Associated With Intrathecal Baclofen Treatment and Duloxetine in Patients With Multiple Sclerosis.
Associated with intrathecal baclofen treatment and duloxetine in patients with multiple sclerosis.
Int J Immunopathol Pharmacol. 2012 Jan-Mar; 25(1 Suppl): 51S-56S
Ranieri M, Putignano P, Fiore P, Santamato A, Megna G, Bellomo RG, Cristella G, Saggini R, Megna M
Baclofen is now used in treatment of patients with severe spasticity secondary to neurological diseases through the direct infusion of the drug into the subarachnoid space with an implanted programmable pump. Among patients whose quality of life improved after the use of intrathecal systems, a very important role belongs to people with multiple sclerosis (MS): a disease that due to a great variety of symptoms and signs, seriously affects the activities of daily living. Among the clinical manifestations of MS are also found mental health problems including depression mood. The drugs most commonly offered, for treatment of depression in patients with MS, are selective serotonin reuptake inhibitors (SSRIs), reuptake inhibitors of serotonin and norepinephrine (SNRIs) and tricyclic antidepressants (TCA). Duloxetine presents a high affinity for transporters reuptake of serotonin and noradrenalin, and exerts its activity on both molecules. In addiction, Duloxetine has demonstrated very effective in treatment of depressive disorders of mood as demonstrated by scientific evidences about the utility of Duloxetine in the modulation of painful physical symptoms associated with depression and in treatment of pain associated with diabetic neuropathy. The purpose of our study is to evaluate the effects of antidepressant therapy with duloxetine, 60 mg/day in 7 patients with multiple sclerosis treated with intrathecal baclofen for spastic modulation of tone. The experience we gained, according to data from several multicenter trials confirmed the efficacy of Baclofen intrathecally administered, especially with regards to modulation of spasticity. Our study also showed, although the limitations of a small sample size still, a good clinical response to combined treatment Baclofen intrathecal/duloxetine 60 mg/day. HubMed – addiction
Nitric Oxide (NO) Signaling as a Potential Therapeutic Modality Against Psychostimulants.
Curr Pharm Des. 2013 Apr 5;
Liddie S, Balda MA, Itzhak Y
Abuse of psychostimulants presents a significant health and social problem worldwide. Traditionally, the dopaminergic system has received much attention for its role in the development and manifestation of addictive behavior. The identification of the close interaction between the dopaminergic and glutamatergic pathway and by extension the nitric oxide (NO) signaling pathway (the nitrergic system) has provided a broader scope on the mechanisms underlying the development of addictive behavior following exposure to cocaine and methamphetamine. NO signaling is associated with the acquisition and maintenance of several behavioral phenotypes induced by cocaine and methamphetamine (METH), as well as in METH-induced dopaminergic depletion. Because it appears that NO signaling influences response to reward, memory formation, and free radical-induced neurotoxicity, pharmacotherapies targeting NO signaling pathway may prove beneficial in the treatment of psychostimulants abuse. HubMed – addiction
Addictions And Stress: Clues For Cocaine Pharmacotherapies.
Curr Pharm Des. 2013 Apr 5;
Picetti R, Schlussman SD, Zhou Y, Ray B, Ducat E, Yuferov V, Kreek MJ
Addictions are chronic relapsing brain diseases, with behavioral manifestations. Three main factors contribute to the development of an addiction: environment, including stress, the reinforcing effects of the drug, and genetics. In this review we will discuss the involvement of the dysregulation of the stress responsive hypothalamic-pituitary-adrenal (HPA) axis in the acquisition of, and persistence to drug addiction (Section B). Addictions to specific drugs such as cocaine/psychostimulants, alcohol, and mu-opioid receptor agonists (e.g., heroin) have some common direct or downstream effects, including modulation of dopaminergic systems. Through its action on the dopaminergic signaling pathways, cocaine affects the HPA axis, and brain nuclei responsible for movements, and rewarding effects. Several neurobiological systems have been implicated with cocaine addiction, including dopamine, serotonin and glutamate systems, opioid receptor and opioid neuropeptide gene systems, stress-responsive systems including CRF, vasopressin and orexin. The use of animal models (Sections C and D) has been essential for studying the individual vulnerabilities to the effects of drugs of abuse and the neural pathways and neurotransmitters affected by these drugs. Basic clinical research has revealed important relationship between cocaine use, HPA axis responsiveness, and gender (Section E). Finally, we will discuss gene polymorphisms that are associated with drug use (Section F). Results from animal models and basic clinical research have shown important interactions between the dopaminergic and the opioid systems. Hence, compounds modulating the opioid system may be beneficial in treating cocaine addiction. HubMed – addiction
Lipid Transmitter Signaling As A New Target For Treatment Of Cocaine Addiction: New Roles For Acylethanolamides And Lysophosphatidic Acid.
Curr Pharm Des. 2013 Apr 5;
Orio L, Pavón FJ, Blanco E, Serrano A, Araos P, Pedraz M, Rivera P, Calado M, Suárez J, de Fonseca FR
This review analyzes the roles of lipid transmitters, especially those derived from the cleavage of membrane phospholipids, in cocaine-associated behaviors. These lipid signals are important modulators of information processing in the brain, affecting transmitter release, neural plasticity, synaptogenesis, neurogenesis, and cellular energetics. This broad range of actions makes them suitable targets for pharmaceutical development of cocaine addiction therapies because they participate in the main cellular processes underlying the neuroadaptations associated with chronic use of this psychostimulant. The main lipid transmitters reviewed here include a) acylethanolamides and acylglycerols acting on cannabinoid receptors, such as anandamide and 2-arachidonoylglycerol; b) acylethanolamides that do not act on cannabinoid receptors, such as oleoylethanolamide; c) eicosanoids derived from arachidonic acid, including prostaglandins; and d) lysophosphatidic acid, focusing on the role of its LPA-1 receptor. Direct experimental evidence for the significance of these lipids in cocaine-related behaviors is presented and discussed. Additionally, the roles for both their biosynthesis and degradation pathways, as well as the participation of their receptors, are examined. Overall, lipid transmitter signaling can offer new targets for the development of therapies for cocaine addiction. HubMed – addiction
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