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Protracted Withdrawal

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https://www.readbyqxmd.com/read/28574864/methadone-management-of-withdrawal-associated-with-loperamide-related-opioid-use-disorder
#1
Raphael J Leo, Muhammad A Ghazi, Kelly S Jaziri
: Loperamide hydrochloride is an over-the-counter anti-diarrheal agent, acting via mu-opioid receptor agonist effects in the intestinal myenteric plexus. Although preclinical investigations suggested that abuse liability associated with loperamide use is low, there are increasing numbers of cases reported to the US Food and Drug Administration, of abuse, dependence, and withdrawal associated with loperamide use. A case of a patient with opioid use disorder, that is, in the form of protracted loperamide excess use, requiring management of withdrawal with methadone is presented...
June 1, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28561904/neonatal-abstinence-syndrome-neurobehavior-at-6-weeks-of-age-in-infants-with-or-without-pharmacological-treatment-for-withdrawal
#2
Nicole A Heller, Beth A Logan, Deborah G Morrison, Jonathan A Paul, Mark S Brown, Marie J Hayes
Use and abuse of prescription opioids and concomitant increase in Neonatal Abstinence Syndrome (NAS), a condition that may lead to protracted pharmacological treatment in more than 60% of infants, has tripled since 2000. This study assessed neurobehavioral development using the NICU Network Neurobehavioral Scale in 6-week old infants with prenatal methadone exposure who did (NAS+; n = 23) or did not (NAS-; n = 16) require pharmacological treatment for NAS severity determined by Finnegan Scale. An unexposed, demographically similar group of infants matched for age served as comparison (COMP; n = 21)...
May 31, 2017: Developmental Psychobiology
https://www.readbyqxmd.com/read/28492457/the-role-of-amantadine-withdrawal-in-3-cases-of-treatment-refractory-altered-mental-status
#3
Leah D Fryml, Kristen R Williams, Christopher G Pelic, James Fox, Gregory Sahlem, Sophie Robert, Gonzalo J Revuelta, Edward Baron Short
Amantadine, which was originally developed as an antiviral medication, functions as a dopamine agonist in the central nervous system and consequently is utilized in the treatment of Parkinson disease, drug-induced extrapyramidal reactions, and neuroleptic malignant syndrome. For reasons that are not entirely understood, abrupt changes in amantadine dosage can produce a severe withdrawal syndrome. Existing medical literature describes case reports of amantadine withdrawal leading to delirium, which at times has progressed to neuroleptic malignant syndrome...
May 2017: Journal of Psychiatric Practice
https://www.readbyqxmd.com/read/28454983/emerging-pharmacotherapies-for-alcohol-use-disorder
#4
REVIEW
Barbara J Mason
The identification of different stages within the alcohol use disorder (AUD) cycle that are linked to neurocircuitry changes in pathophysiology associated with the negative emotional states of abstinence has provided a view of medication development for AUD that emphasizes changes in the brain reward and stress systems. Alcohol use disorder can be defined as a chronic relapsing disorder that involves compulsive alcohol seeking and taking, loss of control over alcohol intake, and emergence of a negative emotional state during abstinence...
August 1, 2017: Neuropharmacology
https://www.readbyqxmd.com/read/28445527/enhanced-functional-connectivity-and-volume-between-cognitive-and-reward-centers-of-na%C3%A3-ve-rodent-brain-produced-by-pro-dopaminergic-agent-kb220z
#5
Marcelo Febo, Kenneth Blum, Rajendra D Badgaiyan, Pablo D Perez, Luis M Colon-Perez, Panayotis K Thanos, Craig F Ferris, Praveen Kulkarni, John Giordano, David Baron, Mark S Gold
Dopaminergic reward dysfunction in addictive behaviors is well supported in the literature. There is evidence that alterations in synchronous neural activity between brain regions subserving reward and various cognitive functions may significantly contribute to substance-related disorders. This study presents the first evidence showing that a pro-dopaminergic nutraceutical (KB220Z) significantly enhances, above placebo, functional connectivity between reward and cognitive brain areas in the rat. These include the nucleus accumbens, anterior cingulate gyrus, anterior thalamic nuclei, hippocampus, prelimbic and infralimbic loci...
2017: PloS One
https://www.readbyqxmd.com/read/28410131/substance-use-disorder-a-bio-directional-subset-of-reward-deficiency-syndrome
#6
Kenneth Blum, Mark Gold, Zsolt Demetrovics, Trevor Archer, Panayotis K Thanos, David Baron, Rajendra D Badgaiyan
This commentary is to inform clinicians challenged with an increase in people seeking treatment for Substance Use Disorder (SUD), that the ninety percent revolving door, is, in part, due to post-withdrawal, untreated neurotoxicity. This impairment attenuates neurotransmitter signaling and compromises resting state functional connectivity, leading to unwanted sequelae including depression, sleep disturbances, sensation seeking, lack of satisfaction and impulsivity. Neuroimaging studies indicate that neurobiological recovery can take years...
June 1, 2017: Frontiers in Bioscience (Landmark Edition)
https://www.readbyqxmd.com/read/28287793/topiramate-reduces-basal-anxiety-and-relieves-ethanol-withdrawal-induced-anxious-behaviors-in-male-rats
#7
Décio D Junqueira-Ayres, Laila Asth, Adriana S F S J Ayres, Bruno Lobão-Soares, Vanessa de Paula Soares-Rachetti, Elaine C Gavioli
Anxiety disorders are associated with increased impairments in psychosocial functioning, work productivity and health-related quality of life. In addition, anxiety is a common symptom of ethanol withdrawal and it strongly contributes to relapse. Benzodiazepines are frequently prescribed for relief of anxiety and ethanol withdrawal symptoms but considerable side effects, such sedation, tolerance and dependence, are observed during treatment. Therefore, better drugs are needed for the treatment of anxiety states...
April 2017: Experimental and Clinical Psychopharmacology
https://www.readbyqxmd.com/read/28280885/acute-stress-worsens-the-deficits-in-appetitive-behaviors-for-social-and-sexual-stimuli-displayed-by-rats-after-long-term-withdrawal-from-morphine
#8
Yunjing Bai, David Belin, Xigeng Zheng, Zhengkui Liu, Yue Zhang
RATIONALE: Negative affective states, e.g., anhedonia, are suggested to be involved in the long-lasting motivational processes associated with relapse. Here, we investigated whether anhedonic behaviors could be elicited by an acute stress after protracted abstinence from morphine. OBJECTIVES: The behavioral responses to natural stimuli following exposure to an acute stress were examined after 14 days of withdrawal from morphine. Male rats were pretreated with either a binge-like morphine regimen or daily saline injections for 5 days...
March 9, 2017: Psychopharmacology
https://www.readbyqxmd.com/read/28229178/the-consummatory-and-motivational-behaviors-for-natural-rewards-following-long-term-withdrawal-from-morphine-no-anhedonia-but-persistent-maladaptive-behaviors-for-high-value-rewards
#9
Yingying Li, Xigeng Zheng, Na Xu, Yue Zhang, Zhengkui Liu, Yunjing Bai
RATIONALE: The negative affective state, e.g., anhedonia, emerges after abstinence from abused drugs may be linked to the motivational processes of drug craving and relapse. Although anhedonia diminishes over time with drug abstinence, it is not yet rather explicit whether anhedonia exists or not following protracted withdrawal. OBJECTIVES: The behavioral responses to natural rewards were examined after 2 to 3 weeks withdrawal from morphine. Male rats were pretreated with either a binge-like morphine paradigm or daily saline injection for 5 days...
February 22, 2017: Psychopharmacology
https://www.readbyqxmd.com/read/28215305/bdnf-during-withdrawal
#10
H Geoffroy, F Noble
Among the adaptations observed following drugs of abuse consumption, BDNF levels are widely altered in both brain and periphery. In this chapter, we first reviewed these adaptations in preclinical studies, in both juveniles and adult animals. A particular focus was made on protracted withdrawal as incubation is often associated with an increase in central BDNF levels. Then, we reported mixed results regarding the role of BDNF in drug-seeking behavior in animals as BDNF can either enhance reinstatement or have protective properties...
2017: Vitamins and Hormones
https://www.readbyqxmd.com/read/28196368/pericardio-amniotic-shunting-for-incomplete-pentalogy-of-cantrell
#11
Alexander C Engels, Anne Debeer, Francesca M Russo, Michael Aertsen, Katleen Aerts, Marc Miserez, Jan Deprest, Liesbeth Lewi, Roland Devlieger
A 27-year-old woman, gravida 2, para 0, presented with an incomplete Pentalogy of Cantrell with an omphalocele, diaphragmatic hernia, and a pericardial defect at 32 weeks' gestation. A large pericardial effusion compressed the lungs and had led to a reduced lung growth with an observed-to-expected total lung volume of 28% as measured by MRI. The effusion disappeared completely after the insertion of a pericardio-amniotic shunt at 33 weeks. After birth, the newborn showed no signs of pulmonary hypoplasia and underwent a surgical correction of the defect...
2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28173813/can-we-halt-health-workforce-deterioration-in-failed-states-insights-from-guinea-bissau-on-the-nature-persistence-and-evolution-of-its-hrh-crisis
#12
Giuliano Russo, Enrico Pavignani, Catia Sá Guerreiro, Clotilde Neves
BACKGROUND: Guinea-Bissau is one of the world's poorest and least developed countries. Amid poverty, political turmoil and state withdrawal, its health workforce (HW) has been swamped for the last four decades in a deepening crisis of under-resourcing, poor performance and laissez-faire. METHODS: The present study aimed at analysing the human resources for health (HRH) situation in Guinea-Bissau in light of the recent literature on distressed health systems, with the objective of contributing to understanding the ways health workers react to protracted turmoil, the resulting distortions and the counter-measures that might be considered...
February 7, 2017: Human Resources for Health
https://www.readbyqxmd.com/read/28159647/alcohol-stress-and-glucocorticoids-from-risk-to-dependence-and-relapse-in-alcohol-use-disorders
#13
REVIEW
Sara K Blaine, Rajita Sinha
In this review, we detail the clinical evidence supporting the role of psychological and physiological stress in instrumental motivation for alcohol consumption during the development of mild to moderate alcohol use disorders (AUDs) and in the compulsive, habitual alcohol consumption seen in severe, chronic, relapsing AUDs. Traditionally, the study of AUDs has focused on the direct and indirect effects of alcohol on striatal dopaminergic pathways and their role in the reinforcing effects of alcohol. However, growing evidence also suggests that alcohol directly stimulates the hypothalamic pituitary adrenal (HPA) axis and has effects on glucocorticoid receptors in extrahypothalamic, limbic forebrain, and medial Prefrontal Cortex (PFC) circuits, which contribute to the development of AUDs and their progression in severity, chronicity, and relapse risk...
August 1, 2017: Neuropharmacology
https://www.readbyqxmd.com/read/27939979/the-expression-of-amphetamine-sensitization-is-dissociable-from-anxiety-and-aversive-memory-effect-of-an-acute-injection-of-amphetamine
#14
Rafael Ignacio Gatica, Enzo Pérez-Valenzuela, Demetrio Sierra-Mercado, José Antonio Fuentealba
The repeated administration of amphetamine can lead to locomotor sensitization. Although the repeated administration of amphetamine has been associated with anxiety and impaired working memory, it is uncertain if expression of amphetamine sensitization is associated with modifications of emotional memories. To address this issue, rats were injected once daily with amphetamine for five consecutive days (1.5mg/kg). After four days of withdrawal, rats were delivered an acute amphetamine injection to assess the expression of sensitization...
January 18, 2017: Neuroscience Letters
https://www.readbyqxmd.com/read/27915967/liver-transplant-can-resolve-severe-neuropsychiatric-manifestations-of-wilson-disease-a-case-report
#15
Gregory Walker, Trana Hussaini, Robert Stowe, Silke Cresswell, Eric M Yoshida
Although liver transplant for decompensated cirrhosis secondary to Wilson disease is well accepted, the use of transplant for patients with severe neurologic manifestations of this condition remains controversial, and these can be perceived as a contraindication. Here, we describe a 45-year-old woman who presented with an incidental hepatocellular carcinoma at the time of transplant. The patient had severe neurologic manifestations of Wilson disease pretransplant, including dysarthria, hyperreflexia, asymmetrical ataxia, tremor, bradyphrenia, and shuffling gait...
December 2, 2016: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/27890469/methamphetamine-addiction-vulnerability-the-glutamate-the-bad-and-the-ugly
#16
Karen K Szumlinski, Kevin D Lominac, Rianne R Campbell, Matan Cohen, Elissa K Fultz, Chelsea N Brown, Bailey W Miller, Sema G Quadir, Douglas Martin, Andrew B Thompson, Georg von Jonquieres, Matthias Klugmann, Tamara J Phillips, Tod E Kippin
BACKGROUND: The high prevalence and severity of methamphetamine (MA) abuse demands greater neurobiological understanding of its etiology. METHODS: We conducted immunoblotting and in vivo microdialysis procedures in MA high/low drinking mice, as well as in isogenic C57BL/6J mice that varied in their MA preference/taking, to examine the glutamate underpinnings of MA abuse vulnerability. Neuropharmacological and Homer2 knockdown approaches were also used in C57BL/6J mice to confirm the role for nucleus accumbens (NAC) glutamate/Homer2 expression in MA preference/aversion...
June 1, 2017: Biological Psychiatry
https://www.readbyqxmd.com/read/27818644/an-update-on-crf-mechanisms-underlying-alcohol-use-disorders-and-dependence
#17
REVIEW
Isabel Marian Hartmann Quadros, Giovana Camila Macedo, Liz Paola Domingues, Cristiane Aparecida Favoretto
Alcohol is the most commonly used and abused substance worldwide. The emergence of alcohol use disorders, and alcohol dependence in particular, is accompanied by functional changes in brain reward and stress systems, which contribute to escalated alcohol drinking and seeking. Corticotropin-releasing factor (CRF) systems have been critically implied in the transition toward problematic alcohol drinking and alcohol dependence. This review will discuss how dysregulation of CRF function contributes to the vulnerability for escalated alcohol drinking and other consequences of alcohol consumption, based on preclinical evidence...
2016: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/27720809/persistent-strengthening-of-the-prefrontal-cortex-nucleus-accumbens-pathway-during-incubation-of-cocaine-seeking-behavior
#18
Catarina Luís, Nazzareno Cannella, Rainer Spanagel, Georg Köhr
High rates of relapse after prolonged abstinence are often triggered by exposure to drug-associated cues that induce drug craving. Incubation of drug craving is a phenomenon that consists of time-dependent increases in cue-induced drug craving during withdrawal. Plasticity mechanisms in the nucleus accumbens (NAc) underlie drug-seeking responses and involve changes in excitatory synaptic transmission's efficacy. In particular, the prefrontal cortex (PFC) glutamatergic input to the NAc core has been well characterized regarding cocaine-evoked plasticity following non-contingent versus contingent exposure to cocaine or alternatively after protracted abstinence...
October 5, 2016: Neurobiology of Learning and Memory
https://www.readbyqxmd.com/read/27621103/preclinical-voluntary-drinking-models-for-alcohol-abstinence-induced-affective-disturbances-in-mice
#19
REVIEW
K M Holleran, D G Winder
Negative reinforcement is widely thought to play an important role in chronic alcohol-use disorders (AUDs), and high comorbidity between AUDs and affective disorders highlights the importance of investigating this relationship. Prominent models posit that repeated cycles of alcohol (ethanol, EtOH) exposure and withdrawal produce circuit adaptations in the central nervous system that drive a transition from positive- to negative reinforcement-based alcohol seeking. Evidence supporting this theory has accumulated in large part using forced EtOH administration models, such as chronic intragastric gavage and chronic vapor inhalation...
January 2017: Genes, Brain, and Behavior
https://www.readbyqxmd.com/read/27579857/melanin-concentrating-hormone-and-its-mch-1-receptor-relationship-between-effects-on-alcohol-and-caloric-intake
#20
Camilla Karlsson, Abdul Maruf Asif Aziz, Faazal Rehman, Caleb Pitcairn, Riccardo Barchiesi, Estelle Barbier, Mikaela Wendel Hansen, Don Gehlert, Pia Steensland, Markus Heilig, Annika Thorsell
BACKGROUND: Reward and energy homeostasis are both regulated by a network of hypothalamic neuropeptide systems. The melanin-concentrating hormone (MCH) and its MCH-1 receptor (MCH1-R) modulate alcohol intake, but it remains unknown to what extent this reflects actions on energy balance or reward. Here, we evaluated the MCH1-R in regulation of caloric intake and motivation to consume alcohol in states of escalated consumption. METHODS: Rats had intermittent access (IA) to alcohol and were divided into high- and low-drinking groups...
October 2016: Alcoholism, Clinical and Experimental Research
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