS. Results: The Mean±SD age of the study participants was 66.2±5.67 years. The frequency of self-medication to prevent COVID-19 was 190(55.5%); analgesics, vitamins, anti-cold, and antibiotics were the most common drugs used. The major factors associated with self-medication in the COVID-19 pandemic were disease prevention, home quarantine, financial problems, experiencing previous self-medication, and others’ advice. There was a significant relationship between self-medication and education and insurance coverage. No significant relationship was observed between gender, occupation, and marital status, and self-medication. Conclusion: Self-Medication in the COVID-19 epidemic is notable as a crisis threatening the elderly’s health. Controlling and monitoring how the drug is used is among the requirements for protection and health promotion in the elderly.

scholarly journals An Overview of the Psychodynamics of Addiction

2021 ◽  
Vol 49 (3) ◽  
pp. 363-369
Author(s):  
César A. Alfonso
Keyword(s):  
Gene Expression ◽  
Adverse Childhood Experiences ◽  
The Self ◽  
Epigenetic Changes ◽  
Novelty Seeking ◽  
Self Medication ◽  
Childhood Experiences ◽  
Psychotherapeutic Interventions ◽  
Adverse Childhood ◽  
Abuse And Neglect

The author provides an overview of the psychodynamics of addiction, diverging from outdated conceptualizations such as orality and regression, and emphasizing the clinical relevance of the self-medication hypothesis. Rado and Bion paved the way for Khantzian's self-medication hypothesis by describing the drug user's need to escape unpleasure and seek self- containment. The author reviews research corroborating the relevance of the self-medication hypothesis and other relevant constructs such as self-deceptive attempts at adaptation, inability to prioritize self-care or delay gratification, excessive hedonism and novelty seeking, and impulsivity. Adverse childhood experiences, abuse and neglect are known to cause epigenetic changes altering gene expression, which may endure throughout life and be transmitted intergenerationally. Effective psychotherapeutic interventions have the potential to reverse DNA methylation and other epigenetic changes triggered by trauma and co-morbid psychopathology. Lastly, this editorial also introduces the psychodynamically informed clinical recommendations of Baurer and Gottdiener, further described in separate articles in this issue of Psychodynamic Psychiatry.

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