Modulation of neuropeptide Y levels is impaired in crack withdrawal patients

Introduction: The dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis has a key role in drug addiction susceptibility. In addition to the well-known relationship between cortisol and the HPA axis, other molecules are involved with stress response and could modify the HPA activation, such as the neuropeptide Y (NPY), which has anxiolytic proprieties. There are few studies evaluating the effect of NPY levels on addiction, especially in crack cocaine dependence. Objective: To evaluate NPY in crack users during early withdrawal to determine its relationship with drug use and cortisol levels. Methods: We analyzed 25 male inpatient crack users. Serum NPY levels were measured at admission and discharge (mean of 24 days). Morning salivary cortisol was measured at admission. Results: Serum NPY levels at admission and discharge were very similar. Lower NPY levels at discharge were associated with higher lifetime crack use. Also, a negative correlation was found between morning cortisol and delta NPY (NPY discharge – NPY admission). Conclusion: These preliminary findings indicate that crack use influences the modulation of NPY levels and modifies stress response. The NPY pathway may play an important role in the pathophysiology of crack addiction, and the anxiolytic effect of NPY may be impaired in crack users. Future studies should consider NPY as a measurable indicator of the biological state in addiction

Predictive factors associated with driving under the influence among Brazilian drug-using drivers

The incidence of driving under the influence of psychoactive substances (DUI) and its recidivism can be curtailed by the proper identification of specific and predictive characteristics among drug users. In this sense, interpersonal violence (IV), psychiatric comorbidity and impulsivity seem to play an important role in DUI engagement according to previous studies. There are, however, limited data originated from low and middle income countries. In the present study, drug-using Brazilian drivers reporting DUI (n=75) presented a higher prevalence of bipolar disorders (BD; DUI: 8% vs. non-DUI: 0%, p < 0.001), lower prevalence of obsessivecompulsive disorder (OCD; DUI: 0% vs. non-DUI: 12.6%, p < 0.001), and higher prevalence of childhood trauma (DUI: 65.3% vs. non-DUI: 46.8%, p=0.022) than those not reporting DUI (n=79). The evaluation of impulsivity though the Barratt Impulsivity Scale, which give impulsivity scores ranging from 30 to 120, showed higher impulsivity scores in the DUI group (80.4 ± 8) than in the non-DUI group (77.2 ± 10, p=0.045). In general, subjects were young adults (mean age of 36 ± 9 years), Caucasians (58.4%), not married (61.0%), and with elementary schooling (40.3%) with no significant differences in demographic characteristics between drivers with and without DUI behavior A multiple Poisson regression model showed that individuals reporting IV as perpetrators and history of childhood trauma were more likely to report DUI (PR: 1.66, 95%CI 1.22–2.7; PR: 1.57, 95%CI 1.02–2.42, respectively). The overlapping of violent situations (childhood trauma, IV and DUI) in some individuals presented here corroborates literature data suggesting that DUI can be an externalizing expression of a range of risky behavior, such as impulsiveness and aggressiveness. Moreover, while BD and higher impulsivity scores seem to act as risk factors for DUI, OCD was shown as a protective factor. These results corroborate the hypothesis that individuals with high risk for DUI could probably be identified by multidimensional assessment of cognitive, risky taking, and personality traits, which perhaps could facilitate the development of focused interventions

O impacto da abstinência nos níveis séricos de leptina e no perfil nutricional de alcoolistas

Introduction: Alcohol use disorder (AUD) is associated with changes in metabolism and in the nutritional profile. Food-seeking behaviors and psychoactive substances share common biological pathways that activate the reward system and leptin is a modulator of this system. Objective: To measure serum leptin levels and nutritional status of individuals with before their detoxification and then 15 days later. Material and Methods: In total, 38 men diagnosed with AUD and admitted to a detoxification unit were analyzed. Serum leptin levels, Body Mass Index (BMI), Waist Circumference (WC) and body composition were assessed by Bioelectrical Impedance Analysis (BIA) within the first 48 hours of hospital admission and again 15 days after the first assessment. Results: Weight, BMI and WC increased significantly during detoxing (p<0.001), but body fat and leptin levels percentages remained similar. At admission, leptin levels were positively correlated with body fat (0.607), WC (0.696), and BMI (0.357). After 15 days, only leptin and BMI were significantly correlated (0.462). Conclusion: Our results reinforce the relationship between leptin and nutritional parameters related to body weight. It is essential to educate about nutrition and to encourage healthy eating behaviors so individuals with AUD can reduce weight gain during the recovery period.Introdução: O transtorno por uso de álcool (TUA) está associado a alterações metabólicas e perfil nutricional. Comportamento de busca de alimentos e substâncias psicoativas compartilham vias biológicas comuns ativando o sistema de recompensa e a leptina modula esse sistema. Objetivo: Avaliar níveis séricos de leptina e estado nutricional de indivíduos antes e 15 dias após a desintoxicação. Materiais e Métodos: Foram analisados 38 homens com diagnóstico de TUA internados em unidade de desintoxicação. Níveis séricos de leptina, Índice de Massa Corporal (IMC), Circunferência da Cintura (CC) e composição corporal foram avaliados por Bioimpedância Elétrica (BIA) nas primeiras 48 horas de internação e 15 dias após a primeira avaliação. Resultados: Peso, IMC e CC aumentaram significativamente durante a desintoxicação (p<0,001), mas os percentuais de gordura corporal e níveis de leptina permaneceram semelhantes. Na admissão, os níveis de leptina foram positivamente correlacionados com a gordura corporal (0,607), CC (0,696) e IMC (0,357). Após 15 dias, apenas leptina e IMC foram significativamente correlacionados (0,462). Conclusão: Os resultados reforçam a relação entre leptina e parâmetros nutricionais relacionados ao peso corporal. A educação nutricional e o incentivo ao comportamento alimentar saudável são essenciais para que indivíduos com TUA reduzam o ganho de peso na desintoxicação