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先前接触氟哌啶醇而非奥氮平会增强对奖励线索的追求:对精神分裂症物质滥用的影响。

Prior haloperidol, but not olanzapine, exposure augments the pursuit of reward cues: implications for substance abuse in schizophrenia.

机构信息

Department of Pharmacology, Faculty of Medicine, Université de Montréal Montreal, QC, Canada.

出版信息

Schizophr Bull. 2013 May;39(3):692-702. doi: 10.1093/schbul/sbs077. Epub 2012 Aug 27.

Abstract

Drug abuse and addiction are excessively common in schizophrenia. Chronic antipsychotic treatment might contribute to this comorbidity by inducing supersensitivity within the brain's dopamine system. Dopamine supersensitivity can enhance the incentive motivational properties of reward cues, and reward cues contribute to the maintenance and severity of drug addiction. We have shown previously that rats withdrawn from continuous haloperidol (HAL) treatment (via subcutaneous minipump) develop dopamine supersensitivity and pursue reward cues more vigorously than HAL-naive rats following an amphetamine (AMPH) challenge. Atypical antipsychotic drugs are thought to be less likely than typicals to produce dopamine supersensitivity. Thus, we compared the effects of HAL and the atypical antipsychotic olanzapine (OLZ) on the pursuit of reward cues. Rats were trained to associate a light-tone cue with water then treated with HAL or OLZ. Following antipsychotic withdrawal, we assessed AMPH-induced enhancement of lever pressing for the cue. Withdrawal from HAL, but not from OLZ, enhanced this effect. HAL, but not OLZ, also enhanced AMPH-induced psychomotor activation and c-fos mRNA expression in the caudate-putamen. Thus, prior HAL, but not OLZ, enhanced conditioned reward following an AMPH challenge, and this was potentially linked to enhanced behavioral sensitivity to AMPH and AMPH-induced engagement of the caudate-putamen. These findings suggest that HAL, but not an atypical like OLZ, modifies reward circuitry in ways that increase responsiveness to reward cues. Because enhanced responsiveness to reward cues can promote drug-seeking behavior, it should be investigated whether atypical antipsychotics might be a preferential option in schizophrenic patients at risk for drug abuse or addiction.

摘要

药物滥用和成瘾在精神分裂症中极为常见。慢性抗精神病药物治疗可能通过诱导大脑多巴胺系统的超敏反应而导致这种共病。多巴胺超敏反应可以增强奖励线索的激励动机特性,而奖励线索有助于维持和加重药物成瘾。我们之前已经表明,从持续氟哌啶醇(HAL)治疗(通过皮下微泵)中戒断的大鼠在安非他命(AMPH)挑战后比 HAL 未处理的大鼠更强烈地追求奖励线索,表现出多巴胺超敏反应。与典型药物相比,非典型抗精神病药不太可能产生多巴胺超敏反应。因此,我们比较了 HAL 和非典型抗精神病药奥氮平(OLZ)对追求奖励线索的影响。大鼠被训练将光音提示与水联系起来,然后用 HAL 或 OLZ 处理。在抗精神病药戒断后,我们评估了 AMPH 对提示按压的增强作用。HAL 的戒断增强了这种作用,但 OLZ 的戒断没有。HAL 而不是 OLZ 也增强了 AMPH 诱导的运动激活和尾壳核中的 c-fos mRNA 表达。因此,先前的 HAL,而不是 OLZ,增强了 AMPH 挑战后的条件奖励,这可能与增强了对 AMPH 的行为敏感性以及 AMPH 诱导的尾壳核参与有关。这些发现表明,HAL 而非类似 OLZ 的非典型药物以增加对奖励线索的反应性的方式改变了奖励回路。由于对奖励线索的反应性增强会促进觅药行为,因此应该研究在有药物滥用或成瘾风险的精神分裂症患者中,非典型抗精神病药是否可能是一种首选药物。

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