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Biomedical subjects

F H Gawin

Publications and source records attributed to F H Gawin.

At least 19 recordsLinked to original sources
PubMed2000

Psychiatric comorbidity of methamphetamine dependence in a forensic sample.

The objective of this study was to examine the association between psychiatric symptoms and methamphetamine dependence. A four-hour survey was administered to 1,580 arrestees sampled from the 14 most populous counties in California. The survey included items assessing demographic profile, history of substance dependence, and psychiatric symptomatology. In the 12 months prior to the assessment, methamphetamine-dependent individuals were more likely to report depressive symptoms and suicidal ideation than individuals denying methamphetamine dependence, even after controlling for demographic profile and dependence on other drugs. Methamphetamine-dependent individuals also were more likely to report a need for psychiatric assistance at the time of the interview. These findings suggest that methamphetamine-dependent individuals are at greater risk to experience particular psychiatric symptoms. Further study to determine the etiology of these symptoms is warranted.

Adolescent↗
PubMed1997

The face of craving? Facial muscle EMG and reported craving in abstinent and non-abstinent cocaine users.

We studied 12 subjects, half of whom were current cocaine users and half of whom were abstinent former users, using facial EMG before and after subjects completed questionnaires describing cocaine use, craving and mood. Changes in zygomatic EMG tone before and after cocaine questionnaire completion correlated with reported craving in current users. This preliminary study suggests that facial EMG correlates with cocaine craving in current users.

Adult↗
PubMed1994

Psychotherapy and pharmacotherapy for ambulatory cocaine abusers.

BACKGROUND: At present, there is no consensus regarding effective treatment for cocaine abuse or the most productive roles for the two major forms of treatment, pharmacotherapy and psychotherapy. We conducted the first randomized clinical trial evaluating psychotherapy and pharmacotherapy, alone and in combination, as treatment for ambulatory cocaine abusers. METHODS: One hundred thirty-nine subjects were assigned to one of four conditions offered over a 12-week abstinence initiation trial: relapse prevention plus desipramine hydrochloride, clinical management plus desipramine, relapse prevention plus placebo, and clinical management plus placebo. All treatments were manual-guided, delivered by experienced therapists, and monitored to promote the integrity of both forms of treatment. RESULTS: First, although all groups showed significant improvement, significant main effects for medication or psychotherapy, or their combination, were not found for treatment retention, reduction in cocaine use, or other outcomes at 12 weeks. Second, baseline severity of cocaine use interacted differently with psychotherapy and pharmacotherapy: higher-severity patients had significantly better outcome when treated with relapse prevention than with clinical management, while desipramine was associated with improved abstinence initiation among lower-severity subjects. Third, desipramine was significantly more effective than placebo in reducing cocaine use over 6, but not 12, weeks of treatment. Fourth, depressed subjects had greater reduction in cocaine use than nondepressed subjects and had better response to relapse prevention than to clinical management. CONCLUSION: These findings underscore the significance of heterogeneity among cocaine abusers and the need to develop specialized treatments for clinically distinct subgroups of cocaine abusers.

Adult↗
PubMed1992

Neuropsychological impairment in chronic cocaine abusers.

Twenty chronic cocaine abusers were compared with age and education matched controls using standardized neuropsychological assessment procedures to determine whether the cocaine abusers were impaired. Fifty percent of the cocaine abusers in contrast to 15% of the controls scored in the impaired range on the summary index of the Neuropsychological Screening Exam. The cocaine abusers also performed more poorly on the Halstead Category Test, the Symbol Digit Modalities Test, the WAIS-R Arithmetic Test, and a test of verbal memory (forgetting). In the cocaine abuser sample, neuropsychological performance was related to the amount and recency of cocaine use, suggesting a direct role of cocaine on cognitive functioning.

Adult↗
PubMed1992

Intravenous cocaine challenges during desipramine maintenance.

Intravenous challenges with placebo and cocaine doses ranging from 0.125 to 0.5 mg/kg were administered to five subjects using a within subjects design during placebo and active desipramine (DMI) maintenance at a fixed dose of 150 mg daily for at least 10 days. The "high" reported after cocaine infusion was not altered by DMI, but "desire for cocaine" after a single dose was attenuated. Together with the results of clinical trials of DMI for cocaine abuse, these laboratory results suggest that DMI may reduce cocaine craving both during and between cocaine binges. Physiologically, baseline heart rate was higher on DMI, but the incremental heart rate response to cocaine was attenuated.

Adult↗
PubMed1991

Cocaine addiction: psychology and neurophysiology.

Cocaine was considered incapable of producing dependence in 1980 but was recently proclaimed the drug of greatest national health concern. Recent clinical and preclinical investigations demonstrate that cocaine produces unique abuse and withdrawal patterns that differ from those of other major abused drugs and suggest that long-term cocaine abuse produces neurophysiological alterations in specific systems in the central nervous system that regulate the capacity to experience pleasure. It will be necessary to develop clinically pertinent research models before these findings can be considered definitive, but these evolving ideas have already led to applications of promising experimental treatments for cocaine abuse.

Cocaine↗
PubMed1991

Clinical features of cocaine-induced paranoia.

OBJECTIVE: The authors' objective was to assess the frequency and nature of cocaine-induced paranoia. METHOD: They interviewed 50 cocaine-dependent men consecutively admitted to a 28-day rehabilitation program. RESULTS: Thirty-four (68%) of the 50 men reported highly distressing transient paranoid states in the context of cocaine use. The men who experienced paranoia did not differ from those who did not in age, race, or measures of cocaine use. The mean duration and amount of cocaine use before development of paranoia of the men who reported paranoia were not significantly different from the mean lifetime duration and amount of cocaine used by the men who did not report paranoia. Paranoia became more severe and developed more rapidly with continued cocaine use. CONCLUSIONS: The transient paranoid state appears to be a common feature of cocaine dependence and does not seem to be simply a result of exceeding a threshold of use. Rather, affected individuals might possess a predisposition to this drug-induced state. The fact that paranoia became more severe and developed more rapidly with continued drug use is consistent with a sensitization model of cocaine-induced paranoia. In vulnerable individuals, limbic sensitization may underlie its expression, but localization to a specific brain region is speculative. Quantity of use and route of administration do not appear directly to predispose to this phenomenon. Future investigations must be aimed at uncovering the markers and meaning of vulnerability to transient paranoia in heavy cocaine users.

Adult↗
PubMed1991

A comparative trial of psychotherapies for ambulatory cocaine abusers: relapse prevention and interpersonal psychotherapy.

Despite the widespread use of psychotherapy as treatment for cocaine abuse, the effectiveness of psychotherapy has not been explored through clinical trials. Forty-two outpatients who met DSM-III criteria for cocaine abuse were randomly assigned to one of two forms of purely psychotherapeutic treatments of cocaine abuse, either relapse prevention (RPT) or interpersonal psychotherapy (IPT). Subjects assigned to relapse prevention were more likely than subjects in IPT to attain three or more continuous weeks of abstinence (57 versus 33%), be classified as recovered at the point of treatment termination (43 versus 19%), and complete treatment (67 versus 38%). Whereas these differences did not reach statistical significance, significant differences by treatment group did emerge when subjects were stratified by severity of substance use: Among the subgroup of more severe users, subjects who received RPT were significantly more likely to achieve abstinence (54 versus 9%) and be classified as recovered (54 versus 0%). Among the subgroups of subjects with lower severity of substance abuse, outcome was comparable for both treatment types. Comparison of results from this investigation with historical controls from a structurally similar pharmacotherapy trial suggests that purely psychotherapeutic treatments may be both viable and effective approaches for many ambulatory cocaine abusers.

Adolescent↗
PubMed1990

Evidence for altered desipramine disposition in methadone-maintained patients treated for cocaine abuse.

Plasma concentrations of desipramine (DMI) and its 2-hydroxy metabolite (OHDMI) were compared among 72 patients being treated with desipramine for either depression (n = 39) or cocaine abuse (n = 33). Eleven cocaine abusers who were concurrently maintained on methadone had a significantly lower ratio of DMI dose to plasma concentration (0.9) than the depressives (2.2) or nonmethadone cocaine abusers (2.0). Their OHDMI/DMI ratios were significantly lower (0.19) than for either the other 22 cocaine abusers (0.39) or the depressed (0.50) patients. This difference was not due to DMI dosage. Although the underlying mechanism cannot be determined from these plasma studies, possible reduced hydroxylation of DMI in methadone patients suggests the need for DMI plasma monitoring.

Adult↗
PubMed1989

Migrainelike headache and cocaine use.

Migrainelike headache is a sequela of cocaine use. This finding expands the range of neurological complications of cocaine use and is consistent with the potential role of serotonin in the development of migraine. In these subjects, the desire to avoid the cocaine-induced headache eventually became part of the resolve to quit use.

Adult↗