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4 results

  • Chapter 31 - Alzheimer's disease

  • Edited by John I. Nurnberger, Jr, Wade Berrettini, University of Pennsylvania School of Medicine
  • Book:
    Principles of Psychiatric Genetics
    Published online:
    05 October 2012
    Print publication:
    13 September 2012, pp 371-381

  • Summary

    This chapter reviews evidence supporting the hypothesis that genetic inheritance plays a substantial role in dependence on cocaine and (to a less well-studied degree) other illicit psychostimulants. The role of genes in cocaine dependence, however, may largely reflect a more general liability to develop dependence on a variety of substances. Studies of molecular genetic mechanisms in cocaine dependence remain in an early stage of development. A genome-wide association study (GWAS) of methamphetamine dependence, while yielding some interesting leads, requires replication in light of its small size, and reliance on pooled genotyping. While several intriguing candidate-gene associations between specific loci and cocaine dependence have been reported, to date there has yet to be a definitively replicated result reported. Clearly, more work is required in the human genetics of stimulant dependence, to identify and characterize how specific genes influence risk for this set of disorders.

  • Neurocognitive Effects of HIV, Hepatitis C, and Substance Use History

  • Kathryn N. Devlin, Assawin Gongvatana, Uraina S. Clark, Jesse D. Chasman, Michelle L. Westbrook, Karen T. Tashima, Bradford Navia, Ronald A. Cohen
  • Journal:
    Journal of the International Neuropsychological Society / Volume 18 / Issue 1 / January 2012
    Published online by Cambridge University Press:
    02 December 2011, pp. 68-78

  • HIV-associated neurocognitive dysfunction persists in the highly active antiretroviral therapy (HAART) era and may be exacerbated by comorbidities, including substance use and hepatitis C virus (HCV) infection. However, the neurocognitive impact of HIV, HCV, and substance use in the HAART era is still not well understood. In the current study, 115 HIV-infected and 72 HIV-seronegative individuals with significant rates of lifetime substance dependence and HCV infection received comprehensive neuropsychological assessment. We examined the effects of HIV serostatus, HCV infection, and substance use history on neurocognitive functioning. We also examined relationships between HIV disease measures (current and nadir CD4, HIV RNA, duration of infection) and cognitive functioning. Approximately half of HIV-infected participants exhibited neurocognitive impairment. Detectable HIV RNA but not HIV serostatus was significantly associated with cognitive functioning. HCV was among the factors most consistently associated with poorer neurocognitive performance across domains, while substance use was less strongly associated with cognitive performance. The results suggest that neurocognitive impairment continues to occur in HIV-infected individuals in association with poor virologic control and comorbid conditions, particularly HCV coinfection. (JINS, 2012, 18, 68–78)

  • 18 - Genetic variation and drug dependence risk factors

  • from Part V - Specific psychotropic drugs and disorders
    • By Joel Gelernter, Yale University School of Medicine and VA CT Healthcare Center, West Haven, USA, Henry Kranzler, University of Connecticut School of Medicine, Farmington, USA
  • Edited by Bernard Lerer, Hadassah-Hebrew Medical Center, Jerusalem
  • Book:
    Pharmacogenetics of Psychotropic Drugs
    Published online:
    20 August 2009
    Print publication:
    29 August 2002, pp 372-388

  • Summary

    This chapter discusses pharmacogenetics in the context of substance abuse and dependence. Genetic factors are important contributors to risk for substance dependence. Some are specific to the substance (e.g., resulting in different euphoric effects by individual), and some are more general (e.g., personality features, like novelty seeking, antisocial personality, and so on, which may influence exposure to substances or the transition from substance use to dependence). If the set of all genetically influenced disorders is considered, some forms of substance dependence are uniquely influenced by pharmacogenetic factors. The chapter explores some of the mechanisms involved, and their implications for diagnosis, treatment, and research. Specific pharmacogenetic interactions relevant to the understanding of dependence on cocaine, opioids, and nicotine have either been demonstrated or proposed. The chapter presents examples relevant to each phenotype. Pharmacokinetic phenomena relevant to cocaine and nicotine dependence are also discussed.

  • 7 - CRA and Treatment of Cocaine and Opioid Dependence

  • Edited by Robert J. Meyers, University of New Mexico, William R. Miller, University of New Mexico
  • Book:
    A Community Reinforcement Approach to Addiction Treatment
    Published online:
    05 August 2012
    Print publication:
    16 August 2001, pp 123-146

  • Summary

    This chapter reviews positive results from a series of well-controlled clinical trials supporting the efficacy of Community Reinforcement Approach (CRA) treatments for cocaine and opioid dependence. It presents a brief description of the rationale for adding the voucher-based incentives to CRA. In developing this treatment for cocaine dependence in the late 1980s, the goal was to develop an intervention to treat cocaine dependence in outpatient settings. More substantially, the trial by Abbott and colleagues with opioid-dependent individuals did not involve vouchers and yet the CRA treatment resulted in greater reductions in opioid use than standard drug-abuse counseling. Delivered with or without vouchers, CRA represents an efficacious treatment that can enhance treatment outcomes with cocaine and opioid-dependent patients. Recognizing the importance of reinforcement to substance dependence and integrating systematic use of that principle into clinical efforts to reduce cocaine and opioid dependence has the potential to substantially improve treatment outcomes.