Young A M
Department of Psychology, Wayne State University, Detroit, MI 48202, USA.
NIDA Res Monogr. 1991(116):197-211.
The experiments described above highlight the ways behavioral and pharmacodynamic processes interact to modulate the development of tolerance to the discriminative stimulus effects of drugs. These studies suggest that frequent drug exposure does not lead inevitably to the development of tolerance to a drug's discriminative effects. Rather, the interplay between a drug stimulus and reinforcement opportunities shapes the sensitivity of discriminative performances over successive episodes of drug exposure. Maintaining a discriminative relation between a drug and behavior strengthens the likelihood that an initially effective dose will maintain discriminative control. Development of tolerance requires exposure to both treatment regimens appropriate to the agent under study and behavioral contingencies that limit an individual's ability to learn a new discrimination. When both requirements are met, tolerance does develop to drugs acting as discriminative stimuli. When training is suspended during a period of chronic drug treatment, the dose of drug required to evoke stimulus control can be increased by treatment with appropriate maintenance doses of the training drug or a closely related drug. Tolerance is proportional to maintenance dose, develops relatively slowly, and disappears after termination of repeated drug treatment. Tolerance appears pharmacologically specific and can be accompanied by cross-tolerance to other drugs that evoke cross-generalization with the training drug. Finally, tolerance can be diminished markedly by continuing training with the original training dose. Taken together, these patterns suggest that development of tolerance to drugs acting as discriminative stimuli is the result of joint actions of conditioning and pharmacodynamic processes.
上述实验突出了行为和药效学过程相互作用以调节对药物辨别刺激效应耐受性发展的方式。这些研究表明,频繁接触药物并不会不可避免地导致对药物辨别效应产生耐受性。相反,药物刺激与强化机会之间的相互作用塑造了在连续的药物接触过程中辨别行为的敏感性。维持药物与行为之间的辨别关系会增加最初有效剂量维持辨别控制的可能性。耐受性的发展需要接触适合所研究药物的治疗方案以及限制个体学习新辨别的行为条件。当这两个条件都满足时,对作为辨别刺激的药物确实会产生耐受性。在慢性药物治疗期间暂停训练时,通过使用训练药物或密切相关药物的适当维持剂量进行治疗,可以增加唤起刺激控制所需的药物剂量。耐受性与维持剂量成正比,发展相对缓慢,并且在重复药物治疗终止后消失。耐受性在药理学上具有特异性,并且可能伴随着对其他与训练药物引起交叉泛化的药物的交叉耐受性。最后,通过继续使用原始训练剂量进行训练,可以显著降低耐受性。综上所述,这些模式表明,对作为辨别刺激的药物产生耐受性是条件作用和药效学过程共同作用的结果。