PubMed Health⌕ Search

Biomedical subjects

Vania Modesto-Lowe

Publications and source records attributed to Vania Modesto-Lowe.

8 recordsLinked to original sources
PubMed2005

The opioidergic-alcohol link : implications for treatment.

Preclinical and clinical data implicate the endogenous opioid system in alcohol dependence. In vitro studies show that rodent pituitary and hypothalamic tissue responds to acute exposure to alcohol by releasing beta-endorphins. In vivo studies suggest differential activity of endogenous opioid receptors in rodents with high and low alcohol preference. Similarly, humans with a family history of alcohol dependence also show a heightened endorphin response to an acute challenge of alcohol compared with those with no family history of alcohol dependence.The effects of opioid agonists and antagonists on rodent and human alcohol consumption further support the opioid-alcohol link. In rodents and humans, small doses of opioid agonists increase alcohol consumption, while pretreatment with large doses decreases consumption. The opioid antagonist naltrexone decreases rodent alcohol consumption, particularly in low doses under acute and intermittent schedules. Most clinical trials in patients with alcohol dependence support modest therapeutic effects of naltrexone in decreasing alcohol consumption. Efforts to identify subgroups of alcohol-dependent patients responsive to naltrexone, as well as psychosocial and pharmacological augmentation strategies, may further improve the clinical usefulness of the drug.

Alcoholism↗
PubMed2004

Nefazodone treatment of comorbid alcohol dependence and major depression.

BACKGROUND: Major depression is a common comorbid condition among individuals with alcohol dependence. This study examined the effects of nefazodone, a norepinephrine and serotonin reuptake blocker and 5-hydroxytryptamine-2 receptor antagonist, on mood and anxiety symptoms and drinking behavior in a sample of depressed alcoholics. METHODS: This study was a double-blind, placebo-controlled comparison of nefazodone (200-600 mg/day) or placebo in a sample of alcohol-dependent subjects (n = 41; 52% women) with current major depression. After a 1-week placebo lead-in period, subjects were randomly assigned to receive study medication and supportive psychotherapy for 10 weeks. RESULTS: Depressive and anxiety symptoms declined significantly over time. Although the nefazodone group showed greater reductions in these symptoms, the effects did not reach statistical significance. Nonetheless, nefazodone-treated subjects showed a significantly greater reduction in heavy drinking days and in total drinks compared with placebo-treated subjects. CONCLUSIONS: The lack of significant effects on depression and anxiety symptoms may reflect limited statistical power. Despite the small sample size, nefazodone significantly reduced some measures of alcohol consumption in this sample of depressed alcoholics.

Adult↗
PubMed2003

Effects of rapid tryptophan depletion on mood and urge to drink in patients with co-morbid major depression and alcohol dependence.

RATIONALE: Rapid tryptophan depletion (RTD) has been used to study central serotonin function and may therefore be useful in understanding co-morbid alcohol dependence (AD) and major depressive disorder (MDD). OBJECTIVES: To examine (1) the effect of RTD on mood and urge to drink among patients with AD and MDD and (2) the association of RTD effects with alleles of a functional polymorphism in the gene encoding the serotonin transporter protein. METHODS: Double-blind, placebo-controlled study, in which 14 treatment responders recruited from one of two placebo-controlled trials of serotonergic antidepressants were enrolled. Patients underwent two day-long sessions, which were either a tryptophan depletion session or a sham session. During each session, mood and urge for alcohol were measured at regular intervals. RESULTS: Five hours after RTD, plasma TRP concentrations decreased by 73.1%. There was a significant effect of session on both mood and the urge to drink. Genotype moderated the effect of session on mood, such that, during RTD, individuals homozygous for the long allele reported greater depression than did subjects with one or two copies of the S allele. CONCLUSIONS: This study provides support for the role of serotonergic neurotransmission in modulating mood and alcohol urges, and underscores the utility of these effects as a phenotype for genetic analysis. These findings may also help to identify alcoholics who are at greatest risk for MDD.

Adult↗
PubMed2002

Clinical uses of naltrexone: a review of the evidence.

The implication of the opioidergic system in the pathogenesis of various substance use disorders has led to renewed interest in expanding the clinical uses of naltrexone, an opioid antagonist. This article examines the evidence for the efficacy of naltrexone in a variety of substance use and psychiatric disorders. Naltrexone can be an effective treatment for alcohol and opioid dependence if issues of compliance are adequately addressed. Thus far, no definitive role has been found for naltrexone in the treatment of other psychiatric disorders. Further research needs to be done in self-injurious behavior, gambling, cocaine, and nicotine dependence.

Alcoholism↗
PubMed2002

Naltrexone depot (DrugAbuse Sciences).

DrugAbuse Sciences is developing naltrexone depot, a sustained-release (SR) injectable formulation of naltrexone for the potential treatment of alcoholism and opiate addiction. This formulation was developed to help alcoholics and heroin addicts overcome the problems with compliance experienced with the daily-administered tablet form of naltrexone [322165]. Phase III trials of naltrexone depot for the treatment of alcoholics and phase II trials of naltrexone depot for injectable suspension (Naltrel) for the treatment of opiate addiction are ongoing [426301].

Journal Article↗
PubMedDate not supplied

Alcohol dependence and suicidal behavior: from research to clinical challenges.

Epidemiological and clinical data suggest high rates of suicidal behavior in alcohol-dependent individuals. Suicide attempters are likely to be young, to be single or separated, and to have made prior attempts. They differ from non-attempters by higher levels of impulsive aggression, drug use, and psychiatric comorbidity, particularly personality and depressive disorders. Treatment-seeking, alcohol-dependent individuals often present with multiple risk factors. Early recognition of suicidal behavior is hindered, however, by insufficient data regarding the acute phenomenology of imminent risk. Similarly, little research is available to guide intervention efforts. Initial trials support the use of fluoxetine for the treatment of suicidal, alcohol-dependent persons with comorbid depressive disorders. Future studies may clarify the relative efficacy of various psychotherapeutic and pharmacological approaches to treating these patients.

Aggression↗