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Agnieszka Klawiter

on 15 March 2013

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Transcript of Addiction

Neurocircuitry of addiction ADDICTION CB1 receptor antagonists based therapy "Breaking" the addiction pathways with surgery ? Addiction: standard treatments The role of insula in smoking Orbitofrontal cortex and cocaine Food intake vs drug addiction "Spice" - synthetic cannabinoids The problem of "legal drugs" Treatment perspectives There is no universal pathway Questions ? Administration Metabolism Excretion "Spice" pharmacology REFERENCE figure above Synthetic analogues of THC Three stages:
Withdrawal/Negative affect
Preoccupation/Anticipation Addiction: definition (Koob and Le Moal 1997) Light areas: food intake
Food intake is an evolved behaviour that involves many body systems, brain circuits and their interactions.
Drug addiction is triggered by a pharmacological event which activates pathways that have not originally evolved for this purpose (DiLeone et al. 2012) Experimental subjects: brain damaged patients
with insula and non-insula brain damage.
Analysis of quitting pattern and addiction proceedings after lesion onset - regression analysis
Patients with insula damage - disruption in addiction pattern, much less adverse effects when quitting smoking
Insula - crucial neural substrate for smoking addiction Central role of Nucleus Accumbens in addiction

Stereotactic bilateral lesion of NAc - based on animal experiments introduced into clinical trials in early 2000.

Procedure conducted in 272 patients (China) ~ 58% no relapse after 5 years; no major adverse effects

Best alternative for surgery would be deep brain stimulation Early approaches to treat addiction with surgery hypothalamy
cingulatomy MORE DETAILS What are the risks? Dark areas: drug reward 1) "compulsion to seek and take the drug
2) loss of control of limiting intake
3) emergence of negative emotional state"
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