NIH Study Sheds Light on How to Reset the Addicted Brain

Could drug addiction treatment of the future be as simple as an on/off switch in the brain? A study in rats has found that stimulating a key part of the brain reduces compulsive cocaine-seeking and suggests the possibility of changing addictive behavior generally.  The study, published in Nature, was conducted by scientists at the Intramural Research Program of the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health, and the University of California, San Francisco.

“This exciting study offers a new direction of research for the treatment of cocaine and possibly other addictions,” said NIDA Director Dr. Nora D. Volkow.  “We already knew, mainly from human brain imaging studies, that deficits in the prefrontal cortex are involved in drug addiction. Now that we have learned how fundamental these deficits are, we feel more confident than ever about the therapeutic promise of targeting that part of the brain.”

Compulsive drug-taking, despite negative health and social consequences, has been the most difficult challenge in human drug addiction. NIDA researchers used an animal model of cocaine addiction, in which some rats exhibited addictive behavior by pushing levers to get cocaine even when followed by a mild electric shock to the foot.  Other rats did not exhibit addictive responses.

The NIDA scientists compared nerve cell firing patterns in both groups of rats by examining cells from the prefrontal cortex. They determined that cocaine produced greater functional brain deficits in the addicted rats. Scientists then used optogenetic techniques on both groups of rats — essentially shining a light onto modified cells to increase or lessen activity in that part of the brain. In the addicted rats, activating the brain cells (thereby removing the deficits) reduced cocaine-seeking.  In the non-addicted rats, deactivating the brain cells (thereby creating the deficits) increased compulsive cocaine seeking.

“This is the first study to show a cause-and-effect relationship between cocaine-induced brain deficits in the prefrontal cortex and compulsive cocaine-seeking,” said NIDA’s Dr. Billy Chen, first author of the study. “These results provide evidence for a cocaine-induced deficit within a brain region that is involved in disorders characterized by poor impulse control, including addiction.”

“What I find to be an exceptional breakthrough is that our results can be immediately translated to clinical research settings with humans, and we are planning clinical trials to stimulate this brain region using non-invasive methods,” said Dr. Antonello Bonci, NIDA scientific director and senior author of the study. “By targeting a specific portion of the prefrontal cortex, our hope is to reduce compulsive cocaine-seeking and craving in patients.”

In 2011, there were an estimated 1.4 million Americans age 12 and older who were current (past-month) cocaine users, according to the National Survey on Drug Use and Health. However, there are currently no medications approved by the U.S. Food and Drug Administration for the treatment of cocaine addiction.

–National Institute of Drug Abuse

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One Year Later – Coping During the First Anniversary of Superstorm Sandy

Cal the disaster distress hotlineFROM: NYC Voluntary Organizations Active in Disaster, Emotional and Spiritual Care Committee

Superstorm Sandy’s first anniversary is October 29th. As members of organizations providing emotional and spiritual care to those affected by Sandy and all disasters, we’d like to acknowledge that many throughout our area are still experiencing a range of emotions. This includes those most directly affected, others across the city, and those who have responded.

We’d like to highlight to the public that it can be natural for disaster anniversaries to trigger a variety of strong reactions, and at the same time there are coping skills and resources that can comfort and help us recover.

Disasters such as Superstorm Sandy have on-going effects on our emotional, spiritual, physical and financial lives -and impact housing, employment, relationships, and so much more. Among many expressions, children may show behaviors from earlier years, teens and adolescents may act out or become isolated, and adults may turn to adverse coping behaviors such as increasing alcohol or drug use.  

Many individuals and communities show resilience after disasters.  Some may need extra time or support to recover – which is natural and to be expected. That support can come in different forms and from different sources. There is no timeline for when people should ‘get over’ the struggles they face.  As the anniversary of Sandy approaches people may feel anxious or overwhelmed.  Below are examples of things anyone can do to lessen these feelings:

  • Be aware that anniversaries and special days can be difficult, so be gentle with yourself and others
  • Connect to friends and loved ones, accept kindness and help, and reach out and ask for help if needed. Helping others can often help us as well. Consider volunteering at a favorite organization.
  • Do whatever you normally do to cope in positive ways with stress – take walks, go running, get outdoors – and be sure to make time to do these things in the days before, on, and after the 29th
  • Partake in rituals that may provide soothing comfort, and talk about your losses if you need to
  • Do something positive that you would like to do, rather than what you or others might think you should do for the anniversary
  • Draw on your faith/spirituality for guidance and support

If you have tried these healthy coping tips and still find yourself struggling, here are some local and national resources available to you:

  • If you need help/a connection to concrete resources, a trained and compassionate Disaster Case Manager from one of the 19 agencies participating in the NY State Disaster Case Management Program can answer your questions about recovery, work with you to develop a plan to address your needs, and connect you with appropriate community resources.  Call the Sandy DCM Referral line at 1-855-258-0483 (Monday-Friday, 9am – 5pm). For more info, visit
  • The Disaster Distress Helpline is also available 24/7 for New Yorkers and anyone in the U.S./territories affected by and struggling after Hurricane Sandy or any other natural or human-caused disaster (1-800-985-5990 / text “TalkWithUs” to 66746)

Evidence-Based Use of Antipsychotics: A Quick “How To”

How can you apply the framework and philosophy of evidence-based medicine to the use of antipsychotic medication?

Here to discuss is Leslie Citrome, MD, MPH. Dr Citrome is Clinical Professor of Psychiatry and Behavioral Sciences at New York Medical College in Valhalla. He is a scheduled speaker at this year’s US Psychiatric and Mental Health Congress in Las Vegas.

Here is a brief summary of some of the points Dr Citrome makes in his 5-minute audio presentation:

•Evidence-based medicine is not cookbook medicine. It means pairing your clinical judgment with the relevant scientific evidence and including your patients’ values and preferences into making a decision for your patient. It’s about individualizing therapy.

by Leslie L. Citrome, Psychiatric Times

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Limited Progress Made in Schizophrenia Understanding and Treatment

You’ve come a long way, baby. But maybe not long enough, according to Dr Rajiv Tandon, Professor of Psychiatry at the University of Florida College of Medicine and Chief of Psychiatric Services for North Florida/South Georgia Veterans Health System. Dr Tandon shared the evolution of schizophrenia diagnosis and highlighted the current status for attendees at the US Psychiatric and Mental Health Congress in Las Vegas.

Although the disease has been “recognized” for more than 100 years, we have only made a series of baby steps in understanding the etiology, pathology, and treatment of the disease, he said. Psychiatry has moved from very broad definitions, as was found in the DSM II, to extremely narrow definitions, as psychiatry created DSM III in reaction to DSM II. In the 1950s, the idea that “bad mothering” may cause schizophrenia became popular in response to Freud’s influences. With each new revision of the DSM, psychiatry committed to a bit more details in its etiology and pathology.

Starting in the 1980s, for instance, science recognized that genetics played an important role in schizophrenia, but nothing was known about the mode of transmission. In the 1990s, we learned genetics coupled with environment played a role in its etiology. Now, Tandon explained, we know that genetic factors are 60% to 80% liable for the disease. However, science still cannot point to a single or group of major genes responsible for such. On the other hand, he noted, research also demonstrated that some genes may have protective effects for developing schizophrenia. So while understanding of the genetic component has increased, there are still many unanswered questions.

by Heidi Anne Duerr, Psychiatric Times

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Study Finds Link Between Schizophrenia and Autoimmune Diseases

New data show that individuals with schizophrenia are at increased risk of developing autoimmune diseases, according to a study reported yesterday in AJP in Advance….”The increased risk of subsequent autoimmune diseases in individuals with schizophrenia may involve neuropsychiatric manifestations from the undiagnosed autoimmune disease, medical treatment or lifestyle associated with schizophrenia, or common etiological mechanisms, such as infections and shared genetic factors.”

–Psychiatric News Alert

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Sense of Belonging Increases Meaningfulness of Life

A new study finds that when social relationships provide an all important sense of belonging, people feel life has more meaning.

….It’s more than just bonding, therefore, but really feeling like you are fitting in with others which is associated with higher levels of meaningfulness.

Just the reverse effect has been shown in previous studies. People who feel excluded from social groups tend to feel that life has less meaning.


….Feeling that life is meaningful is important because:

  • People who feel life is meaningful are more likely to be in both good psychological and good physical health.
  • People who feel life isn’t meaningful are more likely to be depressed, to require therapy and even feel suicidal.

by Jeremy Dean, PsyBlog

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Antisocial Behavior Prior to Psychosis Points to Later Risk for Violence, Study Suggests

Individuals who engage in antisocial behavior before showing symptoms of schizophrenia are more likely to be violent after a first schizophrenia episode occurs.

“These data have implications for violence prediction and treatment in patients with schizophrenia,” Paul Appelbaum, M.D., told Psychiatric News. “[They] suggest that treatment targeting psychotic symptoms in higher-risk patients may not be enough to prevent violent behavior—interventions aimed specifically at propensities for violence may be needed as well.”

–Psychiatric News Alert

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Modest—But Clinically Useful—Changes for Psychotic Disorders in DSM-5

….With its poor validity and reliability in DSM-IV, the Work Group also tackled the schizoaffective disorder diagnosis, Tandon said. To better differentiate between schizophrenia with mood disorder and schizoaffective disorder, DSM-5 requires a look at the entire course of illness, he explained. Specific mood symptoms must be present for the majority of the illness (at least 50% of the time) to achieve the schizoaffective diagnosis. As a result of this change, Tandon expects there will be less schizoaffective diagnoses and an increase in schizophrenia with major mood disorder. Clinically speaking, that means a change in treatment approach for most patients, he added, with mood stabilizers being used more precisely in these patients.

by Heidi Anne Duerr

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Sleep ‘Detoxes’ The Brain, New Research Suggests

When you sleep, your brain undergoes a mop-up process that removes waste products linked to Alzheimer’s and dementia, according to new research published yesterday in the online version of Science.

….the researchers discovered that a waste-draining system they call the “glymphatic system” is ten times more active during sleep than while awake. This nocturnal cleaning system removes proteins called amyloid-beta, which accumulate into the plaques that contribute to Alzheimer’s disease and dementia.

by Melanie Haiken, Forbes

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