Bossert Jennifer M, Ghitza Udi E, Lu Lin, Epstein David H, Shaham Yavin
Behavioral Neuroscience Branch, IRP/NIDA/NIH/DHHS, 5500 Nathan Shock Drive, Baltimore, MD 21224, USA.
Eur J Pharmacol. 2005 Dec 5;526(1-3):36-50. doi: 10.1016/j.ejphar.2005.09.030. Epub 2005 Nov 14.
The central problem in the treatment of cocaine and heroin addiction is high rates of relapse to drug use after periods of forced or self-imposed abstinence. Relapse can be modeled in laboratory animals a reinstatement procedure in which responding for drug is extinguished and then reinstated by acute exposure to the drug, drug cues, or stress. In this review, we first summarize data from recent (2003-2005) studies on the neural substrates involved in reinstatement of heroin and cocaine seeking. We also discuss the neural mechanisms underlying the progressive increase in cocaine seeking after withdrawal (incubation of cocaine craving). Finally, we provide an update on several novel candidate medications for relapse prevention suggested by recent preclinical studies, and we discuss the translation of findings from nonhuman laboratory studies to the clinical phenomenon of relapse.
可卡因和海洛因成瘾治疗中的核心问题是，在强制戒断或自行戒断一段时间后，复吸率很高。复吸可以在实验动物中通过一种恢复程序来模拟，即对药物的反应被消除，然后通过急性接触药物、药物线索或应激来恢复。在这篇综述中，我们首先总结了近期（2003 - 2005年）关于海洛因和可卡因觅药行为恢复中涉及的神经基质的研究数据。我们还讨论了戒断后可卡因觅药行为逐渐增加（可卡因渴求的潜伏期）背后的神经机制。最后，我们提供了近期临床前研究提出的几种预防复吸的新型候选药物的最新情况，并讨论了从非人类实验室研究结果到复吸临床现象的转化。
