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Nour Alayan, Lucille Eller, Marsha E Bates, Dennis P Carmody
BACKGROUND: The limited success of conventional anticraving interventions encourages research into new treatment strategies. Heart rate variability biofeedback (HRVB), which is based on slowed breathing, was shown to improve symptom severity in various disorders. HRVB, and certain rates of controlled breathing (CB), may offer therapeutic potential as a complementary drug-free treatment option to help control substance craving. METHODS: This review evaluated current evidence on the effectiveness of HRVB and CB training as a complementary anticraving intervention, based on guidelines from the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols...
May 21, 2018: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
Sophie Lebourgeois, María Carmen González-Marín, Jerome Jeanblanc, Mickael Naassila, Catherine Vilpoux
Alcohol use disorder is a chronic and highly relapsing disorder, characterized by a loss of control over alcohol consumption and craving. Several studies suggest a key role of glutamate in this disorder. In recent years, the modulation of cystine/glutamate exchange via the xc - system has emerged as a new therapeutic alternative for reducing the excitatory glutamatergic transmission observed after ethanol self-administration in both rats and humans. The objective of this study was to determine whether a treatment with N-acetylcysteine (NAC), a cystine prodrug, could reduce ethanol self-administration, ethanol-seeking behavior and reacquisition of ethanol self-administration...
March 2018: Addiction Biology
Adam Searby, Natalie van Swet, Phil Maude, Ian McGrath
Alcohol use disorder in older adults is associated with a number of substantial medical complications, including cognitive decline. Due to limited success and application of screening approaches in this cohort, older adults are more likely to present to general hospital settings with undiagnosed problematic alcohol use. Consultation-liaison psychiatry services operating in general hospital settings are likely to be referred older adults with alcohol use disorders for assessment and management. A 77-year-old female presented to a metropolitan hospital with symptoms including frequent falls, slurred speech, difficulty judging distance, hypersomnia, poor reasoning, and odd behaviours...
January 2017: Issues in Mental Health Nursing
David H Epstein, Ashley P Kennedy, Melody Furnari, Markus Heilig, Yavin Shaham, Karran A Phillips, Kenzie L Preston
RATIONALE: In rodents, antagonism of receptors for corticotropin-releasing factor (CRF) blocks stress-induced reinstatement of drug or palatable food seeking. OBJECTIVE: To test anticraving properties of the CRF1 antagonist pexacerfont in humans. METHODS: We studied stress-induced eating in people scoring high on dietary restraint (food preoccupation and chronic unsuccessful dieting) with body-mass index (BMI) >22. In a double-blind, between-groups trial, 31 "restrained" eaters were stabilized on either pexacerfont (300 mg/day for 7 days, then 100 mg/day for 21 days) or placebo...
December 2016: Psychopharmacology
Vijayapandi Pandy, Yasmin Khan
Morinda citrifolia L. commonly known as noni or Indian mulberry belongs to the family Rubiaceae. Noni fruit juice has recently become a very popular remedy for the treatment of several diseases, including psychiatric disorders. This study aimed to investigate the anticraving effect of Tahitian Noni® Juice (TNJ) against ethanol seeking behavior in ICR male mice using the conditioned place preference (CPP) test. The CPP procedure consisted of four phases: preconditioning, conditioning, extinction, and reinstatement...
November 1, 2016: Experimental Animals
Gianni Testino, Silvia Leone, Paolo Borro
Alcohol is one of the top three priority areas for public health worldwide. Alcohol is the second leading cause of liver disease, and 45-60% of cirrhosis deaths are alcohol related. In the United States it represents 30% of liver transplants and in Europe 50%. Twenty to 40% of cases of steatosis evolve into steatohepatitis, and l8-20% directly into liver cirrhosis; 20-40% of cases of steatohepatitis evolve into cirrhosis and 4-5% into hepatocellular carcinoma. This cascade of events takes 5 to 40 years. The temporal variability is related to the genetic pattern of the subject and the presence of associated risk factors...
August 2016: Minerva Medica
Bonnie Law, Matthew J Gullo, Mark Daglish, David J Kavanagh, Gerald F X Feeney, Ross M Young, Jason P Connor
BACKGROUND: Stress, craving, and depressed mood have all been implicated in alcohol use treatment lapses. Few studies have examined all 3 factors. Progress has been limited because of difficulties with craving assessment. The Alcohol Craving Experience Questionnaire (ACE) is a new measure of alcohol craving. It is both psychometrically sound and conceptually rigorous. This prospective study examines a stress-treatment response model that incorporates mediation by craving and moderation by depressed mood and pharmacotherapy...
May 2016: Alcoholism, Clinical and Experimental Research
G Milano, V Zavan, W M Natta, A Martelli, F Mattioli
WHAT IS KNOWN AND OBJECTIVE: Nalmefene, a new opioid system regulator, has recently been approved for the treatment of alcohol dependence, primarily for reducing heavy drinking days. CASES DESCRIPTION: Two patients with a diagnosis of alcohol use disorder were treated with nalmefene. Both patients developed fatigue and deep sleepiness after 2 days of treatment. Only after 1 day of drug discontinuation, symptoms normalized. WHAT IS NEW AND CONCLUSION: We have analysed symptoms' development before and after treatment discontinuation and the possible association with nalmefene therapy...
February 2016: Journal of Clinical Pharmacy and Therapeutics
Bruce Imbert, Jean-Claude Alvarez, Nicolas Simon
BACKGROUND: Baclofen is a GABA-B receptor agonist currently used in the treatment of spasticity. In recent years, baclofen has been used to reduce craving, voluntary alcohol intake and withdrawal syndrome of alcoholic patients. To date, there are no data available to estimate the relationship between baclofen exposure and the variation of craving. The first objective of this study was to investigate the variation of craving as a function of exposure, and the second was to explore the possible existence of baclofen responders and nonresponders...
September 2015: Alcoholism, Clinical and Experimental Research
Narayana Manjunatha, Vivek Benegal
OBJECTIVES: Priapism, or prolonged penile erection in the absence of sexual stimulation, may be a medical emergency. Many medications including antianxiety, antidepressants and antipsychotics have been implicated. This paper presents a case of priapism associated with topiramate use. METHODS: This is a description of case report where topiramate was prescribed as anticraving medication in a patient with alcohol dependence. Episodic priapism developed soon after topiramate was prescribed...
November 2015: General Hospital Psychiatry
Paolo Borro, Silvia Leone, Gianni Testino
Alcohol is the main risk factor for death and disability. The treatment of alcohol dependence (AD) is a complex activity as the variables are numerous; however, those which must necessarily be taken into account are the type of AD, the internal comorbidities and the presence of any psychiatric comorbidity. Liver problems are one of the most common causes of alcohol-related liver damage. 45% of deaths from cirrhosis are alcohol-related. Thus, the treatment of AD must often deal with a more or less severe liver disease, which influences the choice of anticraving drug...
2016: Current Drug Targets
Biswa Ranjan Mishra, Samir Kumar Praharaj, Mohammad Zia Ul Haq Katshu, Sukanto Sarkar, S Haque Nizamie
The objective of this study was to compare the anticraving efficacy of high-frequency repetitive transcranial magnetic stimulation (rTMS) of the right versus left dorsolateral prefrontal cortex (DLPFC) in patients with alcohol dependence. Twenty patients with alcohol dependence syndrome were randomly allocated to receive either right or left rTMS over the right DLPFC (10 sessions at 10 Hz frequency; 20 trains per session; 4.9 seconds per train and intertrain interval 30 seconds) and were assessed on the Alcohol Craving Questionnaire (ACQ-NOW) to measure craving...
2015: Journal of Neuropsychiatry and Clinical Neurosciences
Young-Chul Shin, Sam-Wook Choi, Juwon Ha, Jung Yeon Mok, Se-Won Lim, Jung-Seok Choi, Dai-Jin Kim
OBJECTIVES: This study examined differences in the clinical and treatment-related features of pathological gambling (PG) on the basis of the age of PG onset among pathological gamblers who sought treatment. METHODS: A total of 702 male outpatients with a primary diagnosis of PG and who were treated in a clinical practice were assessed by retrospective chart review. We selected the age of 25 years and younger as the threshold for "group 1." We then stratified the participants into 4 groups on the basis of the age of PG onset in 10-year intervals...
May 2014: Journal of Addiction Medicine
A G I Maremmani, L Rovai, F Rugani, S Bacciardi, L Dell'Osso, I Maremmani
BACKGROUND: Psychoses correlated with substance abuse prove to be more common in cases involving cannabinoids, stimulants, hallucinogens, alcohol and polyabuse. Among substance abusers, it has not been ascertained whether opioids have a psychotic effect. OBJECTIVES: The aim of this review is to investigate whether, among substances of abuse, a distinction can be drawn between pro-psychotic and anti-psychotic agents on the basis of the relationship between these substances and psychosis...
2014: European Review for Medical and Pharmacological Sciences
Michael M Berner, Sonja Wahl, Rigo Brueck, Katrin Frick, Robert Smolka, Monika Haug, Sabine Hoffmann, Iris Reinhard, Tagrid Leménager, Horst Gann, Anil Batra, Karl Mann
BACKGROUND: Goal of the presented study is to evaluate whether alcohol-dependent patients given additional individual psychotherapy after a heavy relapse during pharmacotherapy remain abstinent for longer than those who continue with pharmacotherapy alone. METHODS: In a randomized, multicenter study, 109 alcohol-dependent patients who had suffered a heavy relapse either while receiving anticraving medication or placebo were randomized into 2 groups. One group received medication, medical management, and additional individual, disorder-specific, cognitive-behavioral psychotherapy, while the control group received medication and medical management only...
April 2014: Alcoholism, Clinical and Experimental Research
Benjamin Boutrel, Nadia Steiner, Olivier Halfon
A general consensus acknowledges that drug consumption (including alcohol, tobacco, and illicit drugs) constitutes the leading cause of preventable death worldwide. But the global burden of drug abuse extends the mortality statistics. Indeed, the comorbid long-term debilitating effects of the disease also significantly deteriorate the quality of life of individuals suffering from addiction disorders. Despite the large body of evidence delineating the cellular and molecular adaptations induced by chronic drug consumption, the brain mechanisms responsible for drug craving and relapse remain insufficiently understood, and even the most recent developments in the field have not brought significant improvement in the management of drug dependence...
2013: Frontiers in Behavioral Neuroscience
Chiara Rapinesi, Georgios D Kotzalidis, Daniele Serata, Antonio Del Casale, Francesco S Bersani, Andrea Solfanelli, Paola Scatena, Ruggero N Raccah, Roberto Brugnoli, Vittorio Digiacomantonio, Paolo Carbonetti, Claudio Fensore, Roberto Tatarelli, Gloria Angeletti, Stefano Ferracuti, Paolo Girardi
BACKGROUND: Craving for alcohol is associated with abnormal activation in the dorsolateral prefrontal cortex. Deep transcranial magnetic stimulation (dTMS) has shown promise in the treatment of depression. There are few treatment options for treatment-resistant dysthymic disorder comorbid with alcohol use disorder. OBJECTIVE: To investigate the possible anticraving efficacy of bilateral dorsolateral prefrontal cortex high-frequency dTMS in 3 patients with comorbid long-term DSM-IV-TR dysthymic disorder and alcohol use disorder...
2013: Primary Care Companion to CNS Disorders
Shih-Ku Lin
Substance abuse or addictive disorder is a global problem. A greater understanding of the associated changes in brain pathophysiology supports the notion that pharmacological treatments are part of the necessary treatment options. Craving is a core symptom of addictive disorder. It refers to a strong desire to use drugs again either to re-experience positive effects or to diminish negative experiences. Currently there are a number of medicines that are effective in the treatment of addictive disorders. These medications can either be for substitution (same pharmacological effect as the abused substance) or anticraving (decrease the craving of the abused substance)...
February 2014: British Journal of Clinical Pharmacology
Claus M Gross, Kai Spiegelhalder, Josef Mercak, Bernd Feige, Jens M Langosch
We examined the relationship between relapse risk/duration of abstinence and hippocampal volume as well as the moderating role of various psychological factors in 34 patients who fulfilled the diagnostic criteria for alcohol dependence according to ICD-10 and DSM-IV and 16 healthy controls (9 females and 7 males). This study is part of a single-blind, placebo-controlled, parallel-group treatment trial with the anticraving substance acamprosate administered for 3 months. Patients underwent a psychometric evaluation and a measurement of the hippocampus with magnetic resonance imaging before beginning medication (T0)...
April 30, 2013: Psychiatry Research
Nicola J Kalk, Anne R Lingford-Hughes
Acamprosate is one of the few medications licensed for prevention of relapse in alcohol dependence, and over time it has proved to be significantly, if moderately, effective, safe and tolerable. Its use is now being extended into other addictions and neurodevelopmental disorders. The mechanism of action of acamprosate has been less clear, but in the decade or more that has elapsed since its licensing, a body of translational evidence has accumulated, in which preclinical findings are replicated in clinical populations...
February 2014: British Journal of Clinical Pharmacology
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