Treatment of methamphetamine abuse: research findings and clinical directions

Cretzmeyer, Margaret; Vaughan-Sarrazin, Mary; Huber, Diane L.; Block, Robert I.; Hall, James A.

doi:10.1016/s0740-5472(03)00028-x

Cited by 162 publications

(128 citation statements)

References 11 publications

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“…Although behavioral consequences associated with long-term METH exposure have been extensively documented in METH abusers (Cretzmeyer et al, 2003;Ling et al, 2006;Meredith et al, 2005), the corresponding magnitude and duration of brain alterations remain unclear due, in part, to the paucity of relevant human data. The framework for postulating METH-associated brain changes in humans has been derived mainly from results of experimental METH studies, predominantly in rodents (Seiden, 1985(Seiden, , 1996Bowyer and Holson, 1995;Davidson et al, 2001;Cadet et al, 2003) and relatively fewer in nonhuman primates (Fischman and Schuster, 1977;Melega et al, 1997;Madden et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

Long-Term Methamphetamine Administration in the Vervet Monkey Models Aspects of a Human Exposure: Brain Neurotoxicity and Behavioral Profiles

Melega

Jorgensen

Laćan

et al. 2007

Neuropsychopharmacol

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Methamphetamine (METH)-associated alterations in the human striatal dopamine (DA) system have been identified with positron emission tomography (PET) imaging and post-mortem studies but have not been well correlated with behavioral changes or cumulative METH intake. Animal studies that model some aspects of human long-term METH abuse can establish dose-dependency profiles of both behavioral changes and potential brain neurotoxicities for identifying consequences of particular cumulative exposures. Based on parameters from human and our monkey pharmacokinetic studies, we modeled a prevalent human METH exposure of daily multiple doses in socially housed vervet monkeys. METH doses were escalated over 33 weeks, with final dosages resulting in estimated peak plasma METH concentrations of 1-3 mM, a range measured in human abusers. With larger METH doses, progressive increases in abnormal behavior and decreases in social behavior were observed on 'injection' days. Anxiety increased on 'no injection' days while aggression decreased throughout the study. Thereafter, during 3 weeks abstinence, differences in baseline vs post-METH behaviors were not observed. Post-mortem analysis of METH brains showed 20% lower striatal DA content while autoradiography studies of precommissural striatum showed 35% lower [ 3 H]WIN35428 binding to the DA transporter. No statistically significant changes were detected for [ 3 H]dihydrotetrabenazine binding to the vesicular monoamine transporter (METH-lower by 10%) or for [ 3 H]SCH 23390 and [ 3 H]raclopride binding to DA D1 and D2 receptors, respectively. Collectively, this long-term, escalating dose METH exposure modeling a human abuse pattern, not associated with high-dose binges, resulted in dose-dependent behavioral effects and caused persistent changes in presynaptic striatal DA system integrity.

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Section: Introductionmentioning

confidence: 99%

Long-Term Methamphetamine Administration in the Vervet Monkey Models Aspects of a Human Exposure: Brain Neurotoxicity and Behavioral Profiles

Melega

Jorgensen

Laćan

et al. 2007

Neuropsychopharmacol

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“…52,59 Smoking or injecting is accompanied by an intense rush lasting only a few minutes. Ingesting and snorting are accompanied by a more delayed euphoria without the intense rush.…”

Section: 58mentioning

confidence: 99%

“…Ingesting and snorting are accompanied by a more delayed euphoria without the intense rush. Methamphetamine is commonly used in a binge-and-crash pattern and is associated with increased sex drive 59 and rougher sex that may lead to genital bleeding and abrasions. Methamphetamine availability has increased throughout the United States.…”

Section: 58mentioning

confidence: 99%

Update and Overview of Practical Epidemiologic Aspects of HIV/AIDS among Injection Drug Users in the United States

Garfein²,

et al. 2006

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In a changing public health landscape in which local, state, and federal agencies must confront threats of bioterrorism, emerging infections, and numerous chronic diseases, transmission of HIV among injection drug users (IDUs) continues to be an important public health issue and one of the driving forces behind the HIV epidemic. Using a computerized MEDLINE search of published articles from January 1981 through October 2005, we conducted a literature review of practical epidemiologic aspects of HIV/AIDS among IDUs in the United States. Although recent trends indicate a decline in the proportion of newly diagnosed HIV infections associated with injection drug use, drug-use behaviors overall still account for 32% of new HIV diagnoses. Factors in addition to syringe sharing contribute to HIV transmission among IDUs: risky sexual behaviors, sharing of drug preparation equipment and drug solutions, and contextual and social factors. Promising approaches for HIV prevention include rapid HIV testing, office-based substance abuse treatment, behavioral interventions, improved communication about syringe exchange programs, and case management. HIV among IDUs continues to be an important public health problem in the 21st century. It is imperative that public health agencies continue to monitor and combat the HIV epidemic among IDUs to ensure that hard-won gains will not be eroded.

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“…Weight loss represents still another attribute of MA as indicated in both human [1][2][3][4] and animal [5,6] studies. In fact, weight loss has been reported as a reason for MA use [7][8][9] and MA under the trademark name Desoxyn, has been approved for use clinically in the treatment of exogenous obesity, as well as for ADHD and narcolepsy [10].In animal studies, MA has served as an agent to induce neurotoxicity within the Nigrostriatal Dopaminergic (NSDA) system, and thus a means to study conditions that modulate this neurotoxicity. For example, sex, hormonal factors and adrenergic blockers all affect the degree of MAinduced neurotoxicity [11][12][13][14][15][16].…”

mentioning

confidence: 99%

mentioning

confidence: 99%

Is Body Weight Loss a Harbinger of Methamphetamine-induced Neurotoxicity?

Dluzen¹

2013

J Addict Res Ther

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Methamphetamine (MA) is a drug of abuse of societal concern. Euphoria, increased energy/alertness and enhanced libido all contribute to the appeal, and therefore, abuse of this psychostimulant. Weight loss represents still another attribute of MA as indicated in both human [1][2][3][4] and animal [5,6] studies. In fact, weight loss has been reported as a reason for MA use [7][8][9] and MA under the trademark name Desoxyn, has been approved for use clinically in the treatment of exogenous obesity, as well as for ADHD and narcolepsy [10].In animal studies, MA has served as an agent to induce neurotoxicity within the Nigrostriatal Dopaminergic (NSDA) system, and thus a means to study conditions that modulate this neurotoxicity. For example, sex, hormonal factors and adrenergic blockers all affect the degree of MAinduced neurotoxicity [11][12][13][14][15][16]. A summary of the pair wise differences in MA-induced neurotoxicity (dorsal striatal dopamine depletion) for these three different factors, along with the corresponding changes in body weight to MA is illustrated in panels A-C of the figure 1. In all three situations, conditions showing greater amounts of dopamine depletion (A-males versus females, B-testosterone (TP) versus sesame oil vehicle treated controls, C-Propranolol (PROP) versus Prazosin (PRAZ)) are associated with the greater amounts of body weight reductions.A cursory and seemingly obvious conclusion would be that the greater extent of neurotoxicity produces a corresponding greater degree of generalized malaise, as indicated by body weights. The data presented in panel D of the figure 1 suggest that this may not necessarily be the case. Here are presented results obtained using a similar sex-differences protocol as that presented in panel A, however, with NSDA neurotoxicity induced by 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). While nearly identical dorsal striatal dopamine reductions are obtained with MA and MPTP (A versus D), the corresponding sex differences in body weight present to MA, are completely absent with MPTP (A versus D). Such results suggest that sex differences in response to neurotoxins targeting the NSDA system do not inescapably generate identical changes in body weights. Rather, body weight reductions following MA treatment appear to be closely associated with the degree of NSDA loss and are specific for MA-induced NSDA neurotoxicity.Confirmation or refutation of this intriguing relationship awaits further investigation involving formal experiments on dose-response, time-course, cross-species analyses and food restriction/palatability. Moreover, differences in MA regimes between the mouse models as described above and the clinical/street use of this drug also warrant consideration in evaluating this relationship. While remaining cognizant of these limitations, data derived from these animal experiments have served as relatively valid and reliable models for indices of effects in humans. Women show less toxicity [17] and diminished dopamine responses [18] to MA/amphetami...

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Treatment of methamphetamine abuse: research findings and clinical directions

Cited by 162 publications

References 11 publications

Long-Term Methamphetamine Administration in the Vervet Monkey Models Aspects of a Human Exposure: Brain Neurotoxicity and Behavioral Profiles

Long-Term Methamphetamine Administration in the Vervet Monkey Models Aspects of a Human Exposure: Brain Neurotoxicity and Behavioral Profiles

Update and Overview of Practical Epidemiologic Aspects of HIV/AIDS among Injection Drug Users in the United States

Is Body Weight Loss a Harbinger of Methamphetamine-induced Neurotoxicity?

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