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1.
J Psychoactive Drugs ; 44(5): 398-409, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-23457891

RESUMO

Substance use disorders (SUD) are inheritable and the culprit is hypodopaminergic function regulated by reward genes. We evaluated a natural dopaminergic agonist; KB220 intravenous (IV) and oral variants, to improve dopaminergic function in SUD. Our pilot experiment found a significant reduction of chronic symptoms, measured by the Chronic Abstinence Symptom Severity (CASS) Scale. The combined group (IV and oral) did significantly better than the oral-only group over the first week and 30-day follow-up period. Next, the combination was given to 129 subjects and three factors; Emotion, Somatic, and Impaired Cognition, with eigenvalues greater than one were extracted for baseline CASS-Revised (CASS-R) variables. Paired sample t-tests for pre and post-treatment scales showed significant declines (p = .00001) from pre- to post-treatment: t = 19.1 for Emotion, t = 16.1 for Somatic, and t = 14.9 for Impaired Cognition. In a two-year follow-up of 23 subjects who underwent KB220IV therapy (at least five IV treatments over seven days) plus orals for 30+ days: 21 (91%) were sober at six months, 19 (82%) having no relapse; 19 (82%) were sober at one year, 18 (78%) having no relapse; and 21 (91%) were sober two-years post-treatment, 16(70%) having no relapse. We await additional research and advise caution in interpreting these encouraging results.


Assuntos
Aminoácidos/uso terapêutico , Comportamento/efeitos dos fármacos , Agonistas de Dopamina/uso terapêutico , Transtornos Relacionados ao Uso de Substâncias/reabilitação , Administração Oral , Adulto , Aminoácidos/administração & dosagem , Doença Crônica , Cognição/efeitos dos fármacos , Agonistas de Dopamina/administração & dosagem , Emoções/efeitos dos fármacos , Emoções/fisiologia , Feminino , Humanos , Injeções Intravenosas , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Projetos Piloto , Recidiva , Recompensa , Centros de Tratamento de Abuso de Substâncias , Síndrome de Abstinência a Substâncias/psicologia
2.
Postgrad Med ; 122(6): 188-213, 2010 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-21084795

RESUMO

It is well established that in both food- and drug-addicted individuals, there is dopamine resistance due to an association with the DRD2 gene A1 allele. Evidence is emerging whereby the potential of utilizing a natural, nonaddicting, safe, putative D2 agonist may find its place in recovery from reward deficiency syndrome (RDS) in patients addicted to psychoactive chemicals. Utilizing quantitative electroencephalography (qEEG) as an imaging tool, we show the impact of Synaptamine Complex Variant KB220™ as a putative activator of the mesolimbic system. We demonstrate for the first time that its intravenous administration reduces or "normalizes" aberrant electrophysiological parameters of the reward circuitry site. For this pilot study, we report that the qEEGs of an alcoholic and a heroin abuser with existing abnormalities (ie, widespread theta and widespread alpha activity, respectively) during protracted abstinence are significantly normalized by the administration of 1 intravenous dose of Synaptamine Complex Variant KB220™. Both patients were genotyped for a number of neurotransmitter reward genes to determine to what extent they carry putative dopaminergic risk alleles that may predispose them for alcohol or heroin dependence, respectively. The genes tested included the dopamine transporter (DAT1, locus symbol SLC6A3), dopamine D4 receptor exon 3 VNTR (DRD4), DRD2 TaqIA (rs1800497), COMT val158 met SNP (rs4680), monoamine oxidase A upstream VNTR (MAOA-uVNTR), and serotonin transporter-linked polymorphic region (5HTTLPR, locus symbol SLC6A4). We emphasize that these are case studies, and it would be unlikely for all individuals to carry all putative risk alleles. Based on previous research and our qEEG studies (parts 1 and 2 of this study), we cautiously suggest that long-term activation of dopaminergic receptors (ie, DRD2 receptors) will result in their proliferation and lead to enhanced "dopamine sensitivity" and an increased sense of happiness, particularly in carriers of the DRD2 A1 allele. This is supported by a clinical trial on Synaptamine Complex Variant KB220™ using intravenous administration in > 600 alcoholic patients, resulting in significant reductions in RDS behaviors. It is also confirmed by the expanded oral study on Synaptose Complex KB220Z™, published as part 2 of this study. Future studies must await both functional magnetic resonance imaging and positron emission tomography scanning to determine the acute and chronic effects of oral KB220™ on numbers of D2 receptors and direct interaction at the nucleus accumbens. Confirmation of these results in large, population-based, case-controlled experiments is necessary. These studies would provide important information that could ultimately lead to significant improvement in recovery for those with RDS and dopamine deficiency as a result of a multiple neurotransmitter signal transduction breakdown in the brain reward cascade.


Assuntos
Alcoolismo/genética , Agonistas de Dopamina/uso terapêutico , Dependência de Heroína/genética , Polimorfismo de Nucleotídeo Único , Receptores de Dopamina D2/efeitos dos fármacos , Recompensa , Síndrome de Abstinência a Substâncias/tratamento farmacológico , Síndrome de Abstinência a Substâncias/genética , Alcoolismo/diagnóstico , Alcoolismo/tratamento farmacológico , Alelos , Eletroencefalografia/efeitos dos fármacos , Seguimentos , Dependência de Heroína/diagnóstico , Dependência de Heroína/tratamento farmacológico , Humanos , Injeções Intravenosas , Masculino , Projetos Piloto , Polimorfismo Genético , Receptores de Dopamina D2/genética , Medição de Risco , Síndrome de Abstinência a Substâncias/diagnóstico , Resultado do Tratamento , Adulto Jovem
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