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PSYT 301 > L3 - STIMULANTS > Flashcards

L3 - STIMULANTS Flashcards

1
Q

What are the phases of the VEAR model of addiction? What are the components of each phase? What are the chief factors of each component?

A

Vulnerability
-Genetic predisposition **
-Prenatal
–Addictive substance exposure
-Childhood **
–ADHD
–Social and familial norms
–Neglect and abuse
–Level of education

Exposure
-Adolescence ***
–Youth-related risk factors (sensation seeking, poor behavioural inhibition, hyperactive brain system)

Addiction and Recovery
-Adulthood
–Sustained drug use complications (reduced impulse-control, drug-focused reward system)
-Aggravating factors
–Psychiatric disorders
–Disease
-Treatment
–Antagonists
–CBT
–Replacement therapies

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2
Q

Provide 4 features of a stimulant drug.

A

Increases energy
Elevating mood
Increases the appeal of drug-paired events
Increases catecholamine transmission

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3
Q

List 3 neurotransmitters associated with catecholamine transmission.

A

DA
NE
Epinephrine

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4
Q

True or false: legal problems are a criterion in the DSM-5 for SUD.

A

False: they were before, but got removed in DSM-5.

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5
Q

List the 11 criteria for SUD in the DSM-5.

A

Hazardous use
Social / interpersonal problems related to use
Neglected major roles to use
Withdrawal
Tolerance
Used larger amounts / for longer
Repeated attempts to quit / control use
Much time spent using
Physical / psychological problems related to use
Activities give up to use
Craving

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6
Q

Who first thought of using cocaine as a local anesthetic?

A

William Halsted

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7
Q

True or false: low family income has bigger effect than ethnicity.

A

True: low family income keeps the substance users from seeking treatment.

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8
Q

What is the most common age of onset for SUD?

A

Around 20.

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9
Q

Except higher risk for OD, what consequence can heroin contaminated with fentanyl have on its users?

A

Lead to fentanyl addiction and increase the user’s tolerance.

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10
Q

True or false: at the moment, stimulants know an upward trend of use in the overall population.

A

True.

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11
Q

What is the most prevalent effect of stimulant drug cognitive enhancers on users with no ADHD diagnosed?

A

Only placebo effects.

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12
Q

Name one marketed brand of methylphenidate.

A

Concerta
Ritalin

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13
Q

List one unfavourable consequence from methylphenidate.

A

Perseveration.

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13
Q

True or false: remission probability over time is higher for alcohol than for cocaine.

A

False: the opposite.

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14
Q

What prominent factor can facilitate transition to dependence?

A

Comorbidity (SUD, psychiatric condition).

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15
Q

In which state of the recovery cycle do users tend to be the most stable?

A

In the community in recovery.

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16
Q

True or false: it is highly probably to transition to cocaine dependence in the first years of use, but there is also a high probability of remission for the same period.

A

True.

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17
Q

What are the four overall stages of the pathway to recovery?

A

In the community using
Incarcerated
In treatment
In the community recovering

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18
Q

Externalizing problems tend to lead to what kind of condition? Internalizing problems?

A

Externalizing: substance use.
Internalizing: mood and personality disorders.

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19
Q

What kind of abuse or neglect tend to lead the most to externalizing (substance use)?

A

Emotional abuse and sexual abuse.

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20
Q

How do men and women tend to differ in the management of physical abuse trauma?

A

Women tend to internalize.
Men tend to externalize more than internalize.

21
Q

What is the link between genetics, metabolism and SUD prevalence?

A

The metabolism of an individual is mostly genetically determined. Prevalence for SUD can be partly determined by one’s metabolic efficiency (breaking down drugs more quickly will drive the individual to consume more). In this regard, prevalence for SUD is partly due to genetics.

22
Q

Name a DA antagonist.

A

Haloperidol.

23
Q

What is a progressive ratio breakpoint?

A

Setting in which the subject has to work progressively harder for each drug administration (reward).

24
Q

Why does it make sense for a subject to seek more addictive drug injections when treated with haloperidol?

A

Haloperidol blocks the pleasurable effect of DA (being a DA antagonist), so the subject will consume more to compensate.

25
Q

What is counter-intuitive about stimulant drug-induced reinstatement?

A

After the extinction period, the smallest stimulant dose administered will provoke the highest response, but the provoked drug seeking behaviour will last the least.

26
Q

A part from the drug itself, what can cause reinstatement?

A

Drug-related cues.
Stress.

27
Q

Provide ways to decrease stress- and cue- induced reinstatement?

A

DA antagonists.
NE antagonists for stress-induced reinstatement specifically.

28
Q

True or false: DA antagonists are effective clinical treatments.

A

False.

29
Q

Where is located the NAcc in humans?

A

In the ventral-limbic component of the striatum.

30
Q

True or false: cocaine induces a higher dopamine striatal response than amphetamine.

A

False: the opposite.

31
Q

What are the two main individual differences regarding dopamine?

A

Novelty seeking
Trait impulsivity

32
Q

How are the autoreceptor availability, DA release in striatum and impulsivity or novelty-seeking related?

A

Three-way association: the lower autoreceptor availability → the higher the DA release in the striatum →the higher the patient scores on impulsivity or novelty-seeking tests.

33
Q

What is an acute phenylalanine/tyrosine depletion?

A

A dietary intervention involving the administration of an aa. mixture lacking in tyrosine and phenylalanine, which can be used to selectively lower DA synthesis in humans.

34
Q

If an individual undergoing an APTD can experience pleasure as well as the control individual, what is revealed about dopamine?

A

Dopamine alone cannot account for pleasure.

35
Q

How does APTD affect motivational stages? What does it reveal about dopamine?

A

APTD impairs motivated behaviour (the seeking of rewards). Perhaps dopamine is more intimately linked to motivational states than pleasurable states.

36
Q

What happens to drug-seeking behaviour if DA is decreased?

A

It decreases concomitantly.

37
Q

Why a medicine decreasing DA would not be enough to treat SUDs?

A

The substance users will get the same pleasurable experience from drugs and won’t be discouraged from seeking easily available drugs.

38
Q

What is leading repeated amphetamine administration to?

A

Sensitization.

39
Q

Why is it not too surprising that cravings co-vary with DA release?

A

Because DA release elicits drug-seeking behaviours, which corresponds to the motivational state of someone undergoing cravings.

40
Q

Apart from a low dose of drug, what can induce DA release for an individual diagnosed with SUD?

A

Drug-related cues
Stress

41
Q

Why is it coherent that stress-induced striatal DA release has larger effects in people that received lower maternal care?

A

Lower maternal care potentiates the HPA axis of the child, making the grown individual more vulnerable to stress. More stress more DA release.

42
Q

What is the impact of child maltreatment on cue-induced striatal activation?

A

Potentiates the activation.

43
Q

Between a healthy control group and a CUD group, which one is more likely to release DA when administered a stimulant in full awareness? And when administered a stimulant but told it is a placebo? What are these results proposing?

A

The HC group.
The CUD group.
That expectation is a component of tolerance and that patients withs SUDs HAVE responsive dopamine pathways, but WHEN they are activated is different from HC.

44
Q

Low reward system function plus what factor can increase the response to drug-related cues?

A

High stress.

45
Q

What is impaired in the executive function of SUD patients?

A

Reduced ability to switch behaviours
Dysregulated goal selection

46
Q

High drug cue-induced activation of the orbitofrontal cortex, amygdala, and ventral striatum is usually an indicator of what?

A

Imminent relapse.

47
Q

What is the cortical and dopamine activity like when relapse triggers are absent for a stimulant use disorder patient? When present?

A

Absent:

Low cortical activity
Low DA activity

Present:

High cortical activity
High DA activity

48
Q

True or false: genes playing a role in psychiatric disorders usually do not play a role in neurological conditions as well.

A

True.

49
Q

True or false: genes playing a direct role for certain psychiatric disorders are often involved in other psychiatric disorders as well.

A

True.

50
Q

Recently, a three factor model predicting common early onset DSM-5 disorders showed very high accuracy. What are its three factors?

A

Externalizing personality traits
Early life adversity
Midbrain DA autoreceptors

51
Q

What is the most efficient treatment for stimulant use disorders? What does it consist in?

A

Contingency Management Therapy, a type of behavioural therapy that aims at shifting the reward process from stimulants by rewarding individuals for evidence of positive behavioural change.

PSYT 301 (8 decks)

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