Kalechstein Ari D, Mahoney James J, Verrico Christopher D, De La Garza Richard
Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.
Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.
Neuropharmacology. 2014 Oct;85:493-8. doi: 10.1016/j.neuropharm.2014.05.045. Epub 2014 Jun 12.
Long-term, high-dose methamphetamine (METH) use is associated with decrements in neurocognition and, given the association between impaired neurocognition and poorer treatment outcomes in individuals dependent on alcohol and drugs, it is considered to be a neglected area of critical concern. The objective of this study was to determine whether varenicline, a partial agonist at α4β2- and a full agonist at α7-nicotinic acetylcholine receptors, enhances attention/information processing speed, episodic memory, and working memory in non-treatment seeking METH-dependent participants. Twenty-six participants were randomly assigned to receive oral placebo or oral varenicline (titrated up to 1 mg) over 5 days during three separate inpatient phases, and 17 completed each inpatient phase. Participants were predominately male (71%) and Caucasian (71%). Varenicline significantly improved reaction time on the n-back for visual stimuli (F(1,47)=5.369, p=0.025, η2=0.103), and a trend was observed for improvement in reaction time for auditory stimuli (F(1,47)=3.141, p=0.083, η2=0.063). For those study participants whose reaction time was in the lower half of the distribution at baseline, the effect was even more pronounced for auditory (F(1,22)=5.287, p=0.031, η2=0.194) and visual (F(1,22)=11.981, p=0.002, η2=0.353) stimuli relative to placebo. In contrast, varenicline did not modulate mean or maximum span of working memory or performance on tests of episodic memory or attention (p's>0.05). Given the potential importance of this finding, it should be replicated in a larger sample over a longer treatment period with a higher dose of varenicline (2 mg).
clinicalTrials.gov Identifier NCT01571167.
长期高剂量使用甲基苯丙胺(METH)与神经认知功能下降有关,鉴于神经认知功能受损与酒精和药物依赖个体较差的治疗结果之间存在关联,这被认为是一个被忽视的关键关注领域。本研究的目的是确定伐尼克兰(一种α4β2烟碱型乙酰胆碱受体部分激动剂和α7烟碱型乙酰胆碱受体完全激动剂)是否能提高未寻求治疗的METH依赖参与者的注意力/信息处理速度、情景记忆和工作记忆。26名参与者在三个独立的住院阶段中,随机分配在5天内接受口服安慰剂或口服伐尼克兰(滴定至1毫克),17名参与者完成了每个住院阶段。参与者主要为男性(71%)和白种人(71%)。伐尼克兰显著改善了视觉刺激的n-back反应时间(F(1,47)=5.369,p=0.025,η2=0.103),并且观察到听觉刺激反应时间有改善趋势(F(1,47)=3.141,p=0.083,η2=0.063)。对于那些基线反应时间处于分布下半部分的研究参与者,相对于安慰剂,听觉(F(1,22)=5.287,p=0.031,η2=0.194)和视觉(F(1,22)=11.981,p=0.002,η2=0.353)刺激的效果更为明显。相比之下,伐尼克兰并未调节工作记忆的平均或最大跨度,也未调节情景记忆或注意力测试的表现(p>0.05)。鉴于这一发现的潜在重要性,应在更大样本、更长治疗期且使用更高剂量伐尼克兰(2毫克)的情况下进行重复验证。
clinicalTrials.gov标识符NCT01571167。