Alcohol reward

Krystal JH, Petrakis IL, Mason G, et al V-methyl-D-aspartate glutamate receptors and alcoholism reward, dependence, treatment, and vulnerability. Pharmacol Ther 99 79-94, 2003b... 

Buck KJ, et al. Serotonin 5-HT2 receptors and alcohol reward, withdrawal and discrimination. Alcohol Clin Exp Res 2004 28(2) 211-216. 

Chester JA, Cunningham CL GABA(A) receptor modulation of the rewarding and aversive effects of ethanol. Alcohol 26 131—143, 2002 Chick J Safety issues concerning the use of disulfiram in treating alcohol dependence. Drug Saf 20 427 35, 1999... 

Kleber HD, Weissman MM, Rounsaville BJ, et al Imipramine as treatment for depression in addicts. Arch Gen Psychiatry 40 649-633, 1983 Kleber HD, Riordan CE, Rounsaville BJ, et al Clonidine in outpatient detoxification from methadone maintenance. Arch Gen Psychiatry 42 391-394, 1983 Kleber HD, Topazian M, Gaspari J, et al Clonidine and naltrexone in the outpatient treatment of heroin withdrawal. Am J Drug Alcohol Abuse 13 1-17, 1987 Kornetsky C. Brain stimulation reward, morphine-induced stereotypy, and sensitization implications for abuse. Neurosci Biobehav Rev 27 777-786, 2004 Kosten TR, Kleber HD Buprenorphine detoxification from opioid dependence a pilot study. Life Sci 42 633-641, 1988... 

These dopaminergic reward pathways are critical for normal survival, since they provide the pleasure drives for eating, drinking and reproduction. However, this system produces similar sensations of pleasure with alcohol, cocaine, heroin, nicotine,... 

Kreek, M. J. and Koob, G. F. Drug dependence stress and dysregulation of brain reward pathways. Drug Alcohol Depend. 51 23-47,1998. 

It is in many ways unfortunate that the study of cationic polymerization has, from its very start, been so intimately linked with the very complicated and ill-understood chemistry of the metal halides. This connection is largely fortuitous and there is the promise of much progress in this field when these two problems can be attacked independently. On the one hand, we need to know much more about the complex acids and esters which are formed when water, alcohols, carboxylic acids, and alkyl halides react with metal halides on the other hand, a study of olefin polymerizations catalysed by simple acids such as HBr [14], HC104 [25], and H2S04 [26] should be rewarding, because they would presumably be unobscured by the complications and uncertainties accompanying the formation of the initiating species when this involves a metal halide. 

One of the most fruitful approaches to the elucidation of reaction mechanisms in organic chemistry is the study of the effect of structure on the reactivity and the course of the reaction. This approach is used extensively in homogeneous reactions and found to be equally rewarding in the study of the mechanism of dehydration of alcohols over alumina catalysts. Much information was obtained by changing the configuration of the alcohols. 

Cannon CM, Palmiter RD (2003) Reward without dopamine, J Neurosci 23 10827-10831 Carboni E, Bortone L, Giua C, Di Chiara G (2000) Dissociation of physical abstinence signs from changes in extracellular dopamine in the nucleus accumbens and in the prefrontal cortex of nicotine dependent rats. Drug Alcohol Depend 58 93-102 Castane A, Valjent E, Ledent C, Parmentier M, Maldonado R, Valverde O (2002) Lack of CBl cannabinoid receptors modifies nicotine behavioural responses, but not nicotine abstinence. Neuropharmacology 43 857-867... 

Historically, the treatment of alcohol use disorders with medication has focused on the management of withdrawal from the alcohol. In recent years, medication has also been used in an attempt to prevent relapse in alcohol-dependent patients. The treatment of alcohol withdrawal, known as detoxification, by definition uses replacement medications that, like alcohol, act on the GABA receptor. These medications (i.e., barbiturates and benzodiazepines) are cross-tolerant with alcohol and therefore are useful for detoxification. By contrast, a wide variety of theoretical approaches have been used to reduce the likelihood of relapse. This includes aversion therapy and anticraving therapies using reward substitutes and interference approaches. Finally, medications to treat comorbid psychiatric illness, in particular, depression, have also been used in attempts to reduce the likelihood of relapse. 

Naltrexone (ReVia). Naltrexone is a very potent antagonist of the actions of opiates. It has been used to reduce the rewarding effects of not only opiates but alcohol as well. Like buprenorphine, naltrexone appears to reduce craving for opiates by blocking their pleasurable effects. Naltrexone is not useful for detoxification and in fact worsens withdrawal. Naltrexone can be useful for maintenance treatment in those patients motivated to achieve total abstinence. It is taken at a constant dose of 50mg/day. A sustained-release depot formulation currently under development will likely help to overcome adherence issues that often undermine treatment for substance use disorders. 

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