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Amphetamine Dependence

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Johan Franck – One of the best experts on this subject based on the ideXlab platform.

  • Cue reactivity and opioid blockade in Amphetamine Dependence: A randomized, controlled fMRI study.
    Drug and alcohol dependence, 2018
    Co-Authors: Joar Guterstam, Nitya Jayaram-lindström, Jonathan Berrebi, Predrag Petrovic, Martin Ingvar, Peter Fransson, Johan Franck

    Abstract:

    Abstract Background The opioid antagonist, naltrexone, has been shown to reduce the risk of relapse in Amphetamine Dependence, but the mechanisms behind this effect are not well understood. We aimed to investigate if naltrexone attenuates cue reactivity and craving in Amphetamine Dependence. Methods Forty men with severe, intravenous Amphetamine Dependence were randomized to one dose of naltrexone (50 mg) or placebo. In a BOLD fMRI cue reactivity paradigm, they were exposed to drug-related and neutral films and gave subjective ratings of craving after each film. Twenty-nine patients left data of sufficient quality to be included in the final analysis. Results The drug-related films elicited strong subjective craving and BOLD activations of the striatum, cingulate cortex, and occipito-temporal visual attention networks. Longer history of Amphetamine use was associated with greater activations of the prefrontal cortex. Naltrexone as compared to placebo had no significant effects on brain activations or subjective ratings. Conclusion Patients with severe stimulant use disorder exhibit strong neural cue reactivity, the patterns of which are modulated by duration of drug use. In this sample, we found no evidence for any effects of naltrexone on cue reactivity.

  • Substitution therapy tested against Amphetamine Dependence
    Lakartidningen, 2016
    Co-Authors: Bloniecki Kallio, Joar Guterstam, Johan Franck

    Abstract:

    Amphetamine Dependence is relatively common in Sweden and it is the most frequently used substance among patients with intravenous drug abuse. Current treatment options are limited but recently substitution therapy with psychostimulant medication has been evaluated in several clinical trials. Such treatment is controversial in Sweden, perhaps due to the failure of experimental prescription of psychostimulants in the 1960s. Recent clinical trials however indicate that structured treatment programs with psychostimulants might have positive effects, although the results are inconsistent and the evidence base is still limited. Future research is needed in order to determine the potential role of substitution therapy for Amphetamine Dependence in clinical practice.

  • Methylphenidate for attention deficit hyperactivity disorder and drug relapse in criminal offenders with substance Dependence: a 24-week randomized placebo-controlled trial†
    Addiction (Abingdon England), 2013
    Co-Authors: Maija Konstenius, Nitya Jayaram-lindström, Joar Guterstam, Olof Beck, Björn Philips, Johan Franck

    Abstract:

    Aim

    To test the efficacy and safety of osmotic release oral system (OROS) methylphenidate (MPH) in doses up to 180 mg/day to treat attention deficit hyperactivity disorder (ADHD) and prevent any drug relapse in individuals with a co-diagnosis of ADHD and Amphetamine Dependence.

    Design

    Randomized placebo-controlled 24-week double-blind trial with parallel groups design.

    Setting

    Participants were recruited from medium security prisons in Sweden. The medication started within 2 weeks before release from prison and continued in out-patient care with twice-weekly visits, including once-weekly cognitive behavioural therapy.

    Participants

    Fifty-four men with a mean age of 42 years, currently incarcerated, meeting DSM-IV criteria for ADHD and Amphetamine Dependence.

    Measurements

    Change in self-reported ADHD symptoms, relapse to any drug use (Amphetamine and other drugs) measured by urine toxicology, retention to treatment, craving and time to relapse.

    Findings

    The MPH-treated group reduced their ADHD symptoms during the trial (P = 0.011) and had a significantly higher proportion of drug-negative urines compared with the placebo group (P = 0.047), including more Amphetamine-negative urines (P = 0.019) and better retention to treatment (P = 0.032).

    Conclusions

    Methylphenidate treatment reduces attention deficit hyperactivity disorder symptoms and the risk for relapse to substance use in criminal offenders with attention deficit hyperactivity disorder and substance Dependence.

Nitya Jayaram-lindström – One of the best experts on this subject based on the ideXlab platform.

  • Cue reactivity and opioid blockade in Amphetamine Dependence: A randomized, controlled fMRI study.
    Drug and alcohol dependence, 2018
    Co-Authors: Joar Guterstam, Nitya Jayaram-lindström, Jonathan Berrebi, Predrag Petrovic, Martin Ingvar, Peter Fransson, Johan Franck

    Abstract:

    Abstract Background The opioid antagonist, naltrexone, has been shown to reduce the risk of relapse in Amphetamine Dependence, but the mechanisms behind this effect are not well understood. We aimed to investigate if naltrexone attenuates cue reactivity and craving in Amphetamine Dependence. Methods Forty men with severe, intravenous Amphetamine Dependence were randomized to one dose of naltrexone (50 mg) or placebo. In a BOLD fMRI cue reactivity paradigm, they were exposed to drug-related and neutral films and gave subjective ratings of craving after each film. Twenty-nine patients left data of sufficient quality to be included in the final analysis. Results The drug-related films elicited strong subjective craving and BOLD activations of the striatum, cingulate cortex, and occipito-temporal visual attention networks. Longer history of Amphetamine use was associated with greater activations of the prefrontal cortex. Naltrexone as compared to placebo had no significant effects on brain activations or subjective ratings. Conclusion Patients with severe stimulant use disorder exhibit strong neural cue reactivity, the patterns of which are modulated by duration of drug use. In this sample, we found no evidence for any effects of naltrexone on cue reactivity.

  • Methylphenidate for attention deficit hyperactivity disorder and drug relapse in criminal offenders with substance Dependence: a 24-week randomized placebo-controlled trial†
    Addiction (Abingdon England), 2013
    Co-Authors: Maija Konstenius, Nitya Jayaram-lindström, Joar Guterstam, Olof Beck, Björn Philips, Johan Franck

    Abstract:

    Aim

    To test the efficacy and safety of osmotic release oral system (OROS) methylphenidate (MPH) in doses up to 180 mg/day to treat attention deficit hyperactivity disorder (ADHD) and prevent any drug relapse in individuals with a co-diagnosis of ADHD and Amphetamine Dependence.

    Design

    Randomized placebo-controlled 24-week double-blind trial with parallel groups design.

    Setting

    Participants were recruited from medium security prisons in Sweden. The medication started within 2 weeks before release from prison and continued in out-patient care with twice-weekly visits, including once-weekly cognitive behavioural therapy.

    Participants

    Fifty-four men with a mean age of 42 years, currently incarcerated, meeting DSM-IV criteria for ADHD and Amphetamine Dependence.

    Measurements

    Change in self-reported ADHD symptoms, relapse to any drug use (Amphetamine and other drugs) measured by urine toxicology, retention to treatment, craving and time to relapse.

    Findings

    The MPH-treated group reduced their ADHD symptoms during the trial (P = 0.011) and had a significantly higher proportion of drug-negative urines compared with the placebo group (P = 0.047), including more Amphetamine-negative urines (P = 0.019) and better retention to treatment (P = 0.032).

    Conclusions

    Methylphenidate treatment reduces attention deficit hyperactivity disorder symptoms and the risk for relapse to substance use in criminal offenders with attention deficit hyperactivity disorder and substance Dependence.

  • Genetic Variation of the Ghrelin Signalling System in Individuals with Amphetamine Dependence
    PloS one, 2013
    Co-Authors: Petra Suchankova, Nitya Jayaram-lindström, Elisabet Jerlhag, Staffan Nilsson, Kjell Torén, Annika Rosengren, Jörgen A. Engel, Johan Franck

    Abstract:

    The development of Amphetamine Dependence largely depends on the effects of Amphetamine in the brain reward systems. Ghrelin, an orexigenic peptide, activates the reward systems and is required for reward induced by alcohol, nicotine, cocaine and Amphetamine in mice. Human genetic studies have shown that polymorphisms in the pre-proghrelin (GHRL) as well as GHS-R1A (GHSR) genes are associated with high alcohol consumption, increased weight and smoking in males. Since the heritability factor underlying drug Dependence is shared between different drugs of abuse, we here examine the association between single nucleotide polymorphisms (SNPs) and haplotypes in the GHRL and GHSR, and Amphetamine Dependence. GHRL and GHSR SNPs were genotyped in Swedish Amphetamine dependent individuals (n = 104) and controls from the general population (n = 310). A case-control analysis was performed and SNPs and haplotypes were additionally tested for association against Addiction Severity Interview (ASI) composite score of drug use. The minor G-allele of the GHSR SNP rs2948694, was more common among Amphetamine dependent individuals when compared to controls (pc = 0.02). A significant association between the GHRL SNP rs4684677 and ASI composite score of drug use was also reported (pc = 0.03). The haplotype analysis did not add to the information given by the individual polymorphisms. Although genetic variability of the ghrelin signalling system is not a diagnostic marker for Amphetamine Dependence and problem severity of drug use, the present results strengthen the notion that ghrelin and its receptor may be involved in the development of addictive behaviours and may thus serve as suitable targets for new treatments of such disorders.

Olof Beck – One of the best experts on this subject based on the ideXlab platform.

  • Methylphenidate for attention deficit hyperactivity disorder and drug relapse in criminal offenders with substance Dependence: a 24-week randomized placebo-controlled trial†
    Addiction (Abingdon England), 2013
    Co-Authors: Maija Konstenius, Nitya Jayaram-lindström, Joar Guterstam, Olof Beck, Björn Philips, Johan Franck

    Abstract:

    Aim

    To test the efficacy and safety of osmotic release oral system (OROS) methylphenidate (MPH) in doses up to 180 mg/day to treat attention deficit hyperactivity disorder (ADHD) and prevent any drug relapse in individuals with a co-diagnosis of ADHD and Amphetamine Dependence.

    Design

    Randomized placebo-controlled 24-week double-blind trial with parallel groups design.

    Setting

    Participants were recruited from medium security prisons in Sweden. The medication started within 2 weeks before release from prison and continued in out-patient care with twice-weekly visits, including once-weekly cognitive behavioural therapy.

    Participants

    Fifty-four men with a mean age of 42 years, currently incarcerated, meeting DSM-IV criteria for ADHD and Amphetamine Dependence.

    Measurements

    Change in self-reported ADHD symptoms, relapse to any drug use (Amphetamine and other drugs) measured by urine toxicology, retention to treatment, craving and time to relapse.

    Findings

    The MPH-treated group reduced their ADHD symptoms during the trial (P = 0.011) and had a significantly higher proportion of drug-negative urines compared with the placebo group (P = 0.047), including more Amphetamine-negative urines (P = 0.019) and better retention to treatment (P = 0.032).

    Conclusions

    Methylphenidate treatment reduces attention deficit hyperactivity disorder symptoms and the risk for relapse to substance use in criminal offenders with attention deficit hyperactivity disorder and substance Dependence.

  • 1128 – Methylphenidate for ADHD in adults with substance Dependence: A 24-week randomized placebo-controlled trial
    European Psychiatry, 2013
    Co-Authors: Maija Konstenius, Nitya Jayaram-lindström, Joar Guterstam, Olof Beck, Björn Philips, Johan Franck

    Abstract:

    Introduction There is a lack of evidence for the efficacy of stimulant pharmacotherapy in patients with substance Dependence and comorbid attention deficit hyperactivity disorder (ADHD). Objective The aim of the present trial was to test the efficacy and safety of 180 mg extended release methylphenidate for treating ADHD in patients with Amphetamine Dependence. Method 54 incarcerated men, mean age 42 years, meeting the DSM-IV criteria for Amphetamine Dependence and ADHD were randomized to methylphenidate or placebo in a 24-week randomized double-blind, placebo-controlled trial, with parallel groups design. The medication started within 14 days before release from prison and continued in outpatient care with twice weekly visits including once weekly cognitive behaviour therapy. The primary end point was relapse to any drug use measured by urine toxicology. Secondary endpoints included relapse to Amphetamine use, retention to treatment, and change in selfrated ADHD symptoms. Results The methylphenidate group had significantly fewer drug positive urines compared to the placebo group (95% CI -0.31 to -0.05, P=.034), fewer Amphetamine positive urines, (95% CI -0.36 to -0.07, P=.019) and better retention to treatment (95% CI 15.64 to 78.58, P=.001). Compared to the placebo group, the methylphenidate group also significantly reduced their selfrated ADHD symptoms (95% CI -21.09 to -3.37, P=.008) during the 24-week treatment. Conclusions This is the first randomized clinical trial to demonstrate the efficacy of a stimulant treatment for substance dependent individuals with ADHD. The treatment with MPH led to reduction in drug use and a clinically relevant improvement of ADHD symptoms.

  • Sustained release methylphenidate for the treatment of ADHD in Amphetamine abusers: a pilot study.
    Drug and alcohol dependence, 2009
    Co-Authors: Maija Konstenius, Nitya Jayaram-lindström, Olof Beck, Johan Franck

    Abstract:

    The efficacy of stimulant treatment in patients with substance use disorders and comorbid attention deficit hyperactivity disorder (ADHD) has been tested for cocaine and alcohol Dependence but so far no studies have been conducted in Amphetamine dependent individuals. The present trial was a pilot study aiming to test the feasibility of treating Amphetamine dependent patients with comorbid ADHD with central stimulant medication. The study was a double-blind, placebo controlled trial with parallel groups design comparing the efficacy of a fixed dose (72mg) of OROS methylphenidate (MPH) with placebo (PL) in reducing ADHD symptoms in currently abstinent adults with Amphetamine Dependence and ADHD. Twenty-four treatment seeking patients who met the DSM IV criteria for Amphetamine Dependence and ADHD were randomized to MPH/PL. The trial was conducted at an outpatient facility with twice weekly visits, measuring ADHD symptoms and drug use. Patients rated their ADHD symptoms on a weekly basis and provided supervised urine specimens for drug toxicology twice weekly. All patients participated in weekly sessions of a skills training programme. Both the groups significantly reduced their self-rated ADHD symptoms during the 12-week treatment but there was no difference between the two treatment arms. Drug use, both measured by urine toxicology and self-report did not differ between the groups. No difference was found between the two groups with regards to craving for Amphetamine or in retention in treatment. Larger studies with higher doses combined with individual dosage and longer follow-up periods are warranted.