Addiction Rehab: [Addictive Internet Use as a Comorbid Disorder Among Clients of an Adolescent Psychiatry – Prevalence and Psychopathological Symptoms].
[Addictive internet use as a comorbid disorder among clients of an adolescent psychiatry – prevalence and psychopathological symptoms].
Filed under: Addiction Rehab
Z Kinder Jugendpsychiatr Psychother. 2012 Sep; 40(5): 331-9
Müller KW, Ammerschläger M, Freisleder FJ, Beutel ME, Wölfling K
Objectives: Exzessive and addictive internet use fulfilling criteria of nonsubstance related addiction disorder is increasingly being discussed by scientists and clinicians alike. Its prevalence of about 3 % among minors points to a relatively frequent phenomenon that can lead to functional impairment and distress. However, there is still no evidence concerning its prevalence among underaged patients in psychiatric treatment. Methods: 81 patients between the age of 8 and 17 years were screened by a standardized instrument for internet addiction (AICA-S) to assess the prevalence of internet addiction among minors being treated in psychiatric inpatient settings. Their clinical symptoms were examined using Youth Self-Report and Child Behavior Checklist. Results: 11.3 % of the patients fulfilled the criteria of addictive internet use. These patients were older and more often affected by anxiety and depression than patients without internet addiction. Conclusions: Data suggest that internet addiction is a relevant factor among minors in psychiatric institutions. Those with comorbid internet addiction show distinct patterns of psychopathology and may require disorder-specific treatment.
HubMed – addiction
[The medical treatment of attention deficit hyperactivity disorder (ADHD) with amphetamines in children and adolescents].
Filed under: Addiction Rehab
Z Kinder Jugendpsychiatr Psychother. 2012 Sep; 40(5): 287-300
Frölich J, Banaschewski T, Spanagel R, Döpfner M, Lehmkuhl G
Introduction: Psychostimulants (methylphenidate and amphetamines) are the drugs of first choice in the pharmacological treatment of children and adolescents with attention deficit hyperactivity disorder (ADHD). Objective: We summarize the pharmacological characteristics of amphetamines and compare them with methylphenidate, special emphasisis being given to a comparison of effects and side effects of the two substances. Finally, we analyze the abuse and addiction risks. Methods: Publications were chosen based on a Medline analysis for controlled studies and meta-analyses published between 1980 and 2011; keywords were amphetamine, amphetamine salts, lisdexamphetamine, controlled studies, and metaanalyses. Results and Discussion: Amphetamines generally exhibit some pharmacologic similarities with methylphenidate. However, besides inhibiting dopamine reuptake amphetamines also cause the release of monoamines. Moreover, plasma half-life is significantly prolonged. The clinical efficacy and tolerability of amphetamines is comparable to methylphenidate. Amphetamines can therefore be used if the individual response to methylphenidate or tolerability is insufficient before switching to a nonstimulant substance, thus improving the total response rate to psychostimulant treatment. Because of the high abuse potential of amphetamines, especially in adults, the prodrug lisdexamphetamine (Vyvanse) could become an effective treatment alternative. Available study data suggest a combination of high clinical effect size with a beneficial pharmacokinetic profile and a reduced abuse risk. Conclusions: In addition to methylphenidate, amphetamines serve as important complements in the psychostimulant treatment of ADHD. Future studies should focus on a differential comparison of the two substances with regard to their effects on different core symptom constellations and the presence of various comorbidities.
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Tumour cell responses to new fibroblast growth factor receptor tyrosine kinase inhibitors and identification of a gatekeeper mutation in FGFR3 as a mechanism of acquired resistance.
Filed under: Addiction Rehab
Oncogene. 2012 Aug 6;
Chell V, Balmanno K, Little AS, Wilson M, Andrews S, Blockley L, Hampson M, Gavine PR, Cook SJ
Fibroblast growth factor receptors (FGFRs) can act as driving oncoproteins in certain cancers, making them attractive drug targets. Here we have characterized tumour cell responses to two new inhibitors of FGFR1-3, AZ12908010 and the clinical candidate AZD4547, making comparisons with the well-characterized FGFR inhibitor PD173074. In a panel of 16 human tumour cell lines, the anti-proliferative activity of AZ12908010 or AZD4547 was strongly linked to the presence of deregulated FGFR signalling, indicating that addiction to deregulated FGFRs provides a therapeutic opportunity for selective intervention. Acquired resistance to targeted tyrosine kinase inhibitors is a growing problem in the clinic but has not yet been explored for FGFR inhibitors. To assess how FGFR-dependent tumour cells adapt to long-term FGFR inhibition, we generated a derivative of the KMS-11 myeloma cell line (FGFR(Y373C)) with acquired resistance to AZ12908010 (KMS-11R cells). Basal phosphorylated FGFR and FGFR-dependent downstream signalling were constitutively elevated and refractory to drug in KMS-11R cells. Sequencing of FGFR3 in KMS-11R cells revealed the presence of a heterozygous mutation at the gatekeeper residue, encoding FGFR3(V555M); consistent with this, KMS-11R cells were cross-resistant to AZD4547 and PD173074. These results define the selectivity and efficacy of two new FGFR inhibitors and identify a secondary gatekeeper mutation as a mechanism of acquired resistance to FGFR inhibitors that should be anticipated as clinical evaluation proceeds.Oncogene advance online publication, 6 August 2012; doi:10.1038/onc.2012.319.
HubMed – addiction
Striatal dopamine release in schizophrenia comorbid with substance dependence.
Filed under: Addiction Rehab
Mol Psychiatry. 2012 Aug 7;
Thompson JL, Urban N, Slifstein M, Xu X, Kegeles LS, Girgis RR, Beckerman Y, Harkavy-Friedman JM, Gil R, Abi-Dargham A
Dopamine (DA) has a role in the pathophysiology of schizophrenia and addiction. Imaging studies have indicated that striatal DA release is increased in schizophrenia, predominantly in the precommissural caudate (preDCA), and blunted in addiction, mostly in the ventral striatum (VST). Therefore, we aimed to measure striatal DA release in patients with comorbid schizophrenia and substance dependence. We used [(11)C]raclopride positron emission tomography and an amphetamine challenge to measure baseline DA D(2)-receptor availability (BP(ND)) and its percent change post-amphetamine (?BP(ND), to index amphetamine-induced DA release) in striatal subregions in 11 unmedicated, drug-free patients with both schizophrenia and substance dependence, and 15 healthy controls. There were no significant group differences in baseline BP(ND). Linear mixed modeling using ?BP(ND) as the dependent variable and striatal region of interest as a repeated measure indicated a significant main effect of diagnosis, F(1,?24)=8.38, P=0.008, with significantly smaller ?BP(ND) in patients in all striatal subregions (all P?0.04) except VST. Among patients, change in positive symptoms after amphetamine was significantly associated with ?BP(ND) in the preDCA (r(s)=0.69, P=0.03) and VST (r(s)=0.64, P=0.05). In conclusion, patients with comorbid schizophrenia and substance dependence showed significant blunting of striatal DA release, in contrast to what has been found in schizophrenia without substance dependence. Despite this blunting, DA release was associated with the transient amphetamine-induced positive-symptom change, as observed in schizophrenia. This is the first description of a group of patients with schizophrenia who display low presynaptic DA release, yet show a psychotic reaction to increases in D(2) stimulation, suggesting abnormal postsynaptic D(2) function.Molecular Psychiatry advance online publication, 7 August 2012; doi:10.1038/mp.2012.109.
HubMed – addiction
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