Literature DB >> 1957935

Clinical phenomenology and neurobiology of cocaine abstinence: a prospective inpatient study.

S L Satel1, L H Price, J M Palumbo, C J McDougle, J H Krystal, F Gawin, D S Charney, G R Heninger, H D Kleber.   

Abstract

OBJECTIVE: This study was undertaken to document symptoms and changes in dopaminergic function emerging after abrupt cessation of cocaine use.
METHOD: After admission, 22 patients with DSM-III-R cocaine dependence were observed drug free for 3 weeks. The patient-rated Ribicoff Abstinence Rating Scale, Symptom Rating Scale, Physical Symptom Scale, Patient Rated Anxiety Scale, Beck Depression Inventory, and visual analogue scales for 16 subjective states were completed daily, and nurses rated 13 patients with the global anxiety and depression items of the Short Clinical Rating Scale. Serial blood samples were obtained three times weekly, and the patients' levels of prolactin, growth hormone (GH), and homovanillic acid (HVA) were measured. Their prolactin and GH values were compared with those of matched normal subjects.
RESULTS: A total of 62 subjective symptom variables were evaluated. At baseline, the symptom ratings were mildly elevated. At 3 weeks there were significant decreases from baseline in 28 variables and nearly significant decreases in six additional variables. Nurse-rated anxiety and depression also changed, but in a more variable pattern. There was a small but significant increase from baseline over time in plasma prolactin, but there were no significant changes in GH or HVA. The patients' prolactin and GH values did not differ from those of the normal subjects.
CONCLUSIONS: These findings suggest that symptoms after inpatient cessation of uncomplicated cocaine addiction are relatively mild and decrease linearly over the first month. Evidence of dysregulated central dopamine function was limited. The findings do not support routine use of pharmacological agents in the inpatient management of such patients.

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Year:  1991        PMID: 1957935     DOI: 10.1176/ajp.148.12.1712

Source DB:  PubMed          Journal:  Am J Psychiatry        ISSN: 0002-953X            Impact factor:   18.112


  32 in total

1.  Neuroadaptation. Incubation of cocaine craving after withdrawal.

Authors:  J W Grimm; B T Hope; R A Wise; Y Shaham
Journal:  Nature       Date:  2001-07-12       Impact factor: 49.962

2.  Daily life hour by hour, with and without cocaine: an ecological momentary assessment study.

Authors:  David H Epstein; Kenzie L Preston
Journal:  Psychopharmacology (Berl)       Date:  2010-06-09       Impact factor: 4.530

Review 3.  Neuropsychiatric effects of cocaine use disorders.

Authors:  Charles U Nnadi; Olubansile A Mimiko; Henry L McCurtis; Jean Lud Cadet
Journal:  J Natl Med Assoc       Date:  2005-11       Impact factor: 1.798

4.  Anhedonia and amotivation in psychiatric outpatients with fully remitted stimulant use disorder.

Authors:  Adam M Leventhal; Christopher W Kahler; Lara A Ray; Kristen Stone; Diane Young; Iwona Chelminski; Mark Zimmerman
Journal:  Am J Addict       Date:  2008 May-Jun

5.  Functional consequences of cocaine re-exposure after discontinuation of cocaine availability.

Authors:  Thomas J R Beveridge; Hilary R Smith; Susan H Nader; Michael A Nader; Linda J Porrino
Journal:  Neuropharmacology       Date:  2014-06-19       Impact factor: 5.250

6.  The Obsessive Compulsive Cocaine Use Scale: development and initial validation of a self-rated instrument for the quantification of thoughts about cocaine use.

Authors:  Julia M Hormes; Scott F Coffey; David J Drobes; Michael E Saladin
Journal:  Drug Alcohol Depend       Date:  2011-09-03       Impact factor: 4.492

7.  Demographic and clinical characteristics of current comorbid psychiatric disorders in a randomized clinical trial for adults with stimulant use disorders.

Authors:  Diane Warden; Katherine Sanchez; Tracy Greer; Thomas Carmody; Robrina Walker; Adriane Dela Cruz; Marisa Toups; Chad Rethorst; Madhukar H Trivedi
Journal:  Psychiatry Res       Date:  2016-09-15       Impact factor: 3.222

8.  Tolerance-like attenuation to contingent and noncontingent cocaine-induced elevation of extracellular dopamine in the ventral striatum following 7 days of withdrawal from chronic treatment.

Authors:  W M Meil; J M Roll; J W Grimm; A M Lynch; R E See
Journal:  Psychopharmacology (Berl)       Date:  1995-04       Impact factor: 4.530

9.  Ondansetron augmentation in treatment-resistant obsessive-compulsive disorder: a preliminary, single-blind, prospective study.

Authors:  Stefano Pallanti; Silvia Bernardi; Sarah Antonini; Nikhilesh Singh; Eric Hollander
Journal:  CNS Drugs       Date:  2009-12       Impact factor: 5.749

10.  Blunted opiate modulation of prolactin response in smoking men and women.

Authors:  Darcy Shaw; Mustafa al'Absi
Journal:  Pharmacol Biochem Behav       Date:  2009-12-05       Impact factor: 3.533

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