REINFORCING EFFECTS OF BENZODIAZEPINES IN ANXIETY

描述：(申请人摘要) 这项申请寻求四年的持续资金，以扩大我们的 一种新的自我用药检测方法的研究与开发 焦虑症门诊患者的行为特征。而苯二氮卓类药物 仍然是治疗焦虑的最有效的药物之一，担心 处方药依赖的风险往往会阻碍他们的合理使用。 七个实验将采用药物与安慰剂的选择范例来扩展 治疗中对成瘾行为危险因素的认识 使用苯二氮卓类药物进行自我治疗的人群。这将通过以下方式实现 检查不同的程序、药物、剂量和患者群体 都是以前研究过的；而且这样做的方式允许进行检查 人口统计学、心理学和精神病学的变量来预测 用药行为的个体差异和群体差异。 具体地说，我们将：1)扩大自我用药行为数据库 在没有滥用药物或大量药物使用的焦虑患者中 通过检查不同剂量的阿普唑仑或其他苯二氮类药物的病史 (氯硝西潘和奥沙西潘)具有最小的滥用潜力；2)进一步 通过检查涉及以下内容的自我用药行为来制定程序 有规律地划分每日给药模式，而不是不规律地使用 需要；“3)利用这些程序检查各种各样的病人 以扩大研究结果的普遍性；4)更好地 确定增加苯二氮卓类药物依赖风险的因素，以及5) 进一步检查认知行为疗法的有效性，以减轻 对药物的需求及其随之而来的风险。 这项研究对NIDA来说很重要，因为它开发了一种程序 研究有关处方药依赖的问题。此外，它还 提供有关自我用药和自我用药之间区别的基本数据 并增加了我们对成瘾的作用的理解 心理疗法在治疗精神障碍共病中的作用 吸毒行为的改变。

DESCRIPTION: (Applicant's Abstract) This application seeks four years of continued funding to expand our research and development of a novel procedure to examine the self-medication behavior of outpatients with anxiety disorder. Whereas benzodiazepines remain one of the most effective medications for anxiety, fears regarding risks of prescription drug dependence often prevent their rational use. Seven experiments will employ a drug vs. placebo choice paradigm to expand our knowledge of risk factors for addictive behavior in therapeutic populations self-medicating with benzodiazepines. This will be achieved by examining different procedures, drugs, doses, and patient populations than have been studied previously; and doing so in a way permitting examination of the demographic, psychological, and psychiatric variables that predict individual and population differences in medication use behavior. Specifically, we will: 1) expand the database on self-medication behavior in anxious patients without drug abuse or significant medication use histories by examining varying doses of alprazolam or other benzodiazepines (clonazepam and oxazepam) having minimal potentials for abuse; 2) further develop the procedure by examining self-medication behavior involving regular divided daily dosing patterns rather than irregular usage "as needed;" 3) utilize the procedures to examine a great range of patient populations so as to expand the generality of findings; 4) better characterize factors increasing risks of benzodiazepine dependence, and 5) further examine the effectiveness of cognitive behavior therapy to lessen the need for medication and its attendant risks. This research is important to NIDA because of its development of a procedure to study issues regarding prescription drug dependence. Moreover, it provides basic data regarding distinctions between self-medication and addictive behavior and increases our understanding of the role of psychotherapy in the treatment of co-morbid psychiatric disorders to affect change in drug taking behavior.