1 Department of Psychopharmacology, Center for Psychiatric Medicine , Lawrence, MA, USA.
2 Department of Psychiatry, Boonshoft School of Medicine, Dayton VA Medical Center, Wright State University , Dayton, OH, USA.
J Behav Addict. 2018 Mar 1;7(1):192-203. doi: 10.1556/2006.6.2017.081. Epub 2018 Jan 10.
Background Addictive-like behaviors (e.g., hoarding and shopping) may be the result of the cumulative effects of dopaminergic and other neurotransmitter genetic variants as well as elevated stress levels. We, therefore, propose that dopamine homeostasis may be the preferred goal in combating such challenging and unwanted behaviors, when simple dopaminergic activation through potent agonists may not provide any resolution. Case presentation C.J. is a 38-year-old, single, female, living with her mother. She has a history of substance use disorder as well as attention deficit hyperactivity disorder, inattentive type. She had been stable on buprenorphine/naloxone combination and amphetamine, dextroamphetamine mixed salts for many years when unexpectedly she lost her job for oversleeping and not calling into work. KB200z (a pro-dopamine compound) was added to her regimen for complaints of low drive and motivation. After taking this nutraceutical for 4 weeks, she noticed a marked improvement in her mental status and many behaviors. She noted that her shopping and hoarding addictions had appreciably decreased. Furthermore, her lifelong history of terrifying lucid dreams was eliminated. Finally, she felt more in control; her locus of control shifted from external to more internal. Discussion The hypothesis is that C.J.'s reported, behavioral, and psychological benefits resulted from the pro-dopamine-regulating effect of KB220Z across the brain reward system. Conclusions This effect, we surmise, could be the result of a new dopamine balance, across C.J.'s brain reward system. Dopamine homeostasis is an effect of KB220Z seen in both animal and human placebo-controlled fMRI experiments.
背景 成瘾行为(例如囤积和购物)可能是多巴胺能和其他神经递质遗传变异以及升高的应激水平的累积效应的结果。因此,我们提出,当通过强效激动剂简单地激活多巴胺能不能提供任何解决办法时,多巴胺稳态可能是对抗这些具有挑战性和不受欢迎的行为的首选目标。
病例介绍 C.J. 是一位 38 岁的单身女性,与母亲同住。她有物质使用障碍和注意力缺陷多动障碍(注意力不集中型)病史。她曾长期稳定地使用丁丙诺啡/纳洛酮复方制剂和安非他命、右旋苯丙胺混合盐,直到她因睡过头和未打电话上班而意外失业。KB200z(一种促多巴胺化合物)被添加到她的治疗方案中,用于治疗低动力和低动机的抱怨。服用这种营养补充剂 4 周后,她注意到自己的精神状态和许多行为都有明显改善。她注意到自己的购物和囤积成瘾明显减少了。此外,她一生都有的可怕清醒梦也消失了。最后,她感觉更有控制力了;她的控制源从外部转移到了更内部。
讨论 假设是 C.J. 报告的行为和心理获益是由于 KB220Z 在大脑奖励系统中对多巴胺的调节作用。
结论 我们推测,这种效应可能是 KB220Z 在 C.J. 的大脑奖励系统中产生的新的多巴胺平衡的结果。多巴胺稳态是 KB220Z 在动物和人类安慰剂对照 fMRI 实验中都观察到的一种效应。