Clonidine Improved Laboratory-Measured Decision-Making Performance in Abstinent Heroin Addicts

Abstract

BackgroundImpulsivity refers to a wide spectrum of actions characterized by quick and nonplanned reactions to external and internal stimuli, without taking into account the possible negative consequences for the individual or others, and decision-making is one of the biologically dissociated impulsive behaviors. Changes in impulsivity may be associated with norepinephrine. Various populations of drug addicts all performed impulsive decision making, which is a key risk factor in drug dependence and relapse. The present study investigated the effects of clonidine, which decreased norepinephrine release through presynaptic alpha-2 receptor activation, on the impaired decision-making performance in abstinent heroin addicts.Methodology/Principal FindingsDecision-making performance was assessed using the original version of Iowa Gambling Task (IGT). Both heroin addicts and normal controls were randomly assigned to three groups receiving clonidine, 0, 75 µg or 150 µg orally under double blind conditions. Psychiatric symptoms, including anxiety, depression and impulsivity, were rated on standardized scales. Heroin addicts reported higher scores on the Barratt Impulsiveness Scale and exhibited impaired decision-making on the IGT. A single high-dose of clonidine improved the decision-making performance in heroin addicts.Conclusions/SignificanceOur results suggest clonidine may have a potential therapeutic role in heroin addicts by improving the impaired impulsive decision-making. The current findings have important implications for behavioral and pharmacological interventions targeting decision-making in heroin addiction.

Risky Decision-Making but Not Delay Discounting Improves during Inpatient Treatment of Polysubstance Dependent Alcoholics

“…Previously, several attempts have been made to enhance decision-making using pharmacological interventions. However, up to now results are inconsistent (27–29). The possibility of using psychosocial interventions may open a new window in developing new, more specific interventions.…”

Decision-making ability in current and past users of opiates: A meta-analysis

“…In studies that reported on groups that had been abstinent for an average of less than one month, these groups were classified as current users (Cheng et al, 2012;Kirby and Petry, 2004). For studies that reported baseline and follow-up testing using a behavioural measure, only the baseline values were entered into analyses (Baldacchino et al, 2015;Zhang et al, 2012). For studies that reported data for two or more decision-making measures (Ahn and Vassileva, 2016;Upton et al, 2012), effect sizes for each separate decision-making measure were pooled to create a combined decision-making effect size estimate.…”

Simultaneous blockade of dopamine and noradrenaline reuptake promotes disadvantageous decision making in a rat gambling task

“…In the rGT, performance was slightly impaired after treatment with the 5-HT1A receptor agonist 8-OHDPAT (Zeeb et al 2009). In heroin addicts, treatment with the alpha-2 adrenoceptor agonist clonidine improved decision making performance (Zhang et al 2012). However, the selective NA reuptake inhibitor reboxetine did not influence gambling task performance in healthy subjects (O’Carroll and Papps 2003).…”