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Lecture 7

PSYT 301 Lecture Notes - Lecture 7: Opioid Antagonist, Gaba Receptor, Naltrexone


Department
Psychiatry
Course Code
PSYT 301
Professor
Kathryn Gill
Lecture
7

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Rewel: expression of different subunits in the rat brain
gaba receptor subunit composition varies over different regions
implication is that alcohol sensitivity will be different, across various subunits
and brain regions
given the large number of associations between GABAa subunits, COGA
suggests that the predisposition to alcoholism may be inherited as a general
state of CNS disinhibition/hyperexcitability due to altered responsiveness to
GABA
GABA polymorphisms may result in impulsivity
recent research suggests that GABAa subunit polymorphisms may also affect
alcohol reward and responses
Alpha 4 may be related to the heredity of alcohol dependence
GABA changes may lead to behavioural differences
Solid finding, but mechanism is not unknown, alpha 2 or 4 polymorphisms do
not CAUSE alcohol dependence
Impulsive personality can cause people to make rash decisions
Pharmacotherapy for alcoholism:
placebo effect and desire to leave ward (or treatment) may alter the
effectiveness of drugs
wanting to please the physician, may lie to maintain relationship with the
practitioner
naltrexone: opioid antagonist, increased rates of abstinence, decreased cue-
elicited craving
non replication: FDA approval was based on one study, 3 trials
replicated it and PROJECT COMBINE showed no significant main
effects of acamprosate or naltrexone, alone OR in combination
Replication showed that no difference between naltrexone and
placebo
Topiramate: antiepileptic facilitates GABA and blocks glutamate
large dropout rate in trial, sedation and uncomfortability
small dose: risk of relapse was 56% lower
might be effective, more low dose studies needed
mimics effects of alcohol, smaller dose of an alcohol like substitute
Citalopram: anti-depressants (SSRIs) used to treat alcoholism
worst drinking outcomes in study, more consumption, greater number
of heavy drinking days, negative outcome from SSRI treatments
Student Presentation: Is cognitive bias modification an effective treatment therapeutic
technique for the treatment of alcohol dependence?
cognitive bias: subject to an individual’s construction of reality and can be an
adaptive or maladaptive
in alcohol disorders, cognitive biases have been associated with approach
tendencies
Pavlovian liked response to cues around drinking, doesn't have to be categorically
related
cognitive bias modification is an attempt to modify the automatic processes involved
in addiction
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