Hutchison Kent E, Rutter Marie-Christine, Niaura Raymond, Swift Robert M, Pickworth Wallace B, Sobik Laura
Department of Psychology, University of Colorado, Campus Box 345, Boulder, CO, 80309-0345, USA.
Psychopharmacology (Berl). 2004 Oct;175(4):407-13. doi: 10.1007/s00213-004-1837-3.
Recent biological conceptualizations of craving and addiction have implicated mesolimbic dopamine activity as a central feature of the process of addiction. Imaging, and pharmacological studies have supported a role for dopaminergic structures in cue-elicited craving for tobacco.
If mesolimbic dopamine activity is associated with cue-elicited craving for tobacco, a dopamine antagonist should attenuate cue-elicited craving for tobacco. Thus, the aim of the present study was to determine whether an atypical antipsychotic (olanzapine, 5 mg) decreased cue-elicited craving for tobacco.
Participants were randomly assigned to 5 days of pretreatment with olanzapine (5 mg; n=31) or were randomly assigned to 5 days of a matching placebo (n=28). Approximately 8 h after the last dose, participants were exposed to a control cue (pencil) followed by exposure to smoking cues. Participants subsequently smoked either nicotine cigarettes or de-nicotinized cigarettes.
Olanzapine attenuated cue-elicited craving for tobacco but did not moderate the subjective effects of smoking.
This study represents one of the first investigations of the effect of atypical antipsychotics on cue-elicited craving for tobacco. The results suggest that medications with similar profiles may reduce cue-elicited craving, which in turn, may partially explain recent observations that atypical antipsychotics may reduce substance use.
近期对渴望和成瘾的生物学概念化研究表明，中脑边缘多巴胺活动是成瘾过程的核心特征。影像学和药理学研究支持了多巴胺能结构在提示诱发的烟草渴望中的作用。
如果中脑边缘多巴胺活动与提示诱发的烟草渴望有关，那么多巴胺拮抗剂应能减轻提示诱发的烟草渴望。因此，本研究的目的是确定非典型抗精神病药物（奥氮平，5毫克）是否能减少提示诱发的烟草渴望。
参与者被随机分配接受5天的奥氮平（5毫克；n = 31）预处理，或被随机分配接受5天的匹配安慰剂（n = 28）。在最后一剂药物大约8小时后，参与者先接触对照提示物（铅笔），然后接触吸烟提示物。参与者随后吸食尼古丁香烟或去尼古丁香烟。
奥氮平减轻了提示诱发的烟草渴望，但并未调节吸烟的主观效应。
本研究是对非典型抗精神病药物对提示诱发的烟草渴望影响的首批研究之一。结果表明，具有相似特性的药物可能会减少提示诱发的渴望，这反过来可能部分解释了近期关于非典型抗精神病药物可能减少物质使用的观察结果。
