Does anyone have info on research articles regarding the effectiveness of antidepressant medications in the treatment of addiction?
Here are some research articles we have found on the use of antidepressants and mood stabilizers on addiction.
TOPIRIMATE (topomax) shows promise in treating alcoholism. This anti- convulsant, mood stabilizing medication can help reduce the alcohol cravings of alcohol abusers, making it easier to withdraw from alcohol. The researchers of a recent significant study published in The Lancet on the use of topirimate for alcohol abuse postulated that it reduces alcohol cravings by reducing brain levels of the neurotransmitter dopamine (which is believed to create the pleasurable sensations alcoholics get from drinking). The topirimate seems to reduce the cravings and anxiety associated with withdrawal, and potentially resets the brain's chemistry. Topirimate has also been found to be helpful in treating binge eating disorder. The following online article provides more information about
Topirimate.
Research Study: Johnson BA, Ait-Daoud N, Bowden CL, et al. "Oral topirimate for treatment of alcohol dependence: a randomized trial. The Lancet. 361:1677-1685, 2003.
The articles below can be ordered through www.docdeliver.com
or www.ingenta.com.
Medline Identifier
22674185
Authors
Brown ES. Bobadilla L. Nejtek VA. Perantie D. Dhillon H. Frol A.
Institution
Department of Psychiatry, The University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-8849, USA. Sherwood.Brown@UTsouthwestern.edu
Title
Open-label nefazodone in patients with a major depressive episode and alcohol dependence.
Source
Progress in Neuro-Psychopharmacology & Biological Psychiatry. 27(4):681-5, 2003 Jun.
PURPOSE: Major depressive disorder (MDD) and alcohol dependence (AD) frequently occur together. However, MDD clinical trials generally exclude patients with alcohol-related disorders. GENERAL METHODS: A 12-week, open-label trial of nefazodone in a group of people (n=13) with both a current major depressive episode and current AD was conducted to examine the effect of this antidepressant on depressive symptoms, alcohol use, and cognition. FINDINGS: Scores on the Hamilton Rating Scale for Depression (HRSD) and Hamilton Rating Scale for Anxiety (HRSA) significantly decreased from baseline to exit. In addition, significant reduction in alcohol craving, drinks/week, and days of alcohol use/week was found. Scores on the Rey Auditory Verbal Learning Test (RAVLT) did not significantly improve during the study. Changes in mood/anxiety and memory did not correlate with changes in alcohol use. CONCLUSIONS: Thus, nefazodone therapy was associated with improvement in mood/anxiety and alcohol use, which seem to be independent of each other in this patient sample. However, declarative memory, which was low average at baseline, did not show statistically significant improvement during the 12 weeks of the study.
Medline Identifier
22309875
Piasecki MP. Steinagel GM. Thienhaus OJ. Kohlenberg BS.
Institution
University of Nevada School of Medicine, Department of Psychiatry, Reno 89557-0046, USA. piasecki@med.unr.edu
Title
An exploratory study: the use of paroxetine for methamphetamine craving.
Source
Journal of Psychoactive Drugs. 34(3):301-4, 2002 Jul-Sep.
Methamphetamine abuse and dependence are growing problems nationally and worldwide. There are currently no effective pharmocologic treatments. Animal studies with SSRI's suggest that serotonergic modulation alters methamphetamine's behavioral effects. This exploratory study is a trial of the effects of the SSRI paroxetine versus placebo (in a double blind design) on craving and use in a population of methamphetamine users. Many subjects dropped out of the study, but those in active treatment who completed the eight week trial had a decrease in methamphetamine craving compared to the placebo treatment as measured by the OCDS modified for use in this population. Statistical analyses were not performed due to the low number of subjects. The preliminary data suggest that serotonergic agents may play a role in the effective treatment of methamphetamine abuse and dependence within the context of other effective behavioral interventions.
Medline Identifier
22023696
Feingold A. Oliveto A. Schottenfeld R. Kosten TR.
Institution
Department of Psychiatry, Yale University School of Medicine, VA Connecticut Healthcare System, West Haven 06516, USA.
Title
Utility of crossover designs in clinical trials: efficacy of desipramine vs. placebo in opioid-dependent cocaine abusers.
Source
American Journal on Addictions. 11(2):111-23, 2002 Spring.
The utility of the crossover design in substance abuse research was examined in a 26-week, double-blind clinical trial that evaluated the efficacy of desipramine (0 or 150 mg/day) in 109 male and female cocaine- and opiate-dependent patients maintained on buprenorphine (12 mg/day) or methadone (65 mg/day). After being stabilized on buprenorphine or methadone (weeks 1-2), half of the patients were randomly assigned to receive desipramine for the first half of the trial and placebo for the second, with the order reversed for the second half. Analyses using hierarchical linear models (HLM) indicated that desipramine reduced the use of opiates only when administered at the start (rather than the middle) of the trial, whereas cocaine use was reduced when desipramine was introduced at either time.
Medline Identifier
20378530
Pettinati HM. Volpicelli JR. Kranzler HR. Luck G. Rukstalis MR, et al.
Institution
Center for the Study of Addictions, Department of Psychiatry, University of Pennsylvania School of Medicine, and the Philadelphia Veterans Affairs Medical Center, 19104-6178, USA. Pettinati@research.trc.upenn.edu
Title
Sertraline treatment for alcohol dependence: interactive effects of medication and alcoholic subtype.
Source
Alcoholism: Clinical & Experimental Research. 24(7): 1041-9, 2000 Jul.
Abstract
BACKGROUND: Characteristic behaviors of some alcohol-dependent individuals, e.g., binge drinking, comorbid psychopathology, and some types of alcohol-related problems, have been linked to abnormalities in serotonergic neurotransmission. However, studies that have evaluated serotonergic pharmacotherapy for reducing drinking have yielded conflicting results. One explanation for these findings is a general failure to distinguish alcohol subgroups that may be differentiated on the basis of serotonergic abnormalities. However, in 1996, Kranzler and colleagues reported that Type B alcoholics, who are characterized by high levels of premorbid vulnerability, alcohol dependence severity, and comorbid psychopathology, showed less favorable drinking outcomes in response to treatment with fluoxetine, a serotonin reuptake inhibitor, than with placebo. This medication effect was not seen in Type A alcoholics, i.e., those with lower risk/severity of alcoholism and psychopathology. The aim of the present study was to explore the validity of differential responding by alcohol-dependent subtypes using the serotonin reuptake inhibitor, sertraline. METHODS: A k-means clustering procedure was applied to a sample of alcohol-dependent subjects enrolled in a 14-week, placebo-controlled trial of 200 mg/day of sertraline, classifying them into lower-risk/severity (Type A: n = 55) and higher-risk/severity (Type B: n = 45) subgroups. RESULTS: A significant interaction between alcoholic subtype and medication condition was found, confirming the findings of Kranzler and colleagues that alcoholic subtypes responded differentially to serotonergic medication. Somewhat at variance with their results, however, the present study showed that the lower risk/severity (Type A) subjects had more favorable outcomes when treated with sertraline compared to placebo. CONCLUSIONS: Alcoholic subtypes differentially responded to sertraline when used as a treatment to reduce alcohol drinking, with one subtype having more favorable outcomes. Subtyping alcoholics may help to resolve conflicting findings in the literature on serotonergic treatment of alcohol dependence.
Hope this is helpful to you.
TOPIRIMATE (topomax) shows promise in treating alcoholism. This anti- convulsant, mood stabilizing medication can help reduce the alcohol cravings of alcohol abusers, making it easier to withdraw from alcohol. The researchers of a recent significant study published in The Lancet on the use of topirimate for alcohol abuse postulated that it reduces alcohol cravings by reducing brain levels of the neurotransmitter dopamine (which is believed to create the pleasurable sensations alcoholics get from drinking). The topirimate seems to reduce the cravings and anxiety associated with withdrawal, and potentially resets the brain's chemistry. Topirimate has also been found to be helpful in treating binge eating disorder. The following online article provides more information about
Topirimate.
Research Study: Johnson BA, Ait-Daoud N, Bowden CL, et al. "Oral topirimate for treatment of alcohol dependence: a randomized trial. The Lancet. 361:1677-1685, 2003.
The articles below can be ordered through www.docdeliver.com
or www.ingenta.com.
Medline Identifier
22674185
Authors
Brown ES. Bobadilla L. Nejtek VA. Perantie D. Dhillon H. Frol A.
Institution
Department of Psychiatry, The University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-8849, USA. Sherwood.Brown@UTsouthwestern.edu
Title
Open-label nefazodone in patients with a major depressive episode and alcohol dependence.
Source
Progress in Neuro-Psychopharmacology & Biological Psychiatry. 27(4):681-5, 2003 Jun.
PURPOSE: Major depressive disorder (MDD) and alcohol dependence (AD) frequently occur together. However, MDD clinical trials generally exclude patients with alcohol-related disorders. GENERAL METHODS: A 12-week, open-label trial of nefazodone in a group of people (n=13) with both a current major depressive episode and current AD was conducted to examine the effect of this antidepressant on depressive symptoms, alcohol use, and cognition. FINDINGS: Scores on the Hamilton Rating Scale for Depression (HRSD) and Hamilton Rating Scale for Anxiety (HRSA) significantly decreased from baseline to exit. In addition, significant reduction in alcohol craving, drinks/week, and days of alcohol use/week was found. Scores on the Rey Auditory Verbal Learning Test (RAVLT) did not significantly improve during the study. Changes in mood/anxiety and memory did not correlate with changes in alcohol use. CONCLUSIONS: Thus, nefazodone therapy was associated with improvement in mood/anxiety and alcohol use, which seem to be independent of each other in this patient sample. However, declarative memory, which was low average at baseline, did not show statistically significant improvement during the 12 weeks of the study.
Medline Identifier
22309875
Piasecki MP. Steinagel GM. Thienhaus OJ. Kohlenberg BS.
Institution
University of Nevada School of Medicine, Department of Psychiatry, Reno 89557-0046, USA. piasecki@med.unr.edu
Title
An exploratory study: the use of paroxetine for methamphetamine craving.
Source
Journal of Psychoactive Drugs. 34(3):301-4, 2002 Jul-Sep.
Methamphetamine abuse and dependence are growing problems nationally and worldwide. There are currently no effective pharmocologic treatments. Animal studies with SSRI's suggest that serotonergic modulation alters methamphetamine's behavioral effects. This exploratory study is a trial of the effects of the SSRI paroxetine versus placebo (in a double blind design) on craving and use in a population of methamphetamine users. Many subjects dropped out of the study, but those in active treatment who completed the eight week trial had a decrease in methamphetamine craving compared to the placebo treatment as measured by the OCDS modified for use in this population. Statistical analyses were not performed due to the low number of subjects. The preliminary data suggest that serotonergic agents may play a role in the effective treatment of methamphetamine abuse and dependence within the context of other effective behavioral interventions.
Medline Identifier
22023696
Feingold A. Oliveto A. Schottenfeld R. Kosten TR.
Institution
Department of Psychiatry, Yale University School of Medicine, VA Connecticut Healthcare System, West Haven 06516, USA.
Title
Utility of crossover designs in clinical trials: efficacy of desipramine vs. placebo in opioid-dependent cocaine abusers.
Source
American Journal on Addictions. 11(2):111-23, 2002 Spring.
The utility of the crossover design in substance abuse research was examined in a 26-week, double-blind clinical trial that evaluated the efficacy of desipramine (0 or 150 mg/day) in 109 male and female cocaine- and opiate-dependent patients maintained on buprenorphine (12 mg/day) or methadone (65 mg/day). After being stabilized on buprenorphine or methadone (weeks 1-2), half of the patients were randomly assigned to receive desipramine for the first half of the trial and placebo for the second, with the order reversed for the second half. Analyses using hierarchical linear models (HLM) indicated that desipramine reduced the use of opiates only when administered at the start (rather than the middle) of the trial, whereas cocaine use was reduced when desipramine was introduced at either time.
Medline Identifier
20378530
Pettinati HM. Volpicelli JR. Kranzler HR. Luck G. Rukstalis MR, et al.
Institution
Center for the Study of Addictions, Department of Psychiatry, University of Pennsylvania School of Medicine, and the Philadelphia Veterans Affairs Medical Center, 19104-6178, USA. Pettinati@research.trc.upenn.edu
Title
Sertraline treatment for alcohol dependence: interactive effects of medication and alcoholic subtype.
Source
Alcoholism: Clinical & Experimental Research. 24(7): 1041-9, 2000 Jul.
Abstract
BACKGROUND: Characteristic behaviors of some alcohol-dependent individuals, e.g., binge drinking, comorbid psychopathology, and some types of alcohol-related problems, have been linked to abnormalities in serotonergic neurotransmission. However, studies that have evaluated serotonergic pharmacotherapy for reducing drinking have yielded conflicting results. One explanation for these findings is a general failure to distinguish alcohol subgroups that may be differentiated on the basis of serotonergic abnormalities. However, in 1996, Kranzler and colleagues reported that Type B alcoholics, who are characterized by high levels of premorbid vulnerability, alcohol dependence severity, and comorbid psychopathology, showed less favorable drinking outcomes in response to treatment with fluoxetine, a serotonin reuptake inhibitor, than with placebo. This medication effect was not seen in Type A alcoholics, i.e., those with lower risk/severity of alcoholism and psychopathology. The aim of the present study was to explore the validity of differential responding by alcohol-dependent subtypes using the serotonin reuptake inhibitor, sertraline. METHODS: A k-means clustering procedure was applied to a sample of alcohol-dependent subjects enrolled in a 14-week, placebo-controlled trial of 200 mg/day of sertraline, classifying them into lower-risk/severity (Type A: n = 55) and higher-risk/severity (Type B: n = 45) subgroups. RESULTS: A significant interaction between alcoholic subtype and medication condition was found, confirming the findings of Kranzler and colleagues that alcoholic subtypes responded differentially to serotonergic medication. Somewhat at variance with their results, however, the present study showed that the lower risk/severity (Type A) subjects had more favorable outcomes when treated with sertraline compared to placebo. CONCLUSIONS: Alcoholic subtypes differentially responded to sertraline when used as a treatment to reduce alcohol drinking, with one subtype having more favorable outcomes. Subtyping alcoholics may help to resolve conflicting findings in the literature on serotonergic treatment of alcohol dependence.
Hope this is helpful to you.
