Maintenance Therapy With Opium Tincture for Injecting Drug Users; Implications for Prevention From Viral Infections.

Maintenance Therapy with Opium Tincture for Injecting Drug Users; Implications for Prevention from Viral Infections.

Hepat Mon. 2013 Apr; 13(4): e8334
Alam Mehrjerdi Z, Zarghami M

HubMed – addiction

Norjizak Injection: A Critical Risk for Transmitting Blood-Borne Infectious Diseases.

Hepat Mon. 2013 Apr; 13(4): e8272
Alam Mehrjerdi Z

HubMed – addiction

Attention Deficit Hyperactivity Disorder (ADHD) in the adult patients: view of the clinician.

Actas Esp Psiquiatr. 2013 May; 41(3): 185-195
Quintero J, Balanzá-Martínez V, Correas J, Soler B, Geda-A G

Introduction: ADHD is a clinical entity that persists during adolescence and even into adulthood in many cases. Assuming that most adults with ADHD will not have been diagnosed in childhood, the GEDA-A group (Adult ADHD study group) considered that it was important to assess how much knowledge the clinicians had about ADHD in order to provide for the identification of the disorder in the adult. Methodology: A cross-sectional survey to be fill out by specialists involved in the diagnosis and treatment of ADHD was designed. This survey included questions on awareness of the disease in the different stages of life (childhood, adolescence and adulthood). Results: 484 clinicians, with a mean age of 45 years (95% CI 44-46) and 17 years of professional experience (95% CI 16-18) filled out the survey. 384 were psychiatrists (79.5%), 67 neurologists (13.9%) and 19 addictive behavior specialists (3.9%). When their opinions were compared about the diagnosis and treatment of ADHD in childhood, adolescence and adulthood, significant differences of opinion were found regarding the three stages in all the dimensions analyzed (p<0.0001). Assessment in adulthood systematically showed a lower degree of awareness compared to ADHD in childhood and adolescence. Conclusions: In the clinician’s opinion, ADHD in adulthood is a clinical entity that is less defined and whose diagnosis is not as clear, compared to ADHD in the other stages in life. The GEDA-A group suggests that it is necessary to have more comprehensive training that makes the diagnosis and treatment of ADHD in adults easier. HubMed – addiction

Effects of Methylphenidate on Resting-State Functional Connectivity of the Mesocorticolimbic Dopamine Pathways in Cocaine Addiction.

JAMA Psychiatry. 2013 Jun 26; 1-11
Konova AB, Moeller SJ, Tomasi D, Volkow ND, Goldstein RZ

IMPORTANCE Cocaine addiction is associated with altered resting-state functional connectivity among regions of the mesocorticolimbic dopamine pathways. Methylphenidate hydrochloride, an indirect dopamine agonist, normalizes task-related regional brain activity and associated behavior in cocaine users; however, the neural systems-level effects of methylphenidate in this population have not yet been described. OBJECTIVE To use resting-state functional magnetic resonance imaging to examine changes in mesocorticolimbic connectivity with methylphenidate and how connectivity of affected pathways relates to severity of cocaine addiction. DESIGN Randomized, placebo-controlled, before-after, crossover study. SETTING Clinical research center. PARTICIPANTS Eighteen nonabstaining individuals with cocaine use disorders. INTERVENTIONS Single doses of oral methylphenidate (20 mg) or placebo were administered at each of 2 study sessions. At each session, resting scans were acquired twice: immediately after drug administration (before the onset of effects [baseline]) and 120 minutes later (within the window of peak effects). MAIN OUTCOMES AND MEASURES Functional connectivity strength was evaluated using a seed voxel correlation approach. Changes in this measure were examined to characterize the neural systems-level effects of methylphenidate; severity of cocaine addiction was assessed by interview and questionnaire. RESULTS Short-term methylphenidate administration reduced an abnormally strong connectivity of the ventral striatum with the dorsal striatum (putamen/globus pallidus), and lower connectivity between these regions during placebo administration uniquely correlated with less severe addiction. In contrast, methylphenidate strengthened several corticolimbic and corticocortical connections. CONCLUSIONS AND RELEVANCE These findings help elucidate the neural systems-level effects of methylphenidate and suggest that short-term methylphenidate can, at least transiently, remodel abnormal circuitry relevant to the pathophysiologic characteristics of cocaine addiction. In particular, the effects of methylphenidate within striatal and cortical pathways constitute a potentially viable mechanism by which methylphenidate could facilitate control of behavior in cocaine addiction. HubMed – addiction

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