Impact of acute guanfacine administration on stress and cue reactivity in cocaine-dependent individuals.
Impact of acute guanfacine administration on stress and cue reactivity in cocaine-dependent individuals.
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DOI：
10.3109/00952990.2014.945590
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发表时间：
2015-03
期刊：
影响因子：
--
通讯作者：
McRae-Clark A
中科院分区：
文献类型：
--
作者：
Moran-Santa Maria MM;Baker NL;Ramakrishnan V;Brady KT;McRae-Clark A
压力和药物配对线索增加可卡因依赖个体的药物渴求和去甲肾上腺素能活性，因此减弱去甲肾上腺素能活性的药物可能是可卡因依赖个体的有效治疗选择。研究α-2肾上腺素能受体激动剂胍法辛急性给药对可卡因依赖个体对多种复发风险因素反应的影响。在一项双盲、安慰剂对照研究中，可卡因依赖者（N=84）随机接受2 mg胍法辛（n=50）或安慰剂（n=34）。在每个治疗组中，受试者被随机分配到应激组（胍法辛n=26;安慰剂n=15）或无应激组（胍法辛n=24;安慰剂n=19）。压力组的参与者进行了特里尔社会压力测试。每组的受试者先接触中性线索，然后接触可卡因相关线索。比较四组间血浆皮质醇和主观反应。无压力胍法辛组报告了对可卡因线索的更大渴望，与中性线索相比（p<0.001）。胍法辛应激组在中性提示时的主观应激比基线时更大（p=0.032）。可卡因提示剂增加胍法辛无应激组的主观应激（p<0.001）。胍法辛对应激组和非应激组的皮质醇水平均无影响（均p>0.70）。这项研究发现，单次2 mg剂量的胍法辛对单独的应激和线索反应或应激和药物线索的相互作用没有影响。在可卡因依赖者中，急性2 mg剂量的胍法辛可能不是有效的治疗策略。
Stress and drug-paired cues increase drug craving and noradrenergic activity in cocaine-dependent individuals, thus medications that attenuate noradrenergic activity may be effective therapeutic treatment options for cocaine-dependent individuals. To examine the impact of acute administration of the α-2 adrenergic receptor agonist guanfacine on responses to multiple risk factors for relapse in cocaine-dependent individuals. In a double-blind, placebo-controlled study, cocaine-dependent individuals (N=84), were randomized to receive either 2 mg guanfacine (n=50) or placebo (n=34). Within each treatment arm, subjects were randomized to either a stress (guanfacine n=26; placebo n=15) or a no-stress (guanfacine n=24; placebo n=19) group. Participants in the stress group performed the Trier Social Stress Test. Subjects in each group were exposed to a neutral cue and then to cocaine-related cues. Plasma cortisol and subjective responses were compared between the four groups. The no-stress guanfacine group reported greater craving in response to cocaine-cues as compared to the neutral cue (p<0.001). The guanfacine stress group reported greater subjective stress at the neutral cue than at baseline (p=0.032). The cocaine-cue increased subjective stress in the guanfacine (p<0.001) no-stress group. There were no effects of guanfacine on cortisol levels in either the stress or no stress groups (all p>0.70). This study found no effects of a single 2 mg dose of guanfacine on reactivity to stress and cues alone or on the interaction of stress and drug cues. In cocaine-dependent individuals an acute 2 mg dose of guanfacine may not be an effective therapeutic treatment strategy.
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