Nucleus Accumbens Surgery for Addiction.
Nucleus Accumbens Surgery for Addiction.
Filed under: Addiction Rehab
World Neurosurg. 2012 Oct 6;
Li N, Wang J, Wang XL, Chang CW, Ge SN, Gao L, Wu HM, Zhao HK, Geng N, Gao GD
Opiate addiction remains intractable in a large percentage of patients, and relapse is biggest hurdles to recovery because of the psychological dependence. Multiple studies identify a central role of the nucleus accumbens (NAc) in addiction; several studies note decreased addictive behavior after interventions in this area. Based on animal experiment, our institute started the clinical trial for the treatment of drug addicts’ psychological dependence by making lesions in the bilateral NAc with stereotactic surgery from July 2000.The short-term outcomes were encourage and triggered rapid application of this treatment in China from 2003 to 2004. However, lack of long-term outcomes and controversy eventually lead to halting the surgery for addiction by Ministry of Health of China in November 2004 and a nationwide survey about it later. Our institute had performed this surgery in 272 patients with severe heroin addiction. The follow up study showed the 5 years non-relapse rate was 58% and the quality of life was significantly improved. The patients had several kinds of side effects, but the incidence rate is relatively low. The patients gradually recovered in more than 5 years after the surgery. The side effects would not severely influence individual life and work. Nationwide surgery showed the non-relapse rate was 50% in the sample of 150 cases?from 1167 patients in all who underwent stereotactic surgery in China. Although sometimes accompanied by neuropsychological adverse events, stereotactic ablation of NAc may effectively treat opiate addiction. Lesion location has significantly impacts on treatment efficacy and need further studies. Since ablation is irreversible, the NAc Surgery for addiction should be performed with cautiousness and the deep brain stimulation?DBS?is ideal alternative.
HubMed – addiction
Treatment for tobacco smoking: A new alternative?
Filed under: Addiction Rehab
Med Hypotheses. 2012 Oct 6;
Zaparoli JX, Galduróz JC
Smoking is a very common addiction and is associated with several kinds of diseases including different forms of cancer. Nicotine is the only substance present in cigarettes that can cause dependence. There are pharmacological treatments available to smoking cessation, but all of them are associated with side effects and low efficacy. Therefore, the development of new strategies and treatments is necessary. A possibility is the supplementation with polyunsaturated fatty acids (PUFAs) of the omega 3 series. It is known that low concentration of omega 3 can affect the dopaminergic neurotransmission, resulting in hypofunctioning of the mesocortical system. This system controls the mesolimbic system, associated in rewarding and dependence mechanisms. New perspectives of treatment focus on the reestablishment of the omega 3 levels, having as a result the normalization of the dopaminergic system and the reduction of the negative symptoms of withdrawal.
HubMed – addiction
[Personality in the big five model and maintaining abstinence after one year follow-up].
Filed under: Addiction Rehab
Psychiatr Pol. 2012 May-Jun; 46(3): 387-99
Betkowska-Korpa?a B
To compare Five-Factor personality traits in patients maintaining abstinence and relapsed patients (i.e. those who relapsed within a year after treatment), following eight weeks of in-house treatment and three months of out-patient treatment.In longitudinal studies, a sample of 190 patients was analysed (49 females and 141 males; mean age: 43). The patients participated in therapeutic programmes at several addiction treatment centres across Poland. Personality traits were measured using the NEO PI-R inventory proposed by Costa and McCrae (adapted into Polish by Jerzy Siuta) at the initial stage of the treatment. Abstinence was assessed based on the interview.As far as the main traits are concerned, abstinent patients have higher levels of Agreeableness and Conscientiousness than patients who relapsed within a year following the therapy. Moreover, they are characterised by higher levels of constituent traits: Straightforwardness, Ideas and Altruism, as well as higher levels of Order, Self-Discipline and Dutifulness. However, their levels of Hostility are lower compared to patients not maintaining abstinence.After one year follow-up, the group maintaining abstinence is characterised by a higher Agreeableness and Conscientiousness, which is beneficial for cooperation with others as well as undertaking and realising tasks. Moreover, lower constituent values of Neuroticism are linked to higher adaptability and greater therapy participation than in a relapsed group. An early identification of patients bearing traits linked to lower adaptability will decrease the possibility of relapse thanks to making a greater effort at enhancing treatment participation while paying special attention to any co-existing psychopathology.
HubMed – addiction
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