Eating chocolate
Craving:
The desire to experience the effects of a previously experienced psychoactive substance
Reward:
A process that reinforces behaviour. When offered, causes a behavior to increase in intensity
+
Craving for Chocolate
Chocolate +
No Chocolate
Addiction
Compulsion to seek and take a drug. Chronologically relapsing disorder. Loss of control on intake.
Stages of addiction
1. Acute drug effects- dopamine levels are spiked to very high levels. 2. Transition to addictionglutamatergic projections from the prefrontal cortex to the accumbens is mainly responsible for drug seeking behaviour.
3. End stage addictioncharacterised by overwhelming urge to obtain the drug, a diminished ability to control drug seeking and reduced pleasure from biological rewards.
Neurotransmitters
-chemicals used to relay, amplify and modulate signals between neurons. - Characteristics of a neurotransmitter
1. Made in presynaptic neuron 2. Present and available in presynaptic neuron 3. Postsynaptic receptors should be able to bind to it. 4. A biochemical mechanism for inactivation exists.
It is important to appreciate that it is the receptor that dictates the neurotransmitter's effect.
Major systems
The major neurotransmitter systems are: 1. Noradrenaline system
Effect of drugs
Drugs targeting the neurotransmitter affects the whole system: 1. Cocaine blocks dopamine + dopamine receptor binding, leaving dopamine in the synaptic gap longer. 1 2. Prozac blocks serotonin + serotonin receptor binding, boosting effect of naturally produced serotonin. 1
1. Neurotransmitters, The Wikipedia
Dopamine
- Is a neurotransmitter.
-The Brain is possibly the most complex system known - Complexity at several levels: Molecular (neurotransmitter structures and functions)
Complex systems
- Cellular: Neuron- neuron interactions. Synaptic complexity. -Tissue level: local area organization and functional complexity.
2. Prefrontal Cortex (PFC) : measures intensity of emotion 3. Nucleus Accumbens : linked to reward motivated behavior.
3. The Neural Basis of Addiction: A Pathology of Motivation and Choice Peter W. Kalivas,Nora D. Volkow
- As the causal event X becomes familiar, dopamine release is no longer induced. - BUT: Behavior elicited is still goal directed - BUT, since it is well learned,
DOPAMINE INDUCED NEUROPLASTIC CHANGES ARE NOT NECESSARY.
3. The Neural Basis of Addiction: A Pathology of Motivation and Choice Peter W. Kalivas,Nora D. Volkow
Addiction:
Addiction: a dis-regulation of the motive circuit. This pathway is associated with repeated drug use
COMPULSION
Food
Cue
No Food
Addiction: A Disease of Learning and Memory: Steven E. Hyman, M.D. (Am J Psychiatry 2005; 162:14141422)
Fighting addiction5
Three methods: 1. substitution or a blocking antibody
Pharmacotherapy6
Blocking vs. Antagonist
1. Blocking Antibody is dormant except when drug is taken
2. Stops drug effects at source, which is easier than stopping drug effects later on 3. Blocking antibody does not affect normal neurotransmitter functions
4. Antagonists of the various neurotransmitters would lead to unwanted actions on the many aspects of brain function, for instance, in the case of dopamine, mood, attention, and movement.
6 Neurobiology of addiction and implications for treatment ANNE LINGFORD-HUGHES and DAVID NUTT, BRITISH JOURNAL OF P SYCHIATRY
To sum up
- Addiction cannot be fought by willpower. - Reward not equal to pleasure. - Relapse is due to distributed modalities - Cure doesnt change the circuit