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Biomedical subjects

Charles O'Brien

Publications and source records attributed to Charles O'Brien.

7 recordsLinked to original sources
PubMed2006

Naltrexone for probationers and parolees.

Heroin addiction is a chronic disorder that is usually associated with crimes aimed to obtain funds for the purchase of this illegal drug. When these addicted individuals are apprehended and incarcerated, they temporarily obtain drug-free status, but relapse quickly upon release. There is a medication approved by the Food and Drug Administration (naltrexone) that could prevent relapse and thus break this revolving door cycle. In combination with counseling, former inmates could devote energies to legal jobs or job training instead of drug seeking. The major reasons for the nonuse of this medication appear to be lack of knowledge about the medication and fear that the use of a medication that blocks opiate receptors is somehow unethical. This special issue presents data, discussions, and suggestions regarding the ethical use of naltrexone in incarcerated populations or in those under supervision for parole or probation.

Commitment of Persons with Psychiatric Disorders↗
PubMed2005

Neurobiology of addiction: treatment and public policy ramifications.

In the United States, efforts to treat addiction are hampered by prejudice and a public view that treats it as a disorder of self-control, not a disease. We highlight select advances in addiction research that, if disseminated to the public, could reverse these misconceptions and facilitate changes in policy to improve treatment access and care delivery for this highly prevalent disease.

Behavior, Addictive↗
PubMed2005

Cocaine abuse in schizophrenic patients treated with olanzapine versus haloperidol.

Comorbid cocaine abuse adversely affects clinical outcomes in schizophrenia. Using a prospective, randomized, parallel group design (N = 24), we tested the hypothesis that patients with schizophrenia treated with olanzapine have reduced cocaine craving and abuse compared with those treated with haloperidol. In addition, we examined whether this differential effect correlated with reductions in extrapyramidal symptoms, positive and negative symptoms, and/or depression. There were no significant differences overall in proportions of positive drug screens between treatment groups; no differences in positive, negative, or depressive symptoms; and few differences between treatment conditions in extrapyramidal symptoms. However, craving for cocaine was rated significantly lower by patients treated with haloperidol compared with patients treated with olanzapine. Important study limitations include a small sample size and high attrition rates. Larger controlled studies are necessary to determine optimal antipsychotic therapy for patients with schizophrenia and comorbid cocaine abuse.

Antipsychotic Agents↗
PubMed2003

A pilot trial of piracetam and ginkgo biloba for the treatment of cocaine dependence.

BACKGROUND: Chronic cocaine use is associated with cognitive deficits that may reduce the effectiveness of psychosocial treatment and promote relapse in newly abstinent cocaine-dependent patients. Nootropic agents, such as piracetam and ginkgo biloba, may improve cognitive function and reduce the incidence of relapse in these patients. METHODS: This was a 10-week, double-blind, placebo-controlled pilot trial involving 44 cocaine-dependent subjects. Subjects received either piracetam (4.8 g/day), ginkgo biloba (120 mg/day), or placebo. Subjects were required to attain abstinence from cocaine during a 2-week baseline phase demonstrated by providing at least one benzoylecgonine (BE)-negative urine toxicology screen. Outcome measures included treatment retention, urine toxicology screens, Clinical Global Impression (CGI) scores, and results from the Addiction Severity Index (ASI). RESULTS: Ginkgo biloba was not superior to placebo in any outcome measure. Piracetam was associated with more cocaine use and lower CGI scores compared to placebo. CONCLUSIONS: Neither piracetam nor ginkgo biloba appears to be a promising medication for the treatment of cocaine dependence.

Adolescent↗
PubMed2003

Glutamatergic agents for cocaine dependence.

Effective medications for cocaine dependence are needed to improve outcome in this chronic, relapsing disorder. Medications affecting glutamate function are reasonable candidates for investigation, given the involvement of glutamate circuits in reward-related brain regions and evidence of cocaine-induced glutamatergic dysregulation. In addition, it is increasingly apparent that glutamatergic mechanisms underlie several clinical aspects of cocaine dependence, including euphoria, withdrawal, craving, and hedonic dysfunction. Even denial, traditionally viewed as purely psychological, may result, in part, from dysfunctional glutamate-rich cortical regions. We review the involvement of glutamate in reward-related circuits, the acute and chronic effects of cocaine on these pathways, and glutamatergic mechanisms that contribute to the neurobiology of cocaine dependence. We also present preliminary data from our research of modafinil, a glutamate-enhancing agent with promise in the treatment of cocaine-addicted individuals.

Animals↗