Reid M S, Mickalian J D, Delucchi K L, Hall S M, Berger S P
Department of Psychiatry, New York University, New York Veterans Affairs Medical Center, NY 10010, USA.
Drug Alcohol Depend. 1998 Jan 1;49(2):95-104. doi: 10.1016/s0376-8716(97)00144-0.
The present study examined whether the active component in tobacco, nicotine, can modulate cocaine craving in patients with a history of smoking crack cocaine when exposed to crack cocaine related environmental cues. Twenty patients, all cigarette smokers, were randomly assigned to nicotine (two 22 mg transdermal patches) or placebo in a single-dose, placebo-controlled, crossover, double-blind study. Craving and anxiety were measured before and after cocaine cues with visual analog scales for desire to use cocaine and mood. Skin conductance and skin temperature were recorded before and during cocaine cues. Following exposure to cocaine cues, all patients reported an increase in cocaine craving and anxiety relative to the pre-cue measures. Cue exposure also produced an increase in skin conductance and decrease in skin temperature. The cue-induced increase in cocaine craving was strongly enhanced by nicotine, while the increase in anxiety was slightly augmented. Cue-induced skin conductance and temperature responses were unaffected by nicotine. These findings show that cue-induced cocaine craving is enhanced by nicotine. This occurred in the absence of any tobacco smoking-related cues, suggesting that nicotine may have direct psychopharmacological effects on conditioned cocaine craving.
本研究探讨了烟草中的活性成分尼古丁，在有吸食快克可卡因史的患者暴露于与快克可卡因相关的环境线索时，是否能调节其对可卡因的渴望。在一项单剂量、安慰剂对照、交叉、双盲研究中，20名均为吸烟者的患者被随机分配至尼古丁组（两片22毫克的透皮贴剂）或安慰剂组。使用视觉模拟量表测量对使用可卡因的渴望和情绪，以此在接触可卡因线索前后评估渴望和焦虑程度。在接触可卡因线索之前及期间记录皮肤电导率和皮肤温度。接触可卡因线索后，所有患者报告相对于线索前测量值，对可卡因的渴望和焦虑均有所增加。线索暴露还导致皮肤电导率增加和皮肤温度降低。尼古丁强烈增强了线索诱导的对可卡因渴望的增加，而焦虑的增加略有增强。线索诱导的皮肤电导率和温度反应不受尼古丁影响。这些发现表明，尼古丁增强了线索诱导的对可卡因的渴望。这一情况发生在没有任何与吸烟相关线索的情况下，表明尼古丁可能对条件性可卡因渴望具有直接的心理药理学作用。
