The Role Of Pharmacotherapy In Prevention Of Relapse In Alcohol Dependence
Funder
National Health and Medical Research Council
Funding Amount
$422,310.00
Summary
The physical, psychological and social consequences of alcohol abuse remain a critical health problem. Every year in Australia, excessive consumption is responsible for 3,000-6,000 deaths and costs the community $6 billion. Approximately 15% of Australians abuse alcohol and 5% of men and 3% of women are alcohol dependent (addicted to alcohol). Young men are particularly affected, with 10% of all men aged 18-35 dependent on alcohol. Better treatment for alcohol dependence is urgently needed. Less ....The physical, psychological and social consequences of alcohol abuse remain a critical health problem. Every year in Australia, excessive consumption is responsible for 3,000-6,000 deaths and costs the community $6 billion. Approximately 15% of Australians abuse alcohol and 5% of men and 3% of women are alcohol dependent (addicted to alcohol). Young men are particularly affected, with 10% of all men aged 18-35 dependent on alcohol. Better treatment for alcohol dependence is urgently needed. Less severe forms of alcohol abuse frequently respond to brief screening and intervention programs. Treatment of alcohol dependence remains unsatisfactory. Most treatments lead to abstinence in only 1-3, and approximately 50% of these will relapse within 3 months of completing treatment. Two drugs (naltrexone and acamprosate) appear to interfere with the effects of alcohol on the brain that promote addiction. There is evidence that both drugs are beneficial in the treatment of alcohol dependence and both are now available in Australia. At present, no data have been reported comparing the effectiveness of these two drugs. The proposed project will compare naltrexone and acamprosate in a large carefully performed study. The study will help determine which subjects are likely to benefit from one or other of these agents. Compliance is a major problem with many medications, but is a particular problem with medications for substance abuse. The second aim of this study is to test a novel intervention to increase compliance with medications for alcohol dependent subjects. This intervention comprises 'compliance therapy', which resembles a short training course, a medication alarm, and an assertive reminder program for scheduled medical appointments. The present study will be the first to apply this type of therapy to subjects with alcohol dependence.Read moreRead less
Risk Factors For Compliance With Command Hallucinations In Psychotic Disorders
Funder
National Health and Medical Research Council
Funding Amount
$180,290.00
Summary
There is widespread public concern about the danger individuals with schizophrenia or related disorders pose to themselves and to the community. Whilst a number of violence risk factors such as being male, exhibiting hostility, and having a prior history of violence are well established, they are of limited use to clinicians in making management decisions. Our study will investigate a different approach to identify individuals and occasions when a sufferer might require more intensive care or ob ....There is widespread public concern about the danger individuals with schizophrenia or related disorders pose to themselves and to the community. Whilst a number of violence risk factors such as being male, exhibiting hostility, and having a prior history of violence are well established, they are of limited use to clinicians in making management decisions. Our study will investigate a different approach to identify individuals and occasions when a sufferer might require more intensive care or observation. Most individuals with schizophrenia experience auditory hallucinations. Amongst these hallucinations, voices that command the individual to undertake a particular action are common; many of these involve significant potential harm to the hallucinator or to other persons. We will attempt to identify those factors that are associated with an individual obeying command hallucinations. Variables to be examined include the characteristics of the hallucinated voices, and the beliefs of the subject about the power of the voices. Subjects will be interviewed to find out whether they have delusions that are consistent with their hallucinations, whether they suffer from Antisocial Personality Disorder, or are dependent on alcohol or drugs. We will also determine whether subjects who report being raised by authoritarian parents, who are dependent on the approval of others, or who see external factors as determining the occurrence of major events in their lives, are more likely to act on their hallucinations. Two groups of 100 patients will be studied. One group will be representative of people living in the community with schizophrenia. The other group will be people with schizophrenia who have been treated by the State Forensic Psychiatric Services. Statistical models will be developed in order to determine the accuracy with which compliance with command hallucinations can be predicted. These models with also reveal which risk factors are the most important.Read moreRead less
Attentional Effects On Prepulse Inhibition Of The Acoustic Startle Reflex In Patients With Schizophrenia
Funder
National Health and Medical Research Council
Funding Amount
$278,625.00
Summary
People suffering from schizophrenia exhibit differences from healthy people in the startle reflex, which is a blink of the eyes when a sudden loud sound occurs. Normally, this reflex is reduced in size when a quiet sound occurs a few milliseconds before the startling sound, but this prepulse inhibition of the startle reflex or PPI does not occur to the same degree in people with schizophrenia. The underlying causes of this reduction in PPI in patients with schizophrenia is not known. The most co ....People suffering from schizophrenia exhibit differences from healthy people in the startle reflex, which is a blink of the eyes when a sudden loud sound occurs. Normally, this reflex is reduced in size when a quiet sound occurs a few milliseconds before the startling sound, but this prepulse inhibition of the startle reflex or PPI does not occur to the same degree in people with schizophrenia. The underlying causes of this reduction in PPI in patients with schizophrenia is not known. The most commonly accepted theory is that it reflects a deficit in a basic sensorimotor gating function which could underlie a variety of attentional abnormalities observed in schizophrenia. However, our data indicate that patients exhibit more PPI when they ignore the prepulse stimuli. We wish to test the hypothesis that alterations in PPI in schizophrenic patients are secondary to abnormalities in attention. This is significant because the theory can point to a specific cognitive deficit associated with schizophrenia. We have also found that patients treated with some kinds of antipsychotic medications (the newer atypical antipsychotic medications) do not show reductions in PPI, but patients treated with older types of antipsychotic drug do show reductions in PPI. We intend to investigate the effects of different types of antipsychotics on attentional modulation of PPI. This is significant because it may indicate that patients with a specific kind of cognitive impairment may show improvement with a specific type of medicine. Our data suggests that chronic cannabis use may associated with differences in the startle reflex and in PPI. Understanding how such cannabis use alters PPI may provide insights into why so many people with schizophrenia regularly abuse cannabis.Read moreRead less