COCAINE 2007 / AMPHETAMINES 2007 <483>

Database EMBASE

Accession Number 2008280167

Authors Knapp W.P. Soares B. Farrel M. Lima M.S.

Institution

(Knapp) Psychology, PUC, RS, Avenue Paulo Gama 110, Porto Alegre, Brazil.

Country of Publication

United Kingdom

Title

Psychosocial interventions for cocaine and psychostimulant amphetamines related disorders.

Source

Cochrane Database of Systematic Reviews. (3), 2007. Article Number: CD003023. Date of Publication: 2007.

Abstract

Background: The consumption of psychostimulants for non-medical reasons probably occurs because of their euphoriant and psychomotor-stimulating properties. Chronic consumption of these agents results in development of stereotyped behaviour, paranoia, and possibly aggressive behaviour. Psychosocial treatments for psychostimulant use disorder are supposed to improve compliance, and to promote abstinence. Evidence from randomised controlled trials in this subject needs to be summarised. Objectives: To conduct a systematic review of all RCTs on psychosocial interventions for treating psychostimulant use disorder. Search strategy: Electronic searches of Cochrane Library, EMBASE, MEDLINE, and LILACS (to may 2006); reference searching; personal communication; conference abstracts; unpublished trials from pharmaceutical industry; book chapters on treatment of psychostimulants abuse/dependence. Selection criteria: All randomised-controlled trials focusing on psychosocial interventions for treating psychostimulants abuse/ dependence. Data collection and analysis: Three authors extracted the data independently and Relative Risks, weighted mean difference and number needed to treat were estimated, when possible. The reviewers assumed that people who died or dropped out had no improvement (intention to treat analysis) and tested the sensitivity of the final results to this assumption. Main results: Twenty-seven randomised controlled studies (3663 participants) fulfilled inclusion criteria and had data that could be used for at least one of the main comparisons. There was a wide heterogeneity in the interventions evaluated: this did not allow to provide a summary estimate of effect and results cannot be summarised in a clear cut way. The comparisons between different type of Behavioural Interventions showed results in favour of treatments with some form of Contingency management in respect to both reducing drop outs and lowering cocaine use. Authors' conclusions: Overall this review reports little significant behavioural changes with reductions in rates of drug consumption following an intervention. Moreover, with the evidence currently available, there are no data supporting a single treatment approach that is able to comprise the multidimensional facets of addiction patterns and to significantly yield better outcomes to resolve the chronic, relapsing nature of addiction, with all its correlates and consequences. Copyright copyright 2008 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

ISSN 1469-493X

Publication Type Journal: Review

Journal Name Cochrane Database of Systematic Reviews

Issue Part 3

Year of Publication 2007

Date of Publication 2007

COCAINE 2007 <486>

Database EMBASE

Accession Number 2008279981

Authors Amato L. Minozzi S. Pani P.P. Davoli M.

Institution

(Amato) Deparment of Epidemiology, ASL RM/E, Via di Santa Costanza 53, Rome Lazio 00198, Italy.

Country of Publication

United Kingdom

Title

Antipsychotic medications for cocaine dependence.

Source

Cochrane Database of Systematic Reviews. (3), 2007. Article Number: CD006306. Date of Publication: 2007.

Abstract

Background: Cocaine dependence is a public health problem characterized by recidivism and a host of medical and psychosocial complications. Cocaine dependence remains a disorder for which no pharmacological treatment of proven efficacy exists, although considerable advances in the neurobiology of this addiction could guide future medication development. Objectives: To evaluate the efficacy and the acceptability of antipsychotic medications for cocaine dependence. Search strategy: We searched the following sources: MEDLINE (1966 to October 2006), EMBASE (1980 to October 2006), CINAHL (1982 to October 2006), Cochrane Drug and Alcohol Group Specialised Register (October 2006). We also searched the reference lists of trials, the main electronic sources of ongoing trials (National Research Register, meta-Register of Controlled Trials; Clinical Trials.gov) and conference proceedings likely to contain trials relevant to the review. All searches included also non-English language literature. Selection criteria: All randomised controlled trials and controlled clinical trials with focus on the use of any antipsychotic medication for cocaine dependence. Data collection and analysis: Two authors independently evaluated the papers, extracted data, rated methodological quality. Main results: Seven small studies were included (293 participants): the antipsychotic drugs studied were risperidone, olanzapine and haloperidol. No significant differences were found for any of the efficacy measures comparing any antipsychotic with placebo. Risperidone was found to be superior to placebo in diminishing the number of dropouts, four studies, 178 participants, Relative Risk (RR) 0.77 (95%CI 0.77 to 0.98). Most of the included studies did not report useful results on important outcomes such as side effects, use of cocaine during treatment and craving. The results on olanzapine and haloperidol come from studies too small to give conclusive results. Authors' conclusions: Although caution is needed when assessing results from a limited number of small clinical trials there is no current evidence, at the present, supporting the clinical use of antipsychotic medications in the treatment of cocaine dependence. Furthermore, most of the included studies did not report useful results on important outcomes such as side effects, use of cocaine during the treatment and craving. Aiming to answer the urgent demand of clinicians, patients, families, and the community as a whole for an adequate treatment for cocaine dependence, larger randomised investigations should be designed investigating relevant outcomes and reporting data to allow comparison of results between studies. Moreover some efforts should be done also to investigate the efficacy of other type medications, like anticonvulsant, currently used in clinical practice. Copyright copyright 2008 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

ISSN 1469-493X

Publication Type Journal: Review

Journal Name Cochrane Database of Systematic Reviews

Issue Part 3

Year of Publication 2007

Date of Publication 2007

COCAINE (A) 2007 <618>

Database Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations and Ovid MEDLINE(R)

Unique Identifier 17298672

Status PubMed-not-MEDLINE

Authors Pamplona FA. Vendruscolo LF. Takahashi RN.

Authors Full Name Pamplona, Fabricio A. Vendruscolo, Leandro F. Takahashi, Reinaldo N.

Institution

Departamento de Farmacologia, Centro de Ciencias Biologicas, Universidade Federal de Santa Catarina, Florianopolis, SC, Brazil.

Title

Increased sensitivity to cocaine-induced analgesia in Spontaneously Hypertensive Rats (SHR).

Source

Behavioral & Brain Functions [Electronic Resource]: BBF. 3:9, 2007.

Journal Name

Behavioral & Brain Functions [Electronic Resource]: BBF

Other ID

Source: NLM. PMC1802084

Country of Publication

England

Abstract

This study examined the analgesic effect of cocaine in Spontaneously Hypertensive Rats (SHR), which are considered a suitable model for the study of attention deficit hyperactivity disorder (ADHD), and in Wistar (WIS) rats of both sexes using the hot-plate test. In addition, we tested whether habituation to the unheated hot-plate apparatus, that "normalizes" the basal hypoalgesic phenotype of SHR, alters the subsequent cocaine-induced analgesia (CIA) in this strain. SHR of both sexes were hypoalgesic compared to WIS rats in the hot-plate test and showed higher sensitivity to CIA. Habituation to the unheated hot-plate reduced the basal nociceptive latency of SHR, suggesting cognitive/emotional modulation of pain in this strain, but did not alter the magnitude of CIA. The present study shows increased sensitivity to CIA in SHR, which may be related to abnormalities in the mesocorticolimbic dopaminergic system. Further studies using SHR strain may reveal new information on the neurobiological mechanisms underlying ADHD and its co-morbidity with drug addiction.

Publication Type Journal Article.

Date of Publication 2007

Year of Publication 2007

Volume 3

Page 9

COCAINE (A) 2007 <812>

Database Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations and Ovid MEDLINE(R)

Unique Identifier 17900777

Status MEDLINE

Authors Porrino LJ. Smith HR. Nader MA. Beveridge TJ.

Authors Full Name Porrino, Linda J. Smith, Hilary R. Nader, Michael A. Beveridge, Thomas J R.

Institution

Center for the Neurobiological Investigation of Drug Abuse, Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1083, USA.

Title

The effects of cocaine: a shifting target over the course of addiction. [Review] [64 refs]

Source

Progress in Neuro-Psychopharmacology & Biological Psychiatry. 31(8):1593-600, 2007 Nov 15.

Journal Name

Progress in Neuro-Psychopharmacology & Biological Psychiatry

Other ID

Source: NLM. NIHMS34509

Source: NLM. PMC2211431

Country of Publication

England

Abstract

Repeated exposure to psychostimulant drugs such as cocaine has been shown in numerous studies to produce significant neuroadaptations in both structure and function throughout the brain. Nonhuman primate models provide a way to systematically evaluate these adaptations engendered by cocaine self-administration and simulate the progressive nature of cocaine addiction in humans. Functional activity, measured using the 2-[14C]deoxyglucose method, was evaluated at selected critical time points over the course of chronic cocaine self-administration in rhesus monkeys. The effects of cocaine exposure in the initial stages of self-administration resulted in changes in functional activity in a highly restricted network of interconnected brain regions when compared to activity in food-reinforced controls. This pattern of changes was confined mainly to ventromedial prefrontal cortex and ventral striatum. Following chronic exposure to cocaine self-administration, however, the spatial extent and intensity of significant alterations in functional activity expanded considerably. The shift in topography of these changes was orderly, originating ventromedially in the prefrontal cortical-ventral striatal network and expanding dorsally to encompass the dorsal striatum. A strikingly similar progression occurred within the cortical areas that project to each of these striatal regions. Preliminary studies suggest that this pattern is maintained despite periods of abstinence from cocaine. The shifting patterns of cerebral metabolic function that accompany longer durations of cocaine self-administration may underlie many of the characteristics of chronic drug exposure, and may provide transitional mechanisms to more compulsive cocaine use. [References: 64]

ISSN Print 0278-5846

Publication Type Journal Article. Research Support, N.I.H., Extramural. Review.

Date of Publication 2007 Nov 15

Year of Publication 2007

Issue/Part 8

Volume 31

Page 1593-600

COCAINE (A) 2007 <815>

Database Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations and Ovid MEDLINE(R)

Unique Identifier 17888555

Status MEDLINE

Authors Roberts DC. Morgan D. Liu Y.

Authors Full Name Roberts, David C S. Morgan, Drake. Liu, Yu.

Institution

Wake Forest University Health Sciences, Department of Physiology and Pharmacology, Winston-Salem, NC 27157, United States.

Title

How to make a rat addicted to cocaine. [Review] [78 refs]

Source

Progress in Neuro-Psychopharmacology & Biological Psychiatry. 31(8):1614-24, 2007 Nov 15.

Journal Name

Progress in Neuro-Psychopharmacology & Biological Psychiatry

Other ID

Source: NLM. NIHMS35149

Source: NLM. PMC2140146

Country of Publication

England

Abstract

Procedures have been developed which provide extremely stable patterns of cocaine self-administration in rats and these have been useful in lesion and drug pretreatment studies aimed at understanding the neurobiology of cocaine reinforcement. The issue now is whether studying the neurobiology of reinforcement is the same as studying the neurobiology of addiction. If the goal is to understand a progressive and deteriorating disorder, then the self-administration procedures should model specific aspects of the progressive stages of the addiction process. Here we review theoretical strategies for modeling the addiction process and present data from a series of experiments from our laboratory showing conditions which produce a progressive change in the motivation to self-administer cocaine in rats. This phenomenon is revealed by an escalation in breakpoints on a progressive ratio schedule. The effect, which is robust and persistent, depends on dose and speed of injection. Interestingly, high drug intake can retard the development of this effect, which we argue indicates that the addiction process has a developmental sequence. Finally, we suggest that specific parameters (dose, price and availability) can be used to examine the transition from recreational use to binge-like intake. [References: 78]

ISSN Print 0278-5846

Publication Type Journal Article. Research Support, N.I.H., Extramural. Review.

Date of Publication 2007 Nov 15

Year of Publication 2007

Issue/Part 8

Volume 31

Page 1614-24

COCAINE 2007 <834>

Database Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations and Ovid MEDLINE(R)

Unique Identifier 17636840

Status MEDLINE

Authors Amato L. Minozzi S. Pani PP. Davoli M.

Authors Full Name Amato, L. Minozzi, S. Pani, P P. Davoli, M.

Institution

ASL RM/E, Deparment of Epidemiology, Via di Santa Costanza 53, Rome, Lazio, Italy, 00198.

Title

Antipsychotic medications for cocaine dependence. [Review] [74 refs]

Source

Cochrane Database of Systematic Reviews. (3):CD006306, 2007.

Journal Name

Cochrane Database of Systematic Reviews

Country of Publication

England

Abstract

BACKGROUND: Cocaine dependence is a public health problem characterized by recidivism and a host of medical and psychosocial complications. Cocaine dependence remains a disorder for which no pharmacological treatment of proven efficacy exists, although considerable advances in the neurobiology of this addiction could guide future medication development OBJECTIVES: To evaluate the efficacy and the acceptability of antipsychotic medications for cocaine dependence SEARCH STRATEGY: We searched the following sources: MEDLINE (1966 to October 2006), EMBASE (1980 to October 2006), CINAHL (1982 to October 2006), Cochrane Drug and Alcohol Group Specialised Register (October 2006). We also searched the reference lists of trials, the main electronic sources of ongoing trials (National Research Register, meta-Register of Controlled Trials; Clinical Trials.gov) and conference proceedings likely to contain trials relevant to the review. All searches included also non-English language literature. SELECTION CRITERIA: All randomised controlled trials and controlled clinical trials with focus on the use of any antipsychotic medication for cocaine dependence DATA COLLECTION AND ANALYSIS: Two authors independently evaluated the papers, extracted data, rated methodological quality MAIN RESULTS: Seven small studies were included (293 participants): the antipsychotic drugs studied were risperidone, olanzapine and haloperidol. No significant differences were found for any of the efficacy measures comparing any antipsychotic with placebo. Risperidone was found to be superior to placebo in diminishing the number of dropouts, four studies, 178 participants, Relative Risk (RR) 0.77 (95% CI 0.77 to 0.98). Most of the included studies did not report useful results on important outcomes such as side effects, use of cocaine during treatment and craving. The results on olanzapine and haloperidol come from studies too small to give conclusive results. AUTHORS' CONCLUSIONS: Although caution is needed when assessing results from a limited number of small clinical trials there is no current evidence, at the present , supporting the clinical use of antipsychotic medications in the treatment of cocaine dependence. Furthermore, most of the included studies did not report useful results on important outcomes such as side effects, use of cocaine during the treatment and craving. Aiming to answer the urgent demand of clinicians, patients, families, and the community as a whole for an adequate treatment for cocaine dependence, larger randomised investigations should be designed investigating relevant outcomes and reporting data to allow comparison of results between studies. Moreover some efforts should be done also to investigate the efficacy of other type medications, like anticonvulsant, currently used in clinical practice. [References: 74]