Introduction: Magnesium influences the nervous system via its actions on the release and metabolism of neurotransmitters, and abnormal magnesium metabolism has been implicated in several neuropsychiatric disorders with prominent mood symptoms. The aim of this study was to compare the serum levels of magnesium of cocaine addicts to those of heroin addicts and normal controls. We also attempted to clarify the relationship between the pathophysiology of cocaine abuse and magnesium levels by investigating their association with various clinical dimensions. Methods: Eighty-five consecutive subjects with a history of cocaine or opiate use disorders were recruited, evaluated and compared with 100 controls. The cocaine and heroin abusers were assessed with a 10-cm Visual Analogue Scale, the Symptom Check List-90 Revised, the Brown-Goodwin Scale, and the Barrat Impulsiveness Scale. Results: Magnesium levels were higher in the cocaine group compared to the opiate group and control. Male subjects had lower magnesium levels than the females of all three groups. Scores of impulsiveness, aggressiveness, craving and psychiatric symptomatology were not significantly different between the opiate and cocaine addicts. Discussion: This is the first study evaluating the magnesium level in cocaine addicts. Cocaine addicts showed higher total plasma magnesium levels than opiate addicts and normal controls, even though they remained in the normal range. The roles of the psychiatric comorbidity, of a pharmacokinetic association and of a pharmacodynamic interaction are discussed. Further prospective studies comparing serum levels of cocaine at different times are needed.
Personality disorders (PD) are described as enduring patterns of markedly deviant and pervasive inner experiences and behaviors, with onset in adolescence, which lead to severe distress or impairment. Patients suffering with major depressive disorder (MDD) display higher rates of comorbidity with personality disorders, often complicating the treatment, and worsening the outcome. Borderline personality disorder (BPD) is the most common of PD and is frequently associated with MDD, with which shares several features. The most part of research agrees on the fact that comorbid BPD in MDD patients quite double the poor response to treatments. Moreover, no treatment strategy stands out currently to emerge as more effective in these cases, thus urging the call for the need of a new approach. Herein, we revise the current literature on BPD, its neurobiology and comorbidity with MDD, as well as the more recent treatment strategies used. Then, based on its pharmacology, we propose a possible role of trazodone as a valuable tool to approach underlying BPD in MDD
Backgroung and Aims:Leptin is a 16-kDa protein secreted from white adipocytes; it acts by binding to specific hypothalamic receptors to alter the expression of several neuropeptides regulating neuroendocrine function, food intake and the whole body energy balance. Actually leptin is considered a modulator of withdrawal-induced craving in alcoholic subjects. We studied the hypothesis that leptin might modulate cocaine craving in detoxified cocaine abusers, evaluating any possible correlation with metabolic, hormonal and psychometric parameters.Methods:A sample of 50 cocaine dependent subjects, according to DSM-IV-TR, has been evaluated as follows: Body Mass Index, blood pressure, heart rate, substance and drug consumption, triglicerides, cholesterol, plasma leptin value, cortisol, insulin, ACTH, FT3, FT4, TSH and: SHAPS (Snaith Hamilton Pleasure Scale), VASc/f/s (Visual-Analogue-Scale for cocaine/food/sex), CCQ (Cocaine-Craving-Questionnaire), Barratt Impulsiveness Scale, HAM-D, HAM-A at baseline and after 15 days of abstinence.Results:Leptin levels, corrected for the BMI, resulted positively correlated with CCQ (p<.05). CCQ was positively correlated with VASc (p<.001). SHAPS was positively correlated with VASc (p<.05), CCQ (p<.05), HAM-A (p<.05) and HAM-D (p<.05). Finally HAM-A was negatively correlated with VASs (p<.05). These data are confirmed even after 15 days from baseline.Conclusions:In our sample leptin correlates with cocaine craving measured by CCQ, independently from the hypothalamic-pituitary-adrenal axis. At baseline VASc (mean) was less than VAS f and s mean score, confirming the shifting craving phenomenon. Although our data confirm the correlation between leptin and cocaine craving, further studies are required.
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