AlcoholAbuseNewApproachestoTreatment：治疗酒精滥用的新方法

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1、CravingAlcohol:GeneticandPharmacologicalFactorsKentHutchison,Ph.D.UniversityofColorado-BoulderObjectivesBackgroundandLong-TermObjectiveCurrenttreatmentsthattargetaddictionareonlymodestlyeffectiveDevelopmoreeffectivetreatmentsImmediateObjectivesCharacterizethebehavioralan

2、dbiologicalmechanismsassociatedwiththeetiologyofaddictionCharacterizegeneticfactorsthatinfluencethesemechanismsCharacterizingPharmacologicalandGeneticMechanismsIdentifyimportantbehavioralphenotypesIdentifyandtestunderlyingbiologicalmechanismsIdentifyandtestcandidategenet

3、icfactorsthatmayexplainindividualdifferencesinthesemechanismsandthebehavioralphenotypeInformsapharmacogeneticapproachtothedevelopmentandtestingofnewtreatmentsforaddictivedisordersHomerSimpson:AniIlustrationofPhenotypicHeterogeneityHomerSimpson:AniIlustrationofPhenotypicH

4、eterogeneityPhenotypesofInterestCueelicitedcravingforalcoholPharmacologicalMechanismsGeneticFactorsTreatmentdevelopmentSubjectivesensitivitytoalcoholStimulatoryandEuphoricEffectsSedativeEffectsPhysiologicalsensitivitytoalcoholStartleResponseHeartRateCue-ElicitedCravingas

5、aPhenotypeCue-ElicitedCravingClinicallyrelevantAssociatedwithlossofcontrolandrelapseTargetofnumerousbiologicalandbehavioralinterventionsCanbestudiedinthelaboratoryTriggeredbyenvironmentalcuesTriggeredbysmalldosesofalcoholAlcoholicsreportpowerfulcravingandlossofcontrolaft

6、erinitialdrinkAssociatedwithabiologicalmechanismdopamineneurotransmissioninmidbrain,prefrontalareas,D2andD4receptorsApersonaldescription…Study1:TestingtheBiologicalMechanismWouldexpectolanzapine(D2/D4antagonist)toattenuatecravingafteraprimingdoseofalcoholMethodsSample-26

7、heavydrinkers(Avgage=23;Drinkingdays=16;Drinks/Day=5.8)Randomassignment–Olanz(13),Pla(13)Twoexperimentalsessions–received3alcoholicdrinksor3controldrinksCravingandrewardassessedaftereachdrinkCravingResultsHutchisonetal.,2001,Psychopharmacology,28,234-239ConclusionsMedica

8、tionthatblocksdopaminereceptorsattenuatescravingafteralcoholconsumption,butdoesNOTinfluencetherewarding