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 研究和开发一种新的程序，以检查自我药疗 门诊焦虑症患者的行为。 而苯二氮卓类药物 仍然是最有效的药物之一，焦虑，恐惧， 处方药依赖性的风险往往妨碍其合理使用。 七个实验将采用药物与安慰剂选择范例来扩展 我们对成瘾行为的危险因素的了解， 使用苯二氮卓类药物的人群。 为实现这些目标将 检查不同的程序，药物，剂量和患者人群， 以前已经研究过了;这样做的方式允许检查 人口统计学、心理学和精神病学的变量， 药物使用行为的个体和人群差异。 具体而言，我们将：1）扩大关于自我药疗行为的数据库 在没有滥用药物或大量使用药物的焦虑患者中 通过检查不同剂量的阿普唑仑或其他苯二氮卓类药物 （氯硝西泮和奥沙西泮）具有最小的滥用潜力; 2）进一步 通过检查自我药疗行为来制定程序， 定期每日分次给药模式，而不是不规则使用“， 需要;”3）利用程序来检查大范围的病人 （4）扩大调查结果的一般性;（4）更好地 描述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 对药物的需求及其伴随的风险。 这项研究对NIDA很重要，因为它开发了一种程序， 研究处方药依赖性的问题。 而且 提供了关于自我药疗和 成瘾行为，并增加了我们的理解的作用， 共病精神障碍的心理治疗 改变吸毒行为。

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.