
Michael SoykaLudwig-Maximilians-Universität in Munich | LMU · Department of Psychiatry
Michael Soyka
Prof Dr., MD
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Introduction
Publications
Publications (854)
ZUSAMMENFASSUNG
Ziel der Arbeit Die Problematik der strafbewährten Abstinenzzuweisung bei suchtmittelabhängigen Straftätern wird dargestellt.
Methodik Berichtet wird der exemplarische Fall eines langjährig polytoxikomanen Straftäters, der trotz Abstinenzzuweisung weiter Alkohol und Drogen konsumierte.
Ergebnisse Klinische und forensische Aspekte di...
Aims
Alcohol cravings are considered a major factor in relapse among individuals with alcohol use disorder (AUD). This study aims to investigate the frequency and triggers of cravings in the daily lives of people with alcohol-related issues. Large amounts of data are analyzed with Artificial Intelligence (AI) methods to identify possible groupings...
Background
Polygenic Risk Scores (PRS) based on results from genome-wide association studies offer the prospect of risk stratification for many common and complex diseases. We developed a PRS for alcohol-associated cirrhosis by comparing single-nucleotide polymorphisms among patients with alcohol-associated cirrhosis (ALC) versus drinkers who did n...
Background:
Phenibut (β-phenyl-γ-aminobutyric acid) is an analog of the neurotransmitter gamma-aminobutyric acid (GABA). Like gabapentin and pregabalin, it inhibits α2-δ-subunits of voltage-dependent presynaptic calcium channels. The potential harm resulting from the use of these gabapentinoids is currently a matter of debate.
Methods:
This revi...
ZUSAMMENFASSUNG
Zum 01.10.2023 ist die Neufassung des § 64 StGB, der die Maßregel (Unterbringung psychisch kranker Rechtsbrecher mit Suchterkrankungen) bedingt, in Kraft getreten. Die Neufassung zielt auf eine deutliche Beschränkung der Zahl der nach § 64 StGB untergebrachten Straftäter ab. Das Vorliegen und der Schweregrad einer Substanzkonsumstör...
In Germany, only about 10% of patients with alcohol use disorder (AUD) are treated by the professional help system. “The First 30 Days without Alcohol”, an interactive e-health intervention, was developed to support people with “alcohol problems” to abstain from alcohol. The aim of this study was to examine the feasibility of the approach, the prog...
Chronic insomnia occurs in ~10% of the general population and has numerous negative health effects. The recommended first line treatment of cognitive behavior therapy for insomnia is not widely available for patients in Europe, so pharmacotherapies such as benzodiazepine receptor agonist agents (benzodiazepines and Z-drugs) are commonly used. Howev...
Introduction:
Concomitant drug use is common among opioid-dependent patients in maintenance therapy. Attention deficit hyperactivity disorder (ADHD), a common comorbidity among opioid users, is associated with a higher risk of concomitant drug use. Earlier studies showed that methylphenidate (MPH) can reduce cocaine consumption among patients with...
ZUSAMMENFASSUNG
Diskutiert wird der Fall eines 41-jährigen Piloten ohne relevante psychiatrische Vorgeschichte, der im Kontext einer gesicherten COVID-Infektion mit Kopfschmerzen, Müdigkeit und Antriebsbarmut zeitgleich eine ängstlich-paranoide Symptomatik mit Verfolgungs- und Beziehungsideen entwickelte, die über mehrere Wochen persistierte und un...
Background & Aims: Progression of alcohol-associated liver disease (ALD) is driven by genetic predisposition. The rs13702 variant in the lipoprotein lipase (LPL) gene is linked to non-alcoholic fatty liver disease. We aimed at clarifying its role in ALD. Methods: Patients with alcohol-associated cirrhosis, with (n = 385) and without hepatocellular...
Hepatocellular carcinoma (HCC) is a severe complication of advanced alcoholic liver disease, which is modulated by genetic predisposition. Identifying new genetic loci might improve screening. Genetic variation of SAMM50 was linked to HCC. We aimed to validate this finding in a large cohort of patients with advanced alcoholic liver disease (ALD). A...
To date few medications are approved for treatment of alcohol use disorders. Medications for treatment of alcoholism should either increase abstinence rates resp reduce relapse rates or reduce alcohol intake (number of drinks per day) in affected individuals. Disulfiram has been used for decades. The drug blocks the enzyme alcohol dehydrogenase and...
Pharmacological neuroenhancement (PN) describes the use of divergent psychoactive substances to enhance mental performance (cognition) without medical need. This kind of substance abuse takes place predominantly in stressful situations. Users implicitly—or even explicitly—describe this kind of drug abuse to be a coping strategy. Regarding the decis...
Obwohl der schädliche Gebrauch beziehungsweise die Abhängigkeitsentwicklung von Arzneimitteln sehr häufige Störungen sind, werden sie bislang in suchtmedizinischen Einrichtungen kaum behandelt. Dies ist aus den Statistiken, zum Beispiel des jährlich erscheinenden Jahrbuchs Sucht unschwer zu entnehmen (Übersicht in Soyka [40]).
Compounds known to be successful in the treatment of alcohol use disorder include the aversive agent, Disulfiram, the glutamatergic NMDA receptor antagonist, Acamprosate, and the opioid receptor antagonists, Naltrexone and Nalmefene. Although all four are effective in maintaining abstinence or reduction of alcohol consumption, only a small percenta...
Introduction:
In Germany, the prevalence rates for alcohol use disorders amount to approx. 6%, while about 3% are diagnosed as being alcohol dependent. Only 10% of the patients are undergoing treatment. There are apparent deficits with respect to early interventions. The internet presence of "Ohne Alkohol mit Nathalie" (OAmN) (Abstinence with Nath...
Background:
The rising number of people using methamphetamine leads to an increasing need for treatment options for this patient group. Evidence-based research on the efficacy of treatment programs for methamphetamine users is limited. Due to specific characteristics of methamphetamine users, the question arises whether established treatment metho...
Misuse and dependence from sedatives and hypnotics are frequent, especially with benzodiazepines (BZDs) and non-benzodiazepine hypnotics, the so-called Z-drugs (Zolpidem, Zopiclone, Eszopiclone). They are far less toxic than older sedatives and hypnotics and have replaced other drugs such as barbiturates, meprobamate, chloralhydrat, clomethiazole o...
Introduction:
Comorbidity of bipolar disorder (BD) and alcohol use disorder (AUD) is very frequent resulting in detrimental outcomes, including increased mortality. Diagnosis of AUD in BD and vice versa is often delayed as symptoms of one disorder mimic and obscure the other one. Evidence for pharmacotherapies for people with comorbid BD and AUD r...
Eine lange Einnahme von Benzodiazepinen birgt ein hohes Risiko einer Abhängigkeit. Mithilfe von Psychotherapie und einem schrittweisen Absetzen lassen sich Patienten aus der Sucht herausführen. Missbrauch und Abhängigkeit von Tranquilizern und Hypnotika sind häufig. Das Problem ist jedoch von der klinischen Forschung lange vernachlässigt worden [1,...
BACKGROUND & AIMS Only a minority of excess alcohol drinkers develop cirrhosis. We developed and evaluated risk stratification scores to identify those at highest risk. METHODS Three cohorts (GenomALC-1: n=1690, GenomALC-2: n=3037, UK Biobank: relevant n=6898) with a history of heavy alcohol consumption (≥80 g/day (men), ≥50 g/day (women), for ≥10...
Background
/Objectives Previous genome-wide association studies (GWAS) identified genome-wide significant risk loci in chronic pancreatitis and investigated underlying disease causing mechanisms by simple overlaps with expression quantitative trait loci (eQTLs), a procedure which may often result in false positive conclusions.
Methods
We conducted...
Zusammenfassung
Opiatabhängigkeit ist bei Straftätern häufig und viele opiatabhängige Rechtsbrecher werden nach § 64 STGB im Maßregelvollzug behandelt. Während die Substitutionsbehandlung in Haftanstalten mittlerweile gängige Praxis ist, wird die Substitutionsbehandlung im traditionell abstinenzorientierten Maßregelvollzug sehr kontrovers und regio...
Methamphetamine use disorder is associated with severe psychiatric symptoms and psychosocial problems. Women seem to be more affected than men. Therefore, this study examined psychiatric comorbidities and psychopathology, drug use patterns, and treatment outcomes in women addicted to methamphetamine compared to men. Data on methamphetamine-dependen...
Background: Pharmacological neuroenhancement (PN) is a common healthcare problem at least among students. PN seems to be associated with stressful situations. There is a lack of data about personal characteristics, comorbidities, and coping strategies regarding stress and factors of resilience in students and medical staff.
Methods: A web-based sur...
Methadone, a full opioid agonist at the mu-, kappa-, and delta-receptor, and buprenorphine, a partial agonist at the mu receptor, are first-line medications in opioid maintenance treatment. Transition from methadone to buprenorphine may precipitate withdrawal, and no accepted algorithm for this procedure has been developed. Current treatment strate...
Methamphetamine use disorder is often associated with psychopathological symptoms and attention performance deficits. Little is known about the co-incidence of methamphetamine use disorders and attention deficit hyperactivity disorder in childhood. This study examines potential correlations between substance use patterns, psychopathological symptom...
Background: There is an increasing demand of treatment options for methamphetamine users. The present study evaluates differences between methamphetamine users and users of other substances with respect to cognitive function and psychopathology and possible correlates of treatment outcome.
Method: 110 subjects were recruited for an observational lo...
Background & Aims
Only a minority of excess alcohol drinkers develop cirrhosis. We developed and evaluated risk stratification scores to identify those at highest risk.
Methods
Three cohorts (GenomALC-1: n=1690, GenomALC-2: n=3037, UK Biobank: relevant n=6898) with a history of heavy alcohol consumption (≥80 g/day (men), ≥50 g/day (women), for ≥10...
Oral methadone or sublingual buprenorphine are first-line medications for pharmacotherapy of opioid use disorders (OUDs). Three long-acting buprenorphine depot or implant formulations are currently available for the treatment of OUDs: (1) CAM 2038 (Buvidal) for subcutaneous weekly and monthly application; (2) RBP-6000 (Sublocade™) as a monthly depo...
Background:
Methadone, a full opioid agonist, and buprenorphine, a partial agonist at the opioid receptor, are established first-line medications for opioid maintenance therapy. Transition from methadone to sublingual buprenorphine may precipitate withdrawal and is usually performed only in patients on low dose of methadone (<30-40 mg). Transition...
ZUSAMMENFASSUNG
Nur wenige Substanzen sind als sogenannte Anti-Craving-Me-dikamente zur pharmakogestützten Rückfallprophylaxe der Alkoholabhängigkeit zugelassen. Dazu gehören das in Deutschland nicht mehr vertriebene Disulfiram, die Opioidantagonisten Naltrexon und Nalmefen sowie Acamprosat. Gerade für Acamprosat und Naltrexon ist die Evidenzbasier...
ZUSAMMENFASSUNG
Pharmakologisches Neuroenhancement (PN) beschreibt die Einnahme diverser psychotroper Substanzen zur geistigen Leistungssteigerung, ohne dass dafür eine medizinische Notwendigkeit bestünde. Dazu werden vor allem Stimulanzien (Methylxanthintyp wie Koffein und Amphetamintyp wie Methylphenidat, Amphetamine) sowie Nichtstimulanzien (z....
ZUSAMMENFASSUNG
Die Therapieerfolge von Anti-Craving-Substanzen bewegen sich im Bereich geringer bis moderater Effekte. Gleichzeitig macht die starke Heterogenität der Effekte innerhalb von Studien deutlich, dass sich Patienten im Ansprechen auf Anti-Craving-Substanzen unterscheiden und in bestimmten Patientengruppen stärkere Effekte als im Stichpr...
Introduction: Pharmacological neuroenhancement (PN) is a topic of increasing importance and prevalence among students. However, there is a lack of differentiating PN substances, according to their psychoactive effects. In particular, there is a lack of data about PN by caffeinated drinks, even if coffee is a common and broadly used Neuroenhancer be...
Background & aims:
Bacterial translocation drives liver disease progression. We investigated whether functional genetic variants in toll-like receptor 5 (TLR5), the receptor for bacterial flagellin, affect the risk for hepatocellular carcinoma (HCC).
Methods:
Healthy controls (n=212), patients with alcohol abuse without liver disease (n=382), an...
Zusammenfassung
Hintergrund In Europa gab es in den letzten 15 Jahren mehrere Schädlichkeits-Vergleiche bezüglich der Einnahme von psychotropen Substanzen durch Suchtexperten. Eine einzige Einschätzung liegt bezüglich des potenziellen Nutzens vor. Non-Opioiderge Analgetika (NOA), wie Gabapentinoide und NSARs, die zunehmend Gegenstand von Missbrauch...
Die Substitutionstherapie mit langwirksamen Opioiden hat eine herausragende Bedeutung für die Behandlung und Versorgung von Menschen mit Opiatabhängigkeit. Das Spektrum der einsetzbaren Substanzen hat sich in der letzten Zeit deutlich erweitert, wodurch sich die Prognose für Opiatabhängige erheblich verbessert hat.© shintartanya / stock.adobe.com ©...
Veröffentlichung in: SuchtAktuell, 27 (2), 43-51.
Der Konsum von Methamphetamin (MA) stellt weltweit ein zunehmendes Gesundheitsproblem dar. Es fehlen evidenzbasierte
Therapiekonzepte, die auch die komorbiden psychischen Störungen im Fokus haben. 108 MA-Abhängige in zwei Rehabilitationskliniken
wurden im Rahmen der „Crystal-Studie“ hinsichtlich ps...
Opioid maintenance treatment with oral methadone or sublingual buprenorphine is the first-line treatment in opioid dependence. Three novel long-acting buprenorphine formulations have been approved or will be available soon: for subcutaneous weekly and monthly application, the depot formulations CAM 2038 (Buvidal®), the monthly depot formulation RBP...
Background: Over the past 15 years, comparative assessments of psychoactive substance harms to both users and others have been compiled by addiction experts. None of these rankings however have included synthetic cannabinoids or non-opioid prescription analgesics (NOAs, e.g., gabapentinoids) despite evidence of increasing recreational use. We prese...
Introduction:
Sustained high alcohol intake is necessary but not sufficient to produce alcohol-related cirrhosis. Identification of risk factors, apart from lifetime alcohol exposure, would assist in discovery of mechanisms and prediction of risk.
Methods:
We conducted a multicenter case-control study (GenomALC) comparing 1,293 cases (with alcoh...
Background:
Among opioid-dependent patients on maintenance therapy, concomitant drug abuse is a serious problem. Dextromethorphan, an over-the-counter antitussive agent that can be purchased without prescription, is a drug with a high potential for misuse, especially when consumed in high doses.The objective of this study was to investigate possib...
Background and aims:
Only a minority of heavy drinkers progress to alcohol-associated cirrhosis (ALC). The aim of this study was to identify common genetic variants that underlie risk for ALC.
Approach and results:
We analyzed data from 1,128 subjects of European ancestry with ALC and 614 heavy-drinking subjects without known liver disease from...
Zusammenfassung
Bislang sind nur wenige Medikamente zur pharmakologischen Rückfallprophylaxe der Alkoholabhängigkeit zugelassen. Neben dem in Deutschland nicht mehr vertriebenen Disulfiram sind es die Opioidantagonisten Naltrexon und Nalmefen sowie das vermutlich über glutamaterge Neurone wirkende Acamprosat. Baclofen und γ‑Hydroxybutyrat (GHB) sin...
BACKGROUND & AIMS
Little is known about genetic factors that affect development of alcohol-related cirrhosis. We performed a genome-wide association study (GWAS) of samples from the United Kingdom Biobank (UKB) to identify polymorphisms associated with risk of alcohol-related liver disease.
METHODS
We performed a GWAS of 35,839 participants in the...
This study investigates the effects of two different residential treatments and of treatment drop-out in a German methamphetamine (MA) dependent sample. 108 subjects from two addiction treatment concepts were recruited at treatment begin and followed-up at 12 (T2) and 18 (T3) months after treatment. Based on follow-up samples (n = 38 at T3, n = 25...
Eating disorders and substance use disorders frequently co‐occur. Twin studies reveal shared genetic variance between liabilities to eating disorders and substance use, with the strongest associations between symptoms of bulimia nervosa and problem alcohol use (genetic correlation [rg], twin‐based = 0.23‐0.53). We estimated the genetic correlation...
Pharmacological neuroenhancement (PN) defines the use of various psychoactive substances to improve cognitive performance regarding attention, concentration, vigilance, memory etc. Some»neuroenhancers« derive from the pharmacotherapy of psychiatric disorders in which pro-cognitive effects are increasingly focused. The article presents PN drugs, whi...
Zusammenfassung
Die Opioidsubstitution mit Methadon (oral) oder Buprenorphin (sublingual) ist eine etablierte weltweit praktizierte First-Line-Behandlung der Opiatabhängigkeit. Beide Substanzen müssen täglich oder zumindest alle 2 Tage (Buprenorphin) gegeben werden. Langwirksame Opioide standen zur Substitution nicht zur Verfügung. Das ändert sich...
A continuously rising consumption of methamphetamine (MA) has been suggested to be associated with increasing cognitive dysfunction. The objective of this study was to investigate associations between cognitive functions and gender, drug using patterns and treatment-attending profiles of recently abstinent MA users over the course of six months abs...
Eating disorders and substance use disorders frequently co-occur. Twin studies reveal shared genetic variance between liabilities to eating disorders and substance use, with the strongest associations between symptoms of bulimia nervosa (BN) and problem alcohol use (genetic correlation [rg], twin-based=0.23-0.53). We estimated the genetic correlati...
Introduction: Opioid addiction is a worldwide disease with a significant impact. A multitude of physical and mental comorbidities are associated with opioid addiction, pain being one of the most relevant. Insufficient pain management may lead to a disruption in medical treatment, self-medication, and subsequent harm to patients.
Areas covered: In t...
Die Opioidsubstitution mit Methadon oder Buprenorphin ist eine anerkannte, weltweit praktizierte First-line-Behandlung der Opioidabhängigkeit. Neben dem in Deutschland bereits verfügbaren wöchentlich oder monatlich subkutan injizierbaren Buprenorphin Depot CAM 2038 (Buvidal®) stehen mit dem monatlich zu applizierenden Depotpräparat RBP-6000 (Subloc...
The use of methamphetamine is spreading globally and provokes the need for effective treatment options. Previous research showed increased psychiatric comorbidities in methamphetamine users, but its impact on treatment success is still unclear. This study investigates data from two German addiction rehabilitation centers including 108 methamphetami...
Outcome assessment in the pharmacological treatment of alcohol use disorders (AUDs) faces specific challenges resulting from low adherence to treatment, high rates of dropout, and the susceptibility of patient self-reports to bias. This review discusses methodological issues in planning, conducting, and interpreting clinical trials on AUD treatment...
In der stationären Drogenreha gewinnt Methamphetamin zunehmend an Bedeutung. Für eine erfolgreiche Behandlung sollten die spezifischen Konsumentenmerkmale berücksichtigt werden. Es mangelt an repräsentativen Studien zur Charakterisierung des typischen Crystal-Abhängigen. Das laufende Forschungsprojekt an der MEDIAN Klinik Mecklenburg in Kooperation...
Background:
Among all the treatment methods developed so far, opioid agonist treatment (OAT) is the most effective therapy for opioid dependence. While methadone (MTD) is the most commonly used, fewer data are available on alternative opioid agonist. The aim of this study was to assess the efficacy of buprenorphine (BUP) and slow-released morphine...
Background:
Stimulant drugs can cause persistent changes in the brain. Imaging studies show that these changes are most apparent in dopamine transporter (DAT) or receptor availability within the striatum.
Methods:
This work focuses on influences of stimulant use on dopaminergic function assessed using nuclear-medicine imaging (PET/SPECT). Includ...
Anti-Craving-Substanzen zur Therapie von Alkoholismus werden zu selten eingesetzt — meist nur bei therapieresistenten Patienten. Dabei sind die bislang verfügbaren Substanzen wirksam. Eine initiale Remission des Alkoholkonsums könnte die Chance für weitere psychosoziale Behandlungsoptionen eröffnen.
Subject
Medical care, psychological help, and social support are often required in psychosocial problem situations and crises. Without an ICD-10-classification, psychosocial crises are not legally entitled to treatment with medical and psychotherapeutic care according to the German Social Code. However, untreated psychosocial crises often lead to m...
BACKGROUND:
There is an increasing demand of evidence-based treatment options for methamphetamine users, but research in this field is limited. This study therefore evaluates the efficacy of two residential treatment programs for methamphetamine users.
METHOD:
A total of 108 patients with a history of methamphetamine abuse from two inpatient reh...
Alcohol dependence is a common public health problem and epigenetics may offer new aspects in understanding the biological and genetic underpinnings and improve treatment of this complex disease. Supposedly, methylation and hydroxymethylation are altered in brain tissues and in synapse-related genes due to chronic alcohol intake and during withdraw...
Long-term prescriptions of benzodiazepines are made mainly to elderly and female patients. Withdrawal treatments should be carried out gradually over a period of several weeks. Sleep and depressive disorders during benzodiazepine withdrawal can best be treated with sedating antidepressants. The few studies on this subject suggest psychoeducation, m...
Objectives:
These practice guidelines for the treatment of alcohol use disorders during pregnancy were developed by members of the International Task Force of the World Federation of Societies of Biological Psychiatry and the International Association for Women's Mental Health.
Methods:
We performed a systematic review of all available publicati...
Opioid dependence is the substance use disorder with the highest mortality, and most drug-related overdose deaths are related to opioid use. Abstinence rates following psychosocial interventions hardly exceed 20–30%. Opioid maintenance treatment is the first-line treatment in opioid dependence reducing psychiatric and somatic morbidity. Besides the...