Psychopharmacology of Addiction

Abstract

Addiction is a primary, chronic, neurobiological disease, with genetic, psychosocial, and environmental factors influencing its development. Developments in the psychopharmacology of addiction is much slower than the other disciplines of psychiatry. For a long time, social and behavioral therapeutic approaches are the only choices for the treatment of addictive disorders. Disulfiram was the only pharmacological agent approved for addiction treatment until the end of 20th century. Pharmacological treatment options available for treatment have grown along with our understanding of the neurobiological mechanisms underlying the development and persistence of addiction. Several new medications like naltrexone, acamprosate, methadone and buprenoprhine have been approved for the treatment of alcohol and opioid use disorders ever since. Based on ever-increasing information about neurotransmitter and receptors, many studies have been performed concerning craving and relapse prevention in recent years. Besides many other pharmacological agents have been focus of new researches for treatment of different types of addiction. The aim of this article is to briefly review the literature on psychopharmacology of addictive disorders and recent developments in this area.

Keywords

• Addiction, Alcohol, Drug, Treatment, Immunotherapy

Bağımlılık Psikofarmakolojisi

Öz

Bağımlılık gelişiminde genetik, psikososyal ve çevresel faktörlerin rol oynadığı birincil, kronik nörobiyolojik bir hastalıktır. Bağımlılık psikofarmakolojisindeki gelişmeler psikiyatrinin diğer alanlarına göre daha yavaş bir seyir göstermiştir. Alkol ve madde bağımlılığı tedavisi uzun süre sadece sosyal ve davranışsal yaklaşımlar ile sürdürülmüştür. Yirminci yüzyılın sonuna kadar madde bağımlılığı tedavisinde onay almış tek ajan disülfiram olmuştur. Bağımlılığın oluşumu ve sürmesini sağlayan nörobiyolojik süreçlerin daha iyi anlaşılmaya başlanmasına paralel olarak farmakolojik tedavi seçeneklerinin sayısı da artmaya başlamıştır. Son yıllarda alkol ve opiyat bağımlılığı tedavisinde naltrekson, akamprosat, metadon ve buprenorfin gibi çeşitli ilaçların kullanımına izin verilmiştir. Nörotransmitter ve reseptör düzeyinde artan bilgiler ışığında, özellikle istek ve nükslerin önlenmesi konusunda halen pek çok çalışma yapılmakta, farklı bağımlılık tiplerinde kullanılmak üzere birçok farmakolojik ajanın geliştirme çabaları ve tedavi arayışları devam etmektedir. Bu yazıda alkol ve madde bağımlılığı psikofarmakolojisinde mevcut tedavi seçenekleri ve geliştirme aşamasında olan ilaçlar kısaca gözden geçirilmiştir.

Anahtar Kelimeler

• Bağımlılık, alkol, madde, tedavi, immünoterapi

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