Bipolar Disorder, Cocaine / 16.05.2025
What Is the Relationship Between Bipolar Disorder and Cocaine Addiction?
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Youngeun Armbuster[/caption]
Youngeun Armbuster
Geisinger Commonwealth School of Medicine
Scranton, Pennsylvania
MedicalResearch.com: What is the background for this study?
Response: Cocaine is classified by the U.S. Drug Enforcement Administration (DEA) as a Schedule II drug that can be used as an anesthetic in various types of surgery by otorhinolaryngologists, as well as in diagnosing Horner syndrome. Although controlled doses of cocaine used in topical anesthetics does not cause myocardial infarction as can occur with recreational dosages, intranasal administration of cocaine is absorbed systemically and it results in vasoconstriction of the coronary arteries via stimulation of adrenergic receptors. These potential adverse effects may disincentivize health care providers from medical cocaine use. Our objective was to quantify the trends in licit cocaine distribution in the United States using DEA data and to determine the usage of medical cocaine in Medicaid and Medicare, as well as based on electronic medical records [1].
Dr. Schmitz[/caption]
Joy M. Schmitz, Ph.D.
Professor of Psychiatry Faillace Chair
McGovern Medical School
The University of Texas Health Science Center at Houston
Director, Center for Neurobehavioral Research on Addiction (CNRA)
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Dr. Lane[/caption]
Scott D. Lane Ph.D.
McGovern Medical School
Vice Chair For Research
Director Of Neurobehavioral Laboratory
Center For Neurobehavioral Research On Addiction
Director Of Research
University of Texas Health Science Center at Houston
Houston, TX
MedicalResearch.com: What is the background for this study?
Response: Addiction science has made considerable progress in understanding how cocaine and other addictive drugs impair the brain. Over time, cocaine can disrupt brain regions that help us think, plan, solve problems, and exert self-control. These disruptions in brain structure can be seen in neuroimaging studies that reveal impairment in the nerve fibers or white matter (WM) tracts in the central and front parts of the brain. We conducted two systematic meta-analytic reviews of the literature to document the robustness of evidence showing alterations in WM integrity of chronic stimulant users relative to healthy control subjects who did not use cocaine or other drugs of abuse (Beard et al., 2019; Suchting et al., 2020). Importantly, WM impairments negatively predict treatment outcome, meaning individuals with greater levels of WM impairment are less likely to benefit from treatment and more likely to experience deficits in attention, working memory, and impulse control.
We reasoned that pharmacological interventions shown to protect WM integrity may help improve cognition and treatment outcomes in patients recovering from cocaine addiction. Pioglitazone, an approved medication for type 2 diabetes, has been shown to reduce inflammation and mediate protection after traumatic brain injury. The therapeutic potential of pioglitazone has prompted investigation of its role in neurodegenerative conditions, such as dementia, Alzheimer’s disease, and stroke. Similar to these brain diseases and injuries, pioglitazone might effectively protect the brain from the inflammatory damage created by cocaine use.
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