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Novel research translates to clinical cases of schizophrenic and cocaine psychosis.

Nunes JV, Broderick PA - Neuropsychiatr Dis Treat (2007)

Bottom Line: Their neurochemical neuronal mechanisms of action, as shown in preclinical and clinical studies, involve primarily dopaminergic dysfunction and, secondarily, neuroadaptive effects that seem to involve central serotonergic function.Also, controlled clinical studies have shown that risperidone, an atypical antipsychotic medication, is successful in the treatment of cocaine dependence and withdrawal (Smelson et al 1997, 2002; Grabowski et al 2000).Furthermore, the availability and effectiveness of long-acting risperidone in injectable form opens new possibilities for the long-term management of both disorders.

View Article: PubMed Central - PubMed

Affiliation: Department of Behavioral Medicine, The City University of New York Medical School, The Sophie Davis School of Biomedical Education, NY, NY, USA. nunes@med.cuny.edu

ABSTRACT
Pharmacotherapies for schizophrenic and cocaine psychoses are complex but similar because of similarities in their brain neurochemistry and behavioral outcomes. Their neurochemical neuronal mechanisms of action, as shown in preclinical and clinical studies, involve primarily dopaminergic dysfunction and, secondarily, neuroadaptive effects that seem to involve central serotonergic function. Behavioral outcomes of both disorders include hyperactivity and antipsychotic medications can ameliorate psychotic symptoms. Patients with both disorders often arrive at emergency departments and present floridly psychotic with a predominance of positive symptoms, often prompting physicians to select a typical antipsychotic medication such as haloperidol. While this has become conventional wisdom, we believe that to use an atypical antipsychotic medication, such as risperidone, in the treatment of both psychoses is quite rational for long-term management of both positive and negative symptoms. Also, controlled clinical studies have shown that risperidone, an atypical antipsychotic medication, is successful in the treatment of cocaine dependence and withdrawal (Smelson et al 1997, 2002; Grabowski et al 2000). Furthermore, the availability and effectiveness of long-acting risperidone in injectable form opens new possibilities for the long-term management of both disorders. In this paper, we present data which show that the use of risperidone is plausible for effective pharmacotherapy of schizophrenic and cocaine psychoses.

No MeSH data available.


Related in: MedlinePlus

Day 1 The effect of cocaine (10 mg/kg i.p.) on adult, male Sprague-Dawley laboratory rats (n = 4). Studies were done with neuromolecular imaging (NMI) based on in vivo electrochemistry. The imaging was performed with the BRODERICK PROBE®; sensors. Sensors were implanted in NAcc and verified by the blue dot perfusion method. DA and 5-HT were detected selectively in the freely moving animal (concurrent behavioral data are presented below). Cocaine increased DA release in NAcc up to 75% over baseline (unpaired t-test, p < 0.0001 compared with preadministration), and increased 5-HT by 190% over baseline (unpaired t-test p < 0.0001 compared with baseline).
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f1A-ndt-3-475: Day 1 The effect of cocaine (10 mg/kg i.p.) on adult, male Sprague-Dawley laboratory rats (n = 4). Studies were done with neuromolecular imaging (NMI) based on in vivo electrochemistry. The imaging was performed with the BRODERICK PROBE®; sensors. Sensors were implanted in NAcc and verified by the blue dot perfusion method. DA and 5-HT were detected selectively in the freely moving animal (concurrent behavioral data are presented below). Cocaine increased DA release in NAcc up to 75% over baseline (unpaired t-test, p < 0.0001 compared with preadministration), and increased 5-HT by 190% over baseline (unpaired t-test p < 0.0001 compared with baseline).

Mentions: We have noted earlier that atypicals are quite effective in the management of schizophrenia. In fact, the use of risperidone also has shown promise in cocaine abusing schizophrenic persons (Tsuang et al 2002); in controlling craving for cocaine (Smelson et al 2002); on cocaine-induced euphoria (Newton et al 2001), on cocaine dependence (Grabowski et al 2000); and on cue-elicited craving for cocaine (Smelson et al 1997). Broderick and colleagues (2003) have studied the effects of risperidone on cocaine in the psychostimulant animal model of psychosis and we have proceeded further with new neuromolecular imaging (NMI) research in this area as shown in this paper in Figures 1–3. NMI, with nationally and internationally patented, miniature BRODERICK PROBE® sensors and real time electrochemical detection, is cutting-edge research. NMI is conducted concomitantly and simultaneously with infrared detection of locomotor (ambulatory) behavioral measurements. This research has led to the following conclusions: 1) Cocaine produced withdrawal symptoms in subacute studies, probably due to neuroadaptive mechanisms, especially in dopamine and serotonin release in nucleus accumbens. 2) Risperidone acutely blocked cocaine-enhanced neurochemistry and behavior, and subacutely improved cocaine’s withdrawal effects on accumbens neurochemistry. 3) Risperidone thus may be a viable psychopharmacological tool in the treatment of cocaine addiction, withdrawal, and psychosis.


Novel research translates to clinical cases of schizophrenic and cocaine psychosis.

Nunes JV, Broderick PA - Neuropsychiatr Dis Treat (2007)

Day 1 The effect of cocaine (10 mg/kg i.p.) on adult, male Sprague-Dawley laboratory rats (n = 4). Studies were done with neuromolecular imaging (NMI) based on in vivo electrochemistry. The imaging was performed with the BRODERICK PROBE®; sensors. Sensors were implanted in NAcc and verified by the blue dot perfusion method. DA and 5-HT were detected selectively in the freely moving animal (concurrent behavioral data are presented below). Cocaine increased DA release in NAcc up to 75% over baseline (unpaired t-test, p < 0.0001 compared with preadministration), and increased 5-HT by 190% over baseline (unpaired t-test p < 0.0001 compared with baseline).
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2655083&req=5

f1A-ndt-3-475: Day 1 The effect of cocaine (10 mg/kg i.p.) on adult, male Sprague-Dawley laboratory rats (n = 4). Studies were done with neuromolecular imaging (NMI) based on in vivo electrochemistry. The imaging was performed with the BRODERICK PROBE®; sensors. Sensors were implanted in NAcc and verified by the blue dot perfusion method. DA and 5-HT were detected selectively in the freely moving animal (concurrent behavioral data are presented below). Cocaine increased DA release in NAcc up to 75% over baseline (unpaired t-test, p < 0.0001 compared with preadministration), and increased 5-HT by 190% over baseline (unpaired t-test p < 0.0001 compared with baseline).
Mentions: We have noted earlier that atypicals are quite effective in the management of schizophrenia. In fact, the use of risperidone also has shown promise in cocaine abusing schizophrenic persons (Tsuang et al 2002); in controlling craving for cocaine (Smelson et al 2002); on cocaine-induced euphoria (Newton et al 2001), on cocaine dependence (Grabowski et al 2000); and on cue-elicited craving for cocaine (Smelson et al 1997). Broderick and colleagues (2003) have studied the effects of risperidone on cocaine in the psychostimulant animal model of psychosis and we have proceeded further with new neuromolecular imaging (NMI) research in this area as shown in this paper in Figures 1–3. NMI, with nationally and internationally patented, miniature BRODERICK PROBE® sensors and real time electrochemical detection, is cutting-edge research. NMI is conducted concomitantly and simultaneously with infrared detection of locomotor (ambulatory) behavioral measurements. This research has led to the following conclusions: 1) Cocaine produced withdrawal symptoms in subacute studies, probably due to neuroadaptive mechanisms, especially in dopamine and serotonin release in nucleus accumbens. 2) Risperidone acutely blocked cocaine-enhanced neurochemistry and behavior, and subacutely improved cocaine’s withdrawal effects on accumbens neurochemistry. 3) Risperidone thus may be a viable psychopharmacological tool in the treatment of cocaine addiction, withdrawal, and psychosis.

Bottom Line: Their neurochemical neuronal mechanisms of action, as shown in preclinical and clinical studies, involve primarily dopaminergic dysfunction and, secondarily, neuroadaptive effects that seem to involve central serotonergic function.Also, controlled clinical studies have shown that risperidone, an atypical antipsychotic medication, is successful in the treatment of cocaine dependence and withdrawal (Smelson et al 1997, 2002; Grabowski et al 2000).Furthermore, the availability and effectiveness of long-acting risperidone in injectable form opens new possibilities for the long-term management of both disorders.

View Article: PubMed Central - PubMed

Affiliation: Department of Behavioral Medicine, The City University of New York Medical School, The Sophie Davis School of Biomedical Education, NY, NY, USA. nunes@med.cuny.edu

ABSTRACT
Pharmacotherapies for schizophrenic and cocaine psychoses are complex but similar because of similarities in their brain neurochemistry and behavioral outcomes. Their neurochemical neuronal mechanisms of action, as shown in preclinical and clinical studies, involve primarily dopaminergic dysfunction and, secondarily, neuroadaptive effects that seem to involve central serotonergic function. Behavioral outcomes of both disorders include hyperactivity and antipsychotic medications can ameliorate psychotic symptoms. Patients with both disorders often arrive at emergency departments and present floridly psychotic with a predominance of positive symptoms, often prompting physicians to select a typical antipsychotic medication such as haloperidol. While this has become conventional wisdom, we believe that to use an atypical antipsychotic medication, such as risperidone, in the treatment of both psychoses is quite rational for long-term management of both positive and negative symptoms. Also, controlled clinical studies have shown that risperidone, an atypical antipsychotic medication, is successful in the treatment of cocaine dependence and withdrawal (Smelson et al 1997, 2002; Grabowski et al 2000). Furthermore, the availability and effectiveness of long-acting risperidone in injectable form opens new possibilities for the long-term management of both disorders. In this paper, we present data which show that the use of risperidone is plausible for effective pharmacotherapy of schizophrenic and cocaine psychoses.

No MeSH data available.


Related in: MedlinePlus