Stress, Dysregulation of Drug Reward Pathways, and the Transition to Drug Dependence.

This review provides a neuroadaptive perspective regarding the role of the hormonal and brain stress systems in drug addiction with a focus on the changes that occur during the transition from limited access to drugs to long-term compulsive use of drugs. A dramatic escalation in drug intake with ext...

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Publicado en:American Journal of Psychiatry Vol. 164; no. 8; pp. 1149 - 1160
Autores principales: Koob, George, Kreek, Mary Jeanne
Formato: Artículo
Publicado: American Psychiatric Publishing, Inc. August 2007
Materias:
Acceso en línea:Ver este registro en EBSCOhost
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      dt: August 2007
      vid: 164
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      pub: American Psychiatric Publishing, Inc.
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        10.1176/appi.ajp.2007.05030503
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        atl: Stress, Dysregulation of Drug Reward Pathways, and the Transition to Drug Dependence.
      aug:
        au:
          Koob, George
          Kreek, Mary Jeanne
      su:
        Psychological stress
        Drug abuse
        Brain function localization
      sug:
        subj:
          Psychological stress
          Drug abuse
          Brain function localization
      ab: This review provides a neuroadaptive perspective regarding the role of the hormonal and brain stress systems in drug addiction with a focus on the changes that occur during the transition from limited access to drugs to long-term compulsive use of drugs. A dramatic escalation in drug intake with extended access to drug self-administration is characterized by a dysregulation of brain reward pathways. Hormonal studies using an experimenter-administered cocaine binge model and an escalation self-administration model have revealed large increases in ACTH and corticosterone in rats during an acute binge with attenuation during the chronic binge stage and a reactivation of the hypothalamic-pituitary-adrenal axis during acute withdrawal. The activation of the hypothalamic-pituitary-adrenal axis with cocaine appears to depend on feed-forward activation of the mesolimbic dopamine system. At the same time, escalation in drug intake with either extended access or dependence-induction produces an activation of the brain stress system's corticotropin-releasing factor outside of the hypothalamus in the extended amygdala, which is particularly evident during acute withdrawal. A model of the role of different levels of hormonal/brain stress activation in addiction is presented that has heuristic value for understanding individual vulnerability to drug dependence and novel treatments for the disorder. Reprinted by permission of the publisher.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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