Stimulant Addiction and Norepinephrine Treatments - Elise Howard

Elise Howard                                                                                                                               Blog #4

Stimulant Addiction and Norepinephrine Treatments

According to a study by Sofuoglu and Sewell (2009), there are currently no pharmacotherapies approved for the abuse of stimulants even though their role in our society is a large and troubling one (Sofuoglu & Sewell, 2009). Stimulants increase the levels of dopamine, serotonin, and norepinephrine in brain synapses whether it is the result of reuptake inhibition or increasing release of these neurotransmitters. The most prominent hypothesis about stimulant addiction is via the dopamine reward pathway; however, this alone is not enough to explain the rewarding results of stimulants. Sofuoglu and Sewell (2009) conducted a thorough review of previous literatures and hypothesized that the noradrenergic systems of the body could play a large role in advancing treatments for stimulant addiction (Sofuoglu & Sewell, 2009). The noradrenergic system uses norepinepherine as the main neurotransmitter to send messages to initiate several brain functions such as arousal, attention, and stress responses. In pre-clinical models of addiction, norepinephrine in largely involved in regulating stimulant effects especially craving for more of the drug and sensitization (Sofuoglu & Sewell, 2009).

Clinical trials have shown promise in adrenergic blockers for treatments for cocaine addiction and dependence particularly subjects experiencing withdrawal symptoms. Sofuoglu and Sewell (2009) researched literature and clinical trials on a drug that we have talked about in class as a potential alcohol addiction treatment, Disulfiram, which inhibits norepinephrine synthesis. A controlled clinical trial has shown that the use of disulfiram as a treatment for cocaine addiction reduced the use of cocaine more than that a placebo did in the control group (Sofuoglu & Sewell, 2009). It should be noted that alcohol and cocaine are commonly used together and it is possible that the reduction in cocaine use with a disulfiram treatment is only secondary to the reduction in alcohol consumption (Sofuoglu & Sewell, 2009).

Other clinical trials have shown some success in clonidine and lofexidine treatments for stimulant addiction. Both drugs are alpha₂-adrenergic agonists which seem to play a role in drug craving. Both colidine and lofexidine have shown to attenuate the craving for stimulant drugs in subjects who are addicted (Sofuoglu & Sewell, 2009).

This literature review by Sofuoglu & Sewell (2009) show that there may be great promise in researching norepinephrine pathways when treating stimulant drug abuse and addiction. Further studies may help to gain insight into the multiple pathways that play a role in stimulant addiction as there are clearly is more than one.

References

Sofuoglu, M., & Sewell, R. A. (2009). Norepinephrine and stimulant addiction. Addiction Biology, 14(2), 119-129. doi:10.1111/j.1369-1600.2008.00138.x