Medicines in treatment of addictive disorders
Lekovi u terapiji bolesti zavisnosti
Abstract
It is estimated that annual sales of illegal psychoactive substances account for 8% of total international trade. The large consumption of alcohol and tobacco, as socially accepted drugs, as well as of several classes of medicines (such as opioids and benzodiazepines, though with relatively small contribution) add to the patient population with established addiction. By misuse of these psychoactive substances one bypasses the mechanisms which regulate dopamine release in mesolimbic pathway, with consecutive non-physiological activation of reward pathway. Medicines in therapy of addiction may relieve the detoxification process and support the relapse prevention. Methadone, buprenorphine and naltrexone are used in treatment of opioid addiction; disulfiram, acamprosate and naltrexone in alcohol addiction, while nicotine, bupropion and varenicline are options in tobacco addiction. Clinical efficacy of these drugs, in sum, only partially fulfills the expectations of patients and their famil...ies. Additionally, distinct therapeutic approaches, such as the principle of substitution with less harmful, but still addictive medicines, are subjected to ethical and professional scrutiny. Among newer options, the remarkable one is the development of vaccines, which stimulate production of antibodies specific for the psychoactive compound used as a hapten. Antibodies sequester the psychoactive compound in the blood circulation, denying its distribution into the brain (pharmacokinetic antagonism). Two vaccines, aimed for nicotine and cocaine addiction, are currently in the advanced phases of clinical investigations.
Keywords:
Addiction / Cocaine / Ethanol / Nicotine / OpioidsSource:
Arhiv za farmaciju, 2012, 62, 2, 147-155Publisher:
- Savez farmaceutskih udruženja Srbije, Beograd
Collections
Institution
PharmacyTY - JOUR AU - Savić, Miroslav PY - 2012 UR - http://farfar.pharmacy.bg.ac.rs/handle/123456789/1801 AB - It is estimated that annual sales of illegal psychoactive substances account for 8% of total international trade. The large consumption of alcohol and tobacco, as socially accepted drugs, as well as of several classes of medicines (such as opioids and benzodiazepines, though with relatively small contribution) add to the patient population with established addiction. By misuse of these psychoactive substances one bypasses the mechanisms which regulate dopamine release in mesolimbic pathway, with consecutive non-physiological activation of reward pathway. Medicines in therapy of addiction may relieve the detoxification process and support the relapse prevention. Methadone, buprenorphine and naltrexone are used in treatment of opioid addiction; disulfiram, acamprosate and naltrexone in alcohol addiction, while nicotine, bupropion and varenicline are options in tobacco addiction. Clinical efficacy of these drugs, in sum, only partially fulfills the expectations of patients and their families. Additionally, distinct therapeutic approaches, such as the principle of substitution with less harmful, but still addictive medicines, are subjected to ethical and professional scrutiny. Among newer options, the remarkable one is the development of vaccines, which stimulate production of antibodies specific for the psychoactive compound used as a hapten. Antibodies sequester the psychoactive compound in the blood circulation, denying its distribution into the brain (pharmacokinetic antagonism). Two vaccines, aimed for nicotine and cocaine addiction, are currently in the advanced phases of clinical investigations. PB - Savez farmaceutskih udruženja Srbije, Beograd T2 - Arhiv za farmaciju T1 - Medicines in treatment of addictive disorders T1 - Lekovi u terapiji bolesti zavisnosti VL - 62 IS - 2 SP - 147 EP - 155 ER -
@article{ author = "Savić, Miroslav", year = "2012", url = "http://farfar.pharmacy.bg.ac.rs/handle/123456789/1801", abstract = "It is estimated that annual sales of illegal psychoactive substances account for 8% of total international trade. The large consumption of alcohol and tobacco, as socially accepted drugs, as well as of several classes of medicines (such as opioids and benzodiazepines, though with relatively small contribution) add to the patient population with established addiction. By misuse of these psychoactive substances one bypasses the mechanisms which regulate dopamine release in mesolimbic pathway, with consecutive non-physiological activation of reward pathway. Medicines in therapy of addiction may relieve the detoxification process and support the relapse prevention. Methadone, buprenorphine and naltrexone are used in treatment of opioid addiction; disulfiram, acamprosate and naltrexone in alcohol addiction, while nicotine, bupropion and varenicline are options in tobacco addiction. Clinical efficacy of these drugs, in sum, only partially fulfills the expectations of patients and their families. Additionally, distinct therapeutic approaches, such as the principle of substitution with less harmful, but still addictive medicines, are subjected to ethical and professional scrutiny. Among newer options, the remarkable one is the development of vaccines, which stimulate production of antibodies specific for the psychoactive compound used as a hapten. Antibodies sequester the psychoactive compound in the blood circulation, denying its distribution into the brain (pharmacokinetic antagonism). Two vaccines, aimed for nicotine and cocaine addiction, are currently in the advanced phases of clinical investigations.", publisher = "Savez farmaceutskih udruženja Srbije, Beograd", journal = "Arhiv za farmaciju", title = "Medicines in treatment of addictive disorders, Lekovi u terapiji bolesti zavisnosti", volume = "62", number = "2", pages = "147-155" }
Savić M. Lekovi u terapiji bolesti zavisnosti. Arhiv za farmaciju. 2012;62(2):147-155
Savić, M. (2012). Lekovi u terapiji bolesti zavisnosti. Arhiv za farmacijuSavez farmaceutskih udruženja Srbije, Beograd., 62(2), 147-155.
Savić Miroslav, "Lekovi u terapiji bolesti zavisnosti" 62, no. 2 (2012):147-155