Modafinil decreases cocaine choice in human cocaine smokers only when the response requirement and the alternative reinforcer magnitude are large
Modafinil decreases cocaine choice in human cocaine smokers only when the response requirement and the alternative reinforcer magnitude are large
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DOI：
10.1016/j.pbb.2016.08.009
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发表时间：
2016-11-01
影响因子：
3.6
通讯作者：
Evans, Suzette M.
中科院分区：
文献类型：
--
作者：
Foltin, Richard W.;Haney, Margaret;Evans, Suzette M.
本研究考察了当参与者维持莫达非尼或安慰剂时，可卡因的反应努力（按下键盘按钮）和替代替代品的价值（玩金钱机会游戏的机会）与“免费”可卡因（没有反应努力）结合影响可卡因的选择。非寻求治疗的当前可卡因吸烟者入组一项安慰剂对照、双盲、受试者内研究，包括住院期和门诊期。受试者在一个住院阶段接受安慰剂胶囊（0 mg/天），在另一个住院阶段接受莫达非尼（300 mg/天）胶囊，以平衡顺序。两个15天住院期之间至少有8天的无药日，以允许药物清除。在每种药物治疗条件下，当可卡因的反应努力较低（500次反应/剂量）且具有低价值替代方案（2次游戏游戏赚钱）时，或当可卡因的反应努力较大（2500次反应/剂量）且具有更有价值的替代方案（4次游戏赚钱）时，参与者有机会自行给予烟熏可卡因（25 mg）。在这两种情况下，参与者在进行第一次选择之前接受了一次免费剂量的co-glucose（0，12，25或50 mg）。15人开始研究，7人完成研究。与可卡因的反应努力和替代值较低（5.3 +/-0.14）相比，当可卡因的反应努力和替代值较高（4.4 +/- 0.19）时，参与者选择较少的可卡因剂量。在选择可卡因之前，为个体提供免费的“启动”剂量的可卡因并没有改变可卡因的服用。莫达非尼减少可卡因的选择，只有当可卡因的反应努力和替代价值高。这些结果表明，莫达非尼可能是最有效的治疗时，强调使用可卡因的巨大的个人成本相结合。(C)2016 Elsevier Inc. All rights reserved.
This study examined how-response effort (pressing a keyboard button) for cocaine and the value of an alternative reinforcer (opportunity to play a game of chance for money) combined with 'free' cocaine (with no response effort) affected cocaine choice when participants were maintained on modafinil or placebo. Nontreatment-seeking current cocaine smokers were enrolled in a placebo-controlled, double-blind, within-subject study comprising both inpatient and outpatient phases. Participants were maintained on placebo capsules (0 mg/day) during one inpatient phase and modafinil (300 mg/day) capsules during another inpatient phase in counter-balanced order. A minimum of 8 medication-free days separated the two 15-day inpatient phases to allow for medication clearance. Under each medication condition participants had the opportunity to self-administer smoked cocaine (25 mg) when the response effort for cocaine was low (500 responses/dose) and had a low value alternative (2 game plays for money) or when the response effort for cocaine was large (2500 responses/dose) and had a more valuable alternative (4 game plays for money). Under both conditions, participants received one free dose of co-caine (0,12, 25 or 50 mg) prior to making their first choice of the session. Fifteen individuals began the study and 7 completed it Participants chose fewer cocaine doses when the response effort for cocaine and the alternative value was high (4.4 +/- 0.19) compared to when the response effort for cocaine and the alternative value was low (5.3 +/- 0.14). Providing individuals a free "priming" dose of cocaine prior to making their cocaine choice did not alter cocaine taking. Modafinil decreased cocaine choice only when the response effort for cocaine and the alternative value was high. These results suggest that modafinil may be most effective when combined with therapy emphasizing the large personal costs of using cocaine. (C) 2016 Elsevier Inc. All rights reserved.