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Translating the neuroscience of alcoholism into clinical treatments: from blocking the buzz to curing the blues
National Institute on Alcohol Abuse and Alcoholism, NIH; Bethesda, MD, USA.
National Institute on Alcohol Abuse and Alcoholism, NIH; Bethesda, MD, USA.
Central Institute of Mental Health, Mannheim, Germany.
Central Institute of Mental Health, Mannheim, Germany.
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2010 (English)In: Neuroscience and Biobehavioral Reviews, ISSN 0149-7634, E-ISSN 1873-7528, Vol. 35, no 2, 334-344 p.Article in journal (Refereed) Published
Abstract [en]

Understanding the pathophysiology of addictive disorders is critical for development of new treatments. A major focus of addiction research has for a long time been on systems that mediate acute positively reinforcing effects of addictive drugs, most prominently the mesolimbic dopaminergic (DA) system and its connections. This research line has been successful in shedding light on the physiology of both natural and drug reward, but has not led to therapeutic breakthroughs. The role of classical reward systems is perhaps least clear in alcohol addiction. Here, recent work is summarized that points to some clinically important conclusions. First, important pharmacogenetic differences exist with regard to positively reinforcing effects of alcohol and the ability of this drug to activate classical reward pathways. This offers an opportunity for personalized treatment approaches in alcoholism. Second, brain stress and fear systems become pathologically activated in later stages of alcoholism and their activation is a major influence in escalation of alcohol intake, sensitization of stress responses, and susceptibility to relapse. These findings offer a new category of treatment mechanisms. Corticotropin-releasing hormone (CRH) signaling through CRH1 receptors is a major candidate target in this category, but recent data indicate that antagonists for substance P (SP) neurokinin 1 (NK1) receptors may have a similar potential.

Place, publisher, year, edition, pages
Elsevier, 2010. Vol. 35, no 2, 334-344 p.
Keyword [en]
Alcoholism; Reward; Opioids; Pharmacogenetics; Stress; Anxiety; Amygdala; Corticotropin-releasing hormone; Substance P; Neurokinin
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URN: urn:nbn:se:liu:diva-101847DOI: 10.1016/j.neubiorev.2009.11.018PubMedID: 19941895OAI: diva2:666723
Available from: 2013-11-24 Created: 2013-11-24 Last updated: 2013-12-13

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Heilig, MarkusThorsell, Annika
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