Modafinil, but not escitalopram, improves working memory and sustained attention in long-term, high-dose cocaine users
Modafinil, but not escitalopram, improves working memory and sustained attention in long-term, high-dose cocaine users
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DOI：
10.1016/j.neuropharm.2012.06.064
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发表时间：
2013-01-01
影响因子：
4.7
通讯作者：
De La Garza, R., II
中科院分区：
文献类型：
--
作者：
Kalechstein, A. D.;Mahoney, J. J., III;De La Garza, R., II
目的：本研究的目的是确定莫达非尼、艾司西酞普兰和莫达非尼+艾司西酞普兰给药对长期、高剂量可卡因使用者样本中神经认知的影响。61名可卡因依赖者被随机分配接受安慰剂（n = 14），莫达非尼，200 mg，每日一次（n = 16），艾司西酞普兰，20 mg，每日一次（n = 16），或莫达非尼和艾司西酞普兰，每日一次（n = 15），在住院基础上持续5天。尿分析用于确认在入院当天和接下来的五天内戒断可卡因。基线神经认知评估，包括注意力/信息处理、情景记忆和工作记忆的测量，在洗脱期后和莫达非尼给药前立即进行。随访评估是在参与者接受莫达非尼或安慰剂治疗5天后进行的。重复测量，混合模型方差分析表明，莫达非尼管理与工作记忆广度的两个措施的表现显着改善（平均n-背跨度，最大n-back跨度）和视觉工作记忆测量的显著改善趋势（视觉准确性）和持续注意力的两个指标，反应时间的一致性（变异性）和冲动性的降低（持续性）。莫达非尼管理没有调制的信息处理速度或情节记忆的措施性能。艾司西酞普兰没有调制性能的认知措施，无论是单独或与莫达非尼。结论：本研究提供的初步数据显示，在一个样本的长期，高剂量的可卡因用户，管理的精神药物，如莫达非尼，可以提高性能的工作记忆的措施。此外，它证实了研究精神药物的相互作用的效用，以确认候选药物独立和相互作用地影响神经认知的方式。这些效果可能与可卡因依赖的治疗有关，其中修复受损的工作记忆可能与改善治疗结果有关。(C)2012爱思唯尔有限公司保留所有权利。
Objective: The purpose of the present study was to determine the effects of modafinil, escitalopram, and modafinil + escitalopram administration on neurocognition in a sample of long-term, high-dose cocaine users.Method: Sixty-one cocaine-dependent individuals were randomly assigned to receive placebo (n = 14), modafinil, 200 mg, once daily (n = 16), escitalopram, 20 mg, once daily (n = 16), or modafinil and escitalopram, once daily (n = 15), for five days on an inpatient basis. Urinanalysis was used to confirm abstinence from cocaine on the day of admission and the next five days. Baseline neurocognitive assessment, which included measures of attention/information processing, episodic memory, and working memory, was conducted immediately after the washout phase and prior to the administration of modafinil. The follow-up assessment was conducted after participants had received modafinil or placebo for five days.Results: Repeated-measures, mixed model analysis of variance showed that modafinil administration was associated with significantly improved performance on two measures of working memory span (mean n-back span, maximum n-back span) and a trend toward significant improvement on a measure of visual working memory (visual accuracy) and two measures of sustained attention, consistency of response time (Variability) and reduced impulsivity (Perseveration). Modafinil administration did not modulate performance on measures of information processing speed or episodic memory. Escitalopram did not modulate performance on measures of cognition, either alone or in combination with modafinil.Conclusions: This study provides initial data showing that, in a sample of long-term, high-dose cocaine users, administration of psychotropic medications, such as modafinil, can improve performance on measures of working memory. Moreover, it confirms the utility of studying the interactive effects of psychotropic medications to confirm the manner in which the candidate medications independently and interactively affect neurocognition. These effects are likely relevant in the treatment of cocaine dependence, in which the remediation of impaired working memory may be associated with improved treatment outcomes.This article is part of a Special Issue entitled 'Cognitive Enhancers'. (C) 2012 Elsevier Ltd. All rights reserved.