A nicotine antagonist, mecamylamine, reduces cue-induced cocaine craving in cocaine-dependent subjects.
(1/1125)
We have previously shown that nicotine enhances cue-induced cocaine craving. In the present study, the effects of a nicotine antagonist, mecamylamine, on cue-induced cocaine craving were investigated. Twenty-three cocaine-dependent patients, all cigarette smokers, were randomly assigned to mecamylamine (2.5 mg tablet) or placebo in a single-dose, placebo-controlled, crossover, double-blind study. Craving and anxiety were measured before and after cocaine cues with visual analog scales for desire to use cocaine and mood. Skin conductance, skin temperature and heart rate were recorded before and during cocaine cues. Following exposure to cocaine cues, all patients reported an increase in cocaine craving and anxiety relative to the precue measures. Cue exposure also produced an increase in skin conductance and decrease in skin temperature. The cue-induced increase in cocaine craving was reduced, while the cue-induced skin conductance and temperature responses were unaffected, by mecamylamine. These findings show that cue-induced cocaine craving is attenuated by mecamylamine. Further study on the use of mecamylamine in relapse prevention programs are suggested. (+info)
Effects of olfactory stimuli on urge reduction in smokers.
(2/1125)
This study examined the possibility that exposure to olfactory stimuli can reduce self-reported urge to smoke. After an initial assessment of self-reported urge, nicotine-deprived smokers evaluated the pleasantness of a series of 8 odors. Facial expressions during odor presentations were coded with P. Ekman and W. V. Friesen's (1978a) Facial Action Coding System. After odor administration, participants were exposed to smoking cues. Next, participants were administered their most pleasant, least pleasant, or a control odor (water) and reported their urge to smoke. Results indicated that sniffing either a pleasant or unpleasant odor reduced reported urge to smoke relative to the control odor. Reported pleasantness of the odors did not differentially affect urge reduction. Odors eliciting negative-affect-related expressions, however, were less effective than odors that did not elicit negative-affect-related expressions in reducing reported urge. Results of this preliminary investigation provide support for the consideration of odor stimuli as an approach to craving reduction. (+info)
Comparing single and cumulative dosing procedures in human triazolam discriminators.
(3/1125)
This study evaluated a cumulative dosing procedure for drug discrimination with human participants. Four participants learned to discriminate triazolam (0.35 mg/70 kg) from placebo. A crossover design was used to compare the results under a single dosing procedure with results obtained under a cumulative dosing procedure. Under the single dosing procedure, a dose of triazolam (0, 0.05, 0.15, or 0.35 mg/70 kg) or secobarbital (0, 25, 75, or 175 mg/70 kg) was administered 45 min before assessment. Determining each dose-effect curve thus required four sessions. Under the cumulative dosing procedure, four doses of triazolam (0, 0.05, 0.10, and 0.20 mg/70 kg) or secobarbital (0, 25, 50, and 100 mg/70 kg) were administered approximately 55 min apart, producing a complete dose-effect curve in one four-trial session. Regardless of procedure, triazolam and secobarbital produced discriminative stimulus and self-reported effects similar to previous single dosing studies in humans. Shifts to the right in cumulative dose-effect curves compared to single dose-effect curves occurred on several self-report measures. When qualitative stimulus functions rather than quantitative functions are of interest, application of cumulative dosing may increase efficiency in human drug discrimination. (+info)
A three-pathway psychobiological model of craving for alcohol.
(4/1125)
In this article, by reviewing the psychological, psychophysiological, neurobiological, and psychopharmacological literature on craving for alcohol, it is argued that converging evidence from several disciplines suggests a three-pathway psychobiological model of craving. Essential to this model is the appreciation of the role of individual differences in affect regulation strategies or personality styles, conditionability, sensitivity to alcohol's effects, and related dysregulations in distinct neural circuitries or neurotransmitter systems. These factors are of crucial importance to a proper understanding of the nature of craving, its underlying mechanisms and different manifestations. As a first pathway, it is suggested that reward craving or desire for the rewarding, stimulating and/or enhancing effects of alcohol might result from either dopaminergic/opioidergic dysregulation or a personality style characterized by reward seeking or a combination of both. As a second pathway, it is suggested that relief craving or desire for the reduction of tension or arousal might result from either gamma-aminobutyric acid (GABA)ergic/glutamatergic dysregulation or a personality style characterized by stress reactivity or a combination of both. Obsessive craving, the result of the third pathway, can be defined as lack of control over intrusive thoughts about drinking resulting in impaired functioning. This type of craving might result either from a serotonin deficiency or a personality style characterized by low constraint or disinhibition or a combination of both. The putative implications of this three-pathway model for the assessment of alcohol craving, diagnosis and treatment of alcoholism, and future research on craving, are discussed. (+info)
Craving for alcohol: findings from the clinic and the laboratory.
(5/1125)
This paper presents a review of the current status of empirical research in the area of alcohol craving. After an introduction on the origins of the construct of craving, we first present clinical studies that have examined craving as a hallmark symptom of alcohol dependence and demonstrated its sensitivity as an outcome measure in assessing change in pharmacotherapy trials of alcohol dependence. There is also discussion regarding new multifactorial self-report instruments of alcohol craving with good reliability and predictive validity, that may be sensitive to detecting alcohol craving and assessing change in craving as it relates to relapse during treatment. Next, we examine the experimental paradigms that have been used to induce alcohol craving in the laboratory. Further, the methodological issues affecting laboratory-based paradigms are presented, while also elucidating the potential use of effective laboratory-based craving induction paradigms, both in clinical studies as well as in laboratory studies that examine the brain mechanisms associated with the concept of craving. Finally, directions for future research on craving in the laboratory and the clinic are presented in the context of developing more effective treatments for different phases of recovery from alcohol dependence. (+info)
Long-term alcohol self-administration with repeated alcohol deprivation phases: an animal model of alcoholism?
(6/1125)
In order to study the neurobiological and molecular mechanisms of alcohol dependence and addiction, appropriate animal models are warranted. Although animal models cannot incorporate all aspects and criteria of an addictive behaviour to alcohol seen in human alcoholics, they can at least reflect some of the criteria given in the fourth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) of the American Psychiatric Association (1994). Novel aspects of addictive behaviour to alcohol, craving and relapse might be uncovered by animal models of long-term, free-choice, alcohol self-administration followed by alcohol deprivation phases. After several months of voluntary alcohol consumption, the drug-taking behaviour following a deprivation (withdrawal) phase is characterized by increased alcohol intake and preference (alcohol deprivation effect) and changes in alcohol intake patterns where animals consume large amounts of highly concentrated alcohol solutions even at inappropriate times (e.g. during the inactive light phase when drinking activity is minimal). Altogether, alcohol drinking following alcohol deprivation seems to become uncontrolled and inelastic, reflecting an incentive demand for the drug in such a model. Furthermore, the alcohol deprivation effect outlasts very long abstinence phases, which indicates the persistence of a drug memory for alcohol. (+info)
The role of serotonin in craving: from basic research to human studies.
(7/1125)
Increasing evidence suggests that craving may play a central role in the mechanisms of addiction. The experience of craving is largely characterized by obsessional thoughts about drugs, triggering compulsive drug-seeking and drug-taking behaviour. In the present article the possible involvement of brain 5-hydroxytryptamine (5-HT) in the mechanisms of craving and relapse is discussed by integrating the results of basic research with those obtained in human studies. Based on studies suggesting that the brain serotonergic system plays a central role in the regulation of impulse-control mechanisms, it is proposed that 5-HT deficiency may contribute to the loss of control over drug-taking, which is a crucial factor for the maintenance of addictive behaviour. (+info)
Craving and relapse measurement in alcoholism.
(8/1125)
This paper attempts to summarize the measurement of craving with four different craving instruments and to relate this to definitions and measurement of relapse. The definitions of relapse may vary between studies and researchers, but are usually well defined. Five commonly used methods to measure relapse are: (1) quantity/frequency of drinking; (2) cumulative duration of abstinence (CDA); (3) post-withdrawal abstinent period; (4) stable recovery period; (5) the time line follow-back method. The definition of craving is much less clear and is mostly described as an emotional-motivational state or as obsessive-compulsive behaviour. Four self-rating instruments are briefly discussed and compared: the Obsessive-Compulsive Drinking Scale, OCDS, the Lubeck Craving Scale, LCRR, the Alcohol Craving Questionnaire, ACQ-Now-SF-R, and ordinal scales (e.g. visual analogue, Likert, or verbal descriptive scales). These instruments measure different aspects or dimensions of craving over different periods. The different dimensions measured suggest that there is still a need to conceptualize a standard interpretation of the word craving. There is a need also to measure an emotional-motivational dimension, a cognitive-behavioural dimension, expectancies, and effects on positive and negative reinforcement with different instruments or with one multidimensional instrument. It is suggested that different patients are expected to have different craving profiles. (+info)