Effects of Repeated Deep Brain Stimulation on Depressive- and Anxiety-Like Behavior in Rats: Comparing Entopeduncular and Subthalamic Nuclei.

Effects of repeated deep brain stimulation on depressive- and anxiety-like behavior in rats: Comparing entopeduncular and subthalamic nuclei.

Filed under: Addiction Rehab

Brain Stimul. 2012 Oct 13;
Creed MC, Hamani C, Nobrega JN

BACKGROUND: Deep brain stimulation (DBS) of the subthalamic nucleus (STN) or internal globus pallidus (GPi) has been routinely used for the treatment of some movement disorders. However, DBS may be associated with adverse psychiatric effects, such as depression, anxiety and impulsivity. OBJECTIVE: To compare DBS applied to the entopeduncular nucleus (EPN; the rodent homolog of the GPi) and STN in terms of their effects on depressive- and anxiety-like behavior in rats. METHODS: DBS was applied for 21 days (4 h a day) to either the STN or EPN. Rats then underwent behavioral testing on learned helplessness and elevated plus maze tasks before being sacrificed for brain analyses of zif268, BDNF and trkB mRNA as well as BDNF protein levels. RESULTS: Repeated DBS of the STN, but not of the EPN, led to impaired performance in the learned helplessness task, suggesting that STN-DBS induces or potentiates depressive-like behavior. There was no effect of DBS on elevated plus maze or on open field behavior. Repeated STN-DBS, but not EPN-DBS, led to decreased levels of BDNF and trkB mRNA in hippocampus. Acute stimulation of the STN or EPN resulted in similar changes in zif268 levels in several brain areas, except for the raphe where decreases were seen only after STB-DBS. CONCLUSIONS: Together these results indicate that the effects of STN- and EPN-DBS differ in behavioral and neurochemical respects. Results further suggest that the EPN may be a preferable target for clinical DBS when psychiatric side effects are considered insofar as it may be associated with a lower incidence of depressive-like behavior than the STN.
HubMed – addiction


Acceptance of Non-Abstinence Goals by Addiction Professionals in the United States.

Filed under: Addiction Rehab

Psychol Addict Behav. 2012 Oct 22;
Davis AK, Rosenberg H

Previous research has found relatively limited acceptance of nonabstinence goals in addiction treatment settings in the United States. Because such attitudes may have changed over time, this study was designed to assess the current acceptance of nonabstinence goals by addiction professionals as a function of type of substance (alcohol vs. drug), severity of the disorder (DSM-IV abuse vs. DSM-IV dependence), and finality of the outcome goal (intermediate vs. final). The sample comprised 913 members of a national association of addiction professionals who completed a web-based survey. Over one half of respondents rated nonabstinence as somewhat or completely acceptable as both an intermediate and final outcome goal for clients with alcohol abuse, but considerably smaller proportions rated nonabstinence an acceptable intermediate or final outcome goal for clients with alcohol dependence. Regarding drug-taking clients, one half and one third of respondents rated nonabstinence at least somewhat acceptable as an intermediate goal and final outcome goal, respectively, for clients with drug abuse, but fewer rated nonabstinence an acceptable outcome goal for clients with drug dependence. One implication of the findings is that individuals with alcohol and drug problems who avoid treatment because they are ambivalent about abstinence should know that-depending on the severity of their condition, the finality of their nonabstinence goal, and their drug of choice-their interest in moderating their consumption will be acceptable to many clinicians, especially those working in outpatient and independent practice settings. (PsycINFO Database Record (c) 2012 APA, all rights reserved).
HubMed – addiction


Injectable and implantable sustained release naltrexone in the treatment of opioid addiction.

Filed under: Addiction Rehab

Br J Clin Pharmacol. 2012 Oct 22;
Kunøe N, Lobmaier P, Ngo H, Hulse GK

BACKGROUND: Sustained release technologies for administering the opioid antagonist naltrexone (SRX) have the potential to assist opioid-addicted patients in their efforts to maintain abstinence from heroin and other opioid agonists. Recently, reliable SRX formulations in intramuscular or implantable polymers that release naltrexone for 1-7 months have become available for clinical use and – research. METHODS: This qualitative review of the literature provides an overview of the technologies currently available for sustained release naltrexone (SRX) and their effectiveness in reducing opioid use and other relevant outcomes. RESULTS: The majority of studies indicate that SRX is effective in reducing heroin use, and the most frequently studied SRX formulations have acceptable adverse events profiles. Registry data indicate a protective effect of SRX on mortality and morbidity. In some studies, SRX also seems to affect other outcomes like concomitant substance use, vocational training attendance, needle use, and risk behaviour for blood-borne diseases like Hepatitis or HIV. There is a general need for more controlled studies, in particular comparing SRX with agonist maintenance treatment, combinations of SRX with behavioural interventions, and with at-risk groups like prison inmates or opioid addicted pregnant patients. CONCLUSION: The literature suggests that sustained release naltrexone is a feasible, safe and effective option for assisting abstinence efforts in opioid addiction.
HubMed – addiction


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