DR.KARIMI

1
???? ???

• DR.KARIMI

2
DRUG ABUSE MENTAL ILLNESS Progress in
Understanding COMORBIDITY
3
(No Transcript)
4
Effects of Drugs on Dopamine Levels
COCAINE
AMPHETAMINE
Accumbens
1100
Dopamine Pathways Principal Pleasure System of
the Brain
Accumbens
400
1000
900
DA
800
300
DA
700
600
of Basal Release
500
200
of Basal Release
400
300
100
200
100
0
0
0
1
2
3
4
5 hr
0
1
2
3
4
5 hr
Time After Amphetamine
Time After Cocaine
Source Di Chiara and Imperato
Natural Rewards Elevate Dopamine Levels
FOOD
SEX
200
200
NAc shell
150
150
100
100
of Basal DA Output
15
10
Empty
DA Concentration ( Baseline)
50
Copulation Frequency
Box
Feeding
5
0
0
Scr
Scr
Scr
Scr
0
60
120
180
Bas
Female 1 Present
Female 2 Present
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
Time (min)
Sample Number
Di Chiara et al.
Fiorino and Phillips
5
Brain Dopamine System
DA
DA
Anatomy
DA
DA
DA
DA
DA
DA Transporters
signal
Dopamine Cell
6
Dopamine D2 Receptors in Addiction
Cocaine
Meth
DA D2 Receptor Availability
Alcohol
Food
7
Research Tells Us That STRESS Can Be A Major
Factor In the Initiation of Drug Use
And One of the Most Powerful Triggers for Relapse
In Recovering Addicts
8
(No Transcript)
9
The Stress Hormone Cycle
Kidneys
10
DRUG USE(Self-Medication)
What Role Does Stress Play In Initiating Drug
Use?
STRESS
11
RELAPSE
What Happens When A Person Stops Taking A Drug?
12
Addictive DisordersOften Co-Exist WithMental
Disorders
13
Addictive Disorders Often Co-Exist with or
Predispose to Mental Disorders
14
(No Transcript)
15
Lifetime Prevalence of Drug Disorders
Among Persons With Various Mental Disorders (vs.
any Drug Disorder Alone)
45
40
35
30
25
20
15
10
5
0
Schizo- phrenia
Anxiety
OCD
Depression
Any Drug Disorder (alone)
Panic Disorder
Bipolar Disorder
APD
Source Regier,D.A. et al., JAMA 264(19), pp.
2511-2518, November 21, 1990.
16
What Do Mental and Addictive Disorders Have in
Common?
Both are Behavioral Dysfunctions With Similar
Neurobiological Basis
17
Because of this overlap, drugs of abuse can cause
symptoms that mimic most forms of mental illness
18
Dopamine D2 Receptors in Addiction
Experimental groups
Control groups
Cocaine
DA D2 Receptor Availability
Meth
Alcohol
Food
19
(No Transcript)
20
Some drugs of abuse have a mechanism of action
similar to that of drugs used as
psychotherapeutic agents
Significance rationale for self-administration
21
serotonin synaptic terminal
transporter
Synaptic vesicle
Prozac Cocaine block
Postsynaptic target
22
Chronic use of some of these drugs may alter
the way the brain functions, making persons
particularly susceptible to mental illness
23
(No Transcript)
24
(No Transcript)
25
Comorbid Disorders
26
Increasing Knowledge About Any One of
These Commonly Co-existing Problems May Help Us
Better Understand the Others
Drug Abuse
Depression
HIV/AIDS
Risky Sexual Behavior