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Depression and stimulant dependence - neurobiology and pharmacotherapy

Academic Article
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Overview

authors

  • Kosten, T. R.
  • Markou, A.
  • Koob, George

publication date

  • December 1998

journal

  • Journal of Nervous and Mental Disease  Journal

abstract

  • Depressive disorder rates in stimulant-dependent individuals are substantially higher than community rates. Further, depressive symptoms are considered a major component of stimulant withdrawal. The comorbidity of these disorders may reflect shared neurochemical alterations in the function of serotonin, dopamine, and peptide systems, such as corticotropin releasing factor (CRF) and neuropeptide Y (NPY). These alterations are observed in patients, and in animal models of depression and stimulant dependence, particularly in limbic brain structures. This shared neurobiology does not seem to result from significant shared heritability or genetic linkage; stimulants may induce changes in neurobiology that are similar to those found in depression, and these changes might provide a therapeutic target. Stimulant-dependent patients with a depressive disorder may be a specific subpopulation for antidepressant trials, and they might reduce their stimulant abuse when treated with antidepressants. Nevertheless, concomitant dependence on alcohol or opioids may influence this response, and antidepressants appear to be more effective for depression in combined stimulant and opioid dependence than in combined stimulant and alcohol dependence.

subject areas

  • Antidepressive Agents
  • Central Nervous System Stimulants
  • Clinical Trials as Topic
  • Comorbidity
  • Depressive Disorder
  • Dopamine
  • Humans
  • Limbic System
  • Multicenter Studies as Topic
  • Neurotransmitter Agents
  • Research Design
  • Serotonin
  • Substance-Related Disorders
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Identity

International Standard Serial Number (ISSN)

  • 0022-3018

Digital Object Identifier (DOI)

  • 10.1097/00005053-199812000-00001

PubMed ID

  • 9865811
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Additional Document Info

start page

  • 737

end page

  • 745

volume

  • 186

issue

  • 12

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