D'Souza Manoranjan S
Department of Pharmaceutical and Biomedical Sciences, The Raabe College of Pharmacy, Ohio Northern University, Ada, OH, United States.
Front Psychiatry. 2019 Jul 24;10:509. doi: 10.3389/fpsyt.2019.00509. eCollection 2019.
Addiction to psychostimulants like cocaine, methamphetamine, and nicotine poses a continuing medical and social challenge both in the United States and all over the world. Despite a desire to quit drug use, return to drug use after a period of abstinence is a common problem among individuals dependent on psychostimulants. Recovery for psychostimulant drug-dependent individuals is particularly challenging because psychostimulant drugs induce significant changes in brain regions associated with cognitive functions leading to cognitive deficits. These cognitive deficits include impairments in learning/memory, poor decision making, and impaired control of behavioral output. Importantly, these drug-induced cognitive deficits often impact adherence to addiction treatment programs and predispose abstinent addicts to drug use relapse. Additionally, these cognitive deficits impact effective social and professional rehabilitation of abstinent addicts. The goal of this paper is to review neural substrates based on animal studies that could be pharmacologically targeted to reverse psychostimulant-induced cognitive deficits such as impulsivity and impairment in learning and memory. Further, the review will discuss neural substrates that could be used to facilitate extinction learning and thus reduce emotional and behavioral responses to drug-associated cues. Moreover, the review will discuss some non-pharmacological approaches that could be used either alone or in combination with pharmacological compounds to treat the above-mentioned cognitive deficits. Psychostimulant addiction treatment, which includes treatment for cognitive deficits, will help promote abstinence and allow for better rehabilitation and integration of abstinent individuals into society.
对可卡因、甲基苯丙胺和尼古丁等精神兴奋剂上瘾，在美国乃至全世界都是持续存在的医学和社会挑战。尽管有戒毒的愿望，但在一段时间的禁欲后复吸，是依赖精神兴奋剂的个体中常见的问题。对于依赖精神兴奋剂的个体而言，康复尤其具有挑战性，因为精神兴奋剂会在与认知功能相关的脑区引发显著变化，导致认知缺陷。这些认知缺陷包括学习/记忆受损、决策能力差以及行为输出控制受损。重要的是，这些药物诱发的认知缺陷往往会影响对成瘾治疗项目的依从性，并使戒毒者容易复吸。此外，这些认知缺陷还会影响戒毒者有效的社会和职业康复。本文的目的是基于动物研究回顾神经基质，这些神经基质可以成为药物作用的靶点，以逆转精神兴奋剂诱发的认知缺陷，如冲动性以及学习和记忆障碍。此外，该综述将讨论可用于促进消退学习从而减少对药物相关线索的情绪和行为反应的神经基质。此外，该综述还将讨论一些非药物方法，这些方法可以单独使用或与药物化合物联合使用，以治疗上述认知缺陷。精神兴奋剂成瘾治疗，包括对认知缺陷的治疗，将有助于促进戒毒，并使戒毒者更好地康复并融入社会。
