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L-tryptophan in neuropsychiatric disorders: a review.

Animal data indicate that serotonin (5-HT) is a major neurotransmitter involved in the control of numerous central nervous system functions including mood, aggression, pain, anxiety, sleep, memory, eating behavior, addictive behavior, temperature control, endocrine regulation, and motor behavior. Moreover, there is evidence that abnormalities of 5-HT functions are related to the pathophysiology of diverse neurological conditions including Parkinson's disease, tardive dyskinesia, akathisia, dystonia, Huntington's disease, familial tremor, restless legs syndrome, myoclonus, Gilles de la Tourette's syndrome, multiple sclerosis, sleep disorders, and dementia. The psychiatric disorders of schizophrenia, mania, depression, aggressive and self-injurious behavior, obsessive compulsive disorder, seasonal affective disorder, substance abuse, hypersexuality, anxiety disorders, bulimia, childhood hyperactivity, and behavioral disorders in geriatric patients have been linked to impaired central 5-HT functions. Tryptophan, the natural amino acid precursor in 5-HT biosynthesis, increases 5-HT synthesis in the brain and, therefore, may stimulate 5-HT release and function. Since it is a natural constituent of the diet, tryptophan should have low toxicity and produce few side effects. Based on these advantages, dietary tryptophan supplementation has been used in the management of neuropsychiatric disorders with variable success. This review summarizes current clinical use of tryptophan supplementation in neuropsychiatric disorders.

Dopamine

Similarity of behavior within addict couples. Part II. Addiction-related variables.

The similarity of behavioral patterns within addict couples before, during, and after a relationship is the focus of this paper. The correlations between partners in real and artificially constructed (pseudo) couples for employment, criminal activities, and other behaviors are examined. The effect of a relationship on behavior is also assessed before, during, and after treatment. Significant correlations during real relationships were found for employment, welfare, and illegal income. Joint couple entry into treatment appears to be more effective for women than men. Similarity within couples disappears when the relationship ends.

Behavior

The role of incest issues in relapse.

Comprehensive studies have established that relapse is the most common outcome of recovery programs treating addictive behaviors. This article examines the fact that relapse is often related to uncovering painful early childhood incest experiences that have been defended against through self-destructive addictive behaviors. Another aspect of relapse is the phenomenon of multiaddictions: withdrawal from an identified addictive behavior will often lead to the unmasking of other addictive behaviors. The phenomenon of cross-addiction is widely acknowledged in the addictions field, but the connection between cross-addiction and relapse needs to be more fully explored. This article focuses on the following points: (1) addictive behaviors may serve to defend against memories of sexual abuse; (2) unidentified incest material may precipitate relapse or result from relapse, and therefore must be considered as a possible component of treatment in recovery--indications for treatment in terms of 12-Step recovery in conjunction with therapy are explored; (3) relapse may indicate the existence of additional addictions that must be identified and explored in order for recovery to proceed; and (4) sex and love addiction is often found in conjunction with alcoholism, codependency and compulsive overeating, and often comes to light through the emergence of incest memories. The identification and treatment of this hidden addiction (i.e., sex and love addiction) will determine the extent and depth of recovery.

Child

Drug abuse, dependence, and addiction in chronic pain patients.

It is claimed that a significant percentage of chronic pain patients suffer from drug/alcohol abuse/dependency/addiction. To address this question, 24 articles alluding to chronic pain patient drug/alcohol dependence/addiction were reviewed according to the following criteria: method for drug misuse diagnosis, which drug misuse diagnosis used (abuse, dependence, or addiction), and percentage of patients within each diagnostic category of drug misuse. The result of the review indicated that only seven studies utilized acceptable diagnostic criteria and/or definitions for the drug misuse diagnoses and gave percentages of drug misuse. Within these seven studies, the prevalence percentages for the diagnoses for drug abuse, drug dependence, and drug addiction were in the range of 3.2-18.9%. It is concluded that these diagnoses occur in a significant percentage of chronic pain patients. However, there is little evidence in these studies that addictive behaviors are common within the chronic pain population.

Behavior, Addictive

Role of pituitary and related neuropeptides in alcoholism and pharmacodependence.

Evidence is accumulating that hormonal systems present in the pituitary and the brain play a critical role in behavioral homeostase. The hormones and their fragments, called neuropeptides, produced by these systems modulate neurotransmitter activity and thereby control brain functions. Disturbances in this hormonal control may result in psychopathology, including addiction. Vasopressin and related peptides decrease under certain conditions addictive behavior of experimental animals and humans and brain reward. The pituitary and brain opioid peptides are candidates to play an essential role in reward processes and may be common factors in addiction to various psychoactive drugs, including heroin and alcohol, and to habits. Other pituitary hormones, like ACTH, gamma 2-MSH and prolactin have also been implicated in brain reward and drug addiction. It is postulated that disturbances in the hormonal and neuropeptide systems may lead to a state in which addiction behavior can easily be elicited and that the hormonal climate in the body may be of relevance for the individual susceptibility to addictive drugs. It is proposed to analyse the relation between hormonal systems and addictive behavior.

Adrenocorticotropic Hormone

Similarity of behavior within addict couples. Part I. Methodology and narcotics patterns.

The development and initial assessment of a methodology for measuring the similarity of behavioral patterns within addicted couples over the duration of a relationship is presented. Two subsamples of addicts from methadone maintenance programs in southern California were established: one of couples who had a real relationship during their addiction and treatment careers, and a group of pseudocouples (matched as closely as possible) created from unrelated clients in the same programs. Narcotics use, abstinence, and support patterns are analyzed for couples before, during, and after their relationship. When it occurs during the relationship, treatment effects are also analyzed.

Adult

Cognitive processes and cognitive behavior therapy in the treatment of problem drinking.

Cognitive behavior Therapy has been shown to be an effective therapy for a wide range of clinical problems. However, the efficacy of CBT on addictive behavior is still unknown. This paper reviews the evidence for the efficacy of cognitive behavior therapy treatment for problem drinkers and examines its relationship with cognitive models of problem drinking. A computer search of the literature showed that only 13 studies met the criteria for inclusion in this review. This review indicated that there is evidence to show that cognitive behavior therapy can be successfully applied to addictive behaviors, in particular, problem drinking. However, there is lack of evidence to show that cognitive behavior therapy supports cognitive models of problem drinking. Future direction for research in this area is suggested.

Alcoholism

Precision Genomics: A Reality Having Universal Impact in a New Era of Psychiatry - Lessons Learned, Past and Present.

Addiction neuroscience explores the complex interplay between genetic, neurobiological, environmental, and socio-spiritual factors underlying substance and behavioral addictions. Over the past three decades, research in this domain has identified critical molecular and epigenetic mechanisms-particularly those affecting dopaminergic signaling and reward pathways-that contribute to both vulnerability and resilience to addictive behaviors. Central to this understanding is the concept of reward deficiency syndrome (RDS), first introduced by Kenneth Blum, which posits that hypodopaminergic functioning predisposes individuals to seek maladaptive rewards. Advances in neurogenetics, including the identification of key polymorphisms such as the DRD2 A1 allele, have paved the way for precision tools like the genetic addiction risk severity (GARS®) test. This test, alongside pro-dopaminergic nutraceutical interventions like KB220, demonstrates the potential for early detection and individualized treatment of "pre-addiction" risk states. Despite ongoing reliance on opioids for opioid use disorder (OUD), emerging paradigms advocate for dopamine homeostasis through non-addictive, integrative approaches. Furthermore, the integration of whole genome sequencing data can be used for Genome-Wide Association Studies (GWAS), multi-omics, and machine learning into clinical practice holds promise for advancing personalized medicine in addiction treatment. As the field progresses, addressing health equity and improving genomic representation across populations remain critical goals. This evolving framework underscores the importance of leveraging genomic insights to prevent, predict, and personalize interventions for addiction and mental illness at scale.

Disorder

From one addiction to another: life after alcohol and drug abuse.

Once the alcoholic or drug addict has stopped drinking or using drugs, other addictive behaviors are frequently adopted. These factors must be considered in planning the overall recovery program. Substances likely to be used to excess include nicotine, caffeine, sugar, chocolate, nutritional supplements and medicinal herbs. Addictive behaviors adopted by recovering persons include eating disorders, exercise and body building, workaholism, and dependency on one's own adrenalin. Breaking the cycle of addiction requires commitment to a program of self-growth and becoming responsible for one's actions.

Compulsive Behavior

Environments and addiction: a proposed taxonomy.

When reviewing the broad area that relates environments to addiction one is faced with an enormous volume of research with differing environmental and psychosocial factors, contrasting populations, a variety of addictive substances, and a range of addiction processes. For all these factors, there are important outcome variables. To survey this disparate literature, it is helpful to use a multiaxial model as a framework or taxonomy. In this way it is possible to see the effects that environments, broadly conceived, exert on addictive behaviors. A variety of environments is considered: interpersonal, organizational, cultural and physical, as one axis or dimension. The influence of this dimension on a second dimension relating to type of addiction is also examined. Finally, a dimension pertaining to the "life history" of addictions, from acquisition through maintenance, cessation, and relapse is considered in relation to the first two dimensions. While a variety of environmental factors affect addictive behaviors, current research indicates the need to take individual differences, cognitive mediation, and the interaction of the person with the environment into account. Significant areas that need further exploration are the failure of addictions to occur in some environments, and the development of secondary prevention approaches. Implications for intervention and directions for future research are suggested.

Cross-Cultural Comparison

Adolescent cocaine abuse. Addictive potential, behavioral and psychiatric effects.

Four hundred seventy-nine drug abusing adolescent patients enrolled in seven Straight, Inc. Adolescent Drug-Abuse Treatment Programs in five geographic regions across the United States were studied to determine the severity and patterns of cocaine abuse. Of these, 341 admitted to cocaine use and became part of this survey. Cocaine use was categorized as heavy, intermediate, or light. Areas examined were the addictive spectrum, psychosocial dysfunction, and psychiatric symptoms. Intermediate and heavy users of cocaine abused significantly less marijuana and inhalants than light cocaine abusers. Heavy and intermediate users were more likely to use cocaine intravenously and to use crack. They developed tachyphylaxis more frequently, progressed to weekly use in less than 3 months more frequently, and became preoccupied with obtaining and using cocaine significantly more frequently. They used more sedative hypnotics to calm themselves and engaged in more criminal behavior, such as stealing from parents and stores and passing bad checks. They had more arrests for possession of drugs, stole more cars, sold more drugs, and were more likely to trade sexual favors to obtain the drug. Heavy and intermediate users were significantly more psychiatrically disturbed than light users, becoming more suspicious, nervous, aggressive, and demonstrating increased symptoms of fatigue, sleeplessness, decreased appetite, and increasing cocaine dysphoria. All of these symptoms could be mistaken for psychiatric disorders. This study suggests that cocaine is as addictive in adolescents as in adults; possibly more so. It also causes psychosocial dysfunction and psychiatric symptoms. Further research into cocaine addiction among adolescents is indicated.

Adolescent

Refining models of dependence: variations across persons and situations.

Having established that tobacco smoking is addictive, research should proceed to refine our models of dependence on nicotine and other drugs. Current theories of addiction do not account for between- or within-subjects variations in addictive behavior. Recent evidence that some people can smoke for decades without developing dependence demonstrates the potential for individual differences in vulnerability to dependence. Study of such anomalous smokers may provide insight into the mechanisms underlying nicotine dependence. Current theory and data also fail to provide adequate accounts of situational variation in addictive behavior and of the developmental progression from initial experimentation to dependence.

Humans

Restrained eaters are rapidly habituating sensation seekers.

Several authors have pointed to similarities between eating disorders and addictive behaviors. In earlier studies, addicts were found to score high on the Sensation Seeking Scale (SSS) and to habituate rapidly to neutral stimuli. In this study, we found experimental support for an addiction model of eating disorders: restrained eaters also scored significantly higher on the Sensation Seeking Scale and also habituated significantly quicker to a series of neutral stimuli than unrestrained eaters. No clear evidence was found for the hypothesis that restrained eaters score lower on measurements of anxiety. It is hypothesized that rapid habituation promotes sensation seeking, which may be manifested in excessive consumption of either drugs or food. Restraint may be a strategy to prevent negative consequences of sensation seeking and excessive consumption. The model is related to earlier experimental findings.

Adult