Bruijnzeel Adrie W, Repetto Martin, Gold Mark S
Department of Psychiatry, University of Florida College of Medicine, P.O. Box 100183, Gainesville, FL 32610-0183, USA.
Psychiatr Clin North Am. 2004 Dec;27(4):661-74. doi: 10.1016/j.psc.2004.06.005.
The studies reviewed indicate that brain stress system play an important role in the acquisition and maintenance of drugs of abuse that target the brain's reward centers. In doing so, they may destabilize these areas, making the perception of pleasure more elusive and difficult to attain. Withdrawal from drugs of abuse leads to the activation of brain CRF systems that may produce the anxiogenic response associated with drug withdrawal. More research, however, is needed to investigate the role of brain stress systems and neuropeptides in other drug withdrawal symptoms such as anhedonia. A better understanding of the brain systems underlying drug withdrawal may help in the development of improved pharmacotherapies that can alleviate drug withdrawal symptoms. The second part of the article indicated that there is a very high comorbidity between depression and drug dependence. The reviewed studies suggest that depressed patients initiate drug-taking behavior to self-medicate the symptoms associated with their psychiatric disorder. Chronic use of drugs of abuse, however, may exacerbate the symptoms of pre-existing mental disorders and subsequently increase drug-taking behavior. Conversely, professional treatment of pre-existing psychiatric disorders may decrease the use of illicit substances.
所综述的研究表明，大脑应激系统在针对大脑奖赏中枢的滥用药物的获取和维持过程中发挥着重要作用。在此过程中，它们可能会破坏这些区域的稳定性，使愉悦感更难以捉摸且难以获得。滥用药物的戒断会导致大脑促肾上腺皮质激素释放因子（CRF）系统的激活，这可能会产生与药物戒断相关的焦虑反应。然而，需要更多研究来调查大脑应激系统和神经肽在诸如快感缺失等其他药物戒断症状中的作用。更好地理解药物戒断背后的大脑系统可能有助于开发出能够缓解药物戒断症状的改进药物疗法。文章的第二部分指出，抑郁症与药物依赖之间存在非常高的共病率。所综述的研究表明，抑郁症患者开始吸毒行为是为了自我治疗与其精神疾病相关的症状。然而，长期滥用药物可能会加剧已存在的精神障碍症状，进而增加吸毒行为。相反，对已存在的精神疾病进行专业治疗可能会减少非法物质的使用。
