[Show abstract][Hide abstract] ABSTRACT: The antiglutamatergic drug riluzole (Rilutek) is presently being used off label in the treatment of psychiatric conditions in adult patients and, increasingly, in children. This article briefly reviews the pharmacology of this drug and its current investigative and clinical uses and adverse effects. It also reports on our experience to date in the study of the drug in children, with emphasis on adverse effects noted so far in these younger patients.
Journal of child and adolescent psychopharmacology 08/2010; 20(4):309-15. DOI:10.1089/cap.2010.0009 · 2.93 Impact Factor
"N-acetyl-cysteine (NAC), an amino acid and glutamate modulating agent, has been found to block cocaine-induced reinstatement of drug-seeking in rats and reduce cue-induced craving in individuals with cocaine dependence (Kalivas and Volkow, 2005), and preliminary evidence suggests efficacy for NAC and other glutamatergic agents (e.g., riluzole) in treating PG, ICDs and impulsive behaviors, such as trichotillomania and self-injurious behaviors (Pittenger et al. 2005; Coric et al. 2007; Odlaug and Grant, 2007). Grant and colleagues (2007) conducted an eight-week, open-label, pilot-study with a double-blind discontinuation phase of NAC treatment for PG in a group of 27 individuals with PG with and without other Axis I disorders (thirteen subjects met criteria for alcohol use disorder or major depressive disorder; four met criteria for past-year major depressive disorder; eight met criteria for nicotine dependence). "
[Show abstract][Hide abstract] ABSTRACT: Pathological gambling (PG) is categorized as an impulse control disorder (ICD). Phenomenological, neurobiological and pharmacological data suggest similarities in the pathophysiologies of substance use disorders (SUDs) and PG. Both behavioral and pharmacological approaches, including those that have been empirically validated for SUDs, have shown promise in the treatment of PG. Findings from biological studies of PG are reviewed, and treatment approaches based on controlled studies are summarized.
Journal of Addiction Medicine 09/2009; 3(3):111-119. DOI:10.1097/ADM.0b013e31819b7bff · 1.76 Impact Factor
"(e) Glutamate Glutamate, the most abundant excitatory neurotransmitter , has been implicated in motivational processes and drug addiction (Chambers et al. 2003; Kalivas & Volkow 2005). Based on these data and preliminary findings suggesting a role for glutamatergic therapies in other ICDs (Coric et al. 2007), the glutamatergic modulating agent N-acetyl cysteine was investigated in the treatment of PG (Grant et al. 2007). The study design involved open-label treatment followed by double-blind discontinuation. "
[Show abstract][Hide abstract] ABSTRACT: Gambling is a prevalent recreational behaviour. Approximately 5% of adults have been estimated to experience problems with gambling. The most severe form of gambling, pathological gambling (PG), is recognized as a mental health condition. Two alternate non-mutually exclusive conceptualizations of PG have considered it as an obsessive-compulsive spectrum disorder and a 'behavioural' addiction. The most appropriate conceptualization of PG has important theoretical and practical implications. Data suggest a closer relationship between PG and substance use disorders than exists between PG and obsessive-compulsive disorder. This paper will review data on the neurobiology of PG, consider its conceptualization as a behavioural addiction, discuss impulsivity as an underlying construct, and present new brain imaging findings investigating the neural correlates of craving states in PG as compared to those in cocaine dependence. Implications for prevention and treatment strategies will be discussed.
Philosophical Transactions of The Royal Society B Biological Sciences 10/2008; 363(1507):3181-9. DOI:10.1098/rstb.2008.0100 · 7.06 Impact Factor
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