Frequently encountered withdrawal symptoms
More frequently observed symptom
Less frequently observed symptom
Practically not observed
LSD Lysergic acid diethylamide PCP Phencyclidine
Abused substances
Anxiety Appetite (decreased) Appetite (increased) Autonomic hyperactivity Autonomic hypoactivity Impaired concentration Delirium Dysphoria Diarrhea Dreams (unpleasant) Fatigue Fever Hallucinations (non-specific) Hypersomnia Insomnia Irritability, frustration Lacrimation, rhinorrhea Muscle/bone aches Nausea/vomiting Photophobia Psychomotor agitation Psychomotor retardation Pupillary dilatation Seizures Tremor Tremulousness Yawning Symptoms Opi ates A m phet am in es Coc ai n e PCP Alcohol Canna bis LSD Ben zodi azopi n es Nicoti n eLegend
References
1. Johnson SW, North RA. Opioids excite dopamine neurons by hyperpolarization of local interneurons. J Neurosci 1992; 12: 483–488.
2. Nestler EJ. Molecular neurobiology of addition. Am J Addiction 2001; 10: 201–217.
3. Nestler EJ, Hope BT, Widnell KL. Drug addiction: a model for the molecular basis of neural plasticity. Neuron 1993; 11: 995–1006.
4. Nestler EJ, Aghalanian GK. Molecular and cellular basis of addiction. Science 1997; 278: 58–63.
5. Fingerhood MI, Thompson MR, Jasinski DR. A comparison of clonidine and
buprenorphine in the outpatient treatment of opiate withdrawal. Subst Abus 2001; 22: 193–199.
6. Czerwinski WP. Amphetamine related disorders. J La State Med Soc 1998; 150: 491–499.
7. Christophersen AS. Amphetamine design drugs: an overview and epidemiology. Toxicol Lett 2000; 15: 112–113, 127–131. 8. Srisurapanont M, Jarusuraisin N,
Kittirattanapaiboon P. Treatment for amphetamine dependence and abuse. Cochrane Database Syst Rev. 2001; (4): CD003022.
9. Srisurapanont M, Jarusuraisin N, Kittirattanapaiboon P. Treatment for amphetamine withdrawal. Cochrane Database Syst Rev. 2001; (4): CD003021. 10. Srisurapanont M, Jarusuraisin N,
Kittirattanapaiboon P. Treatment for
amphetamine psychosis. Cochrane Database Syst Rev. 2001; (4): CD003026.
11. Dackis CA, O’Brien CP. Cocaine dependence: the challenge for
pharmacotherapy. Curr Opin Psychiatry 2002; 15: 261–267.
12. Carboni E, Silvagni A, Rolando MT et al. Stimulation of in vivo dopamine
transmission in the bed nucleus of stria terminalis by reinforcing drugs. J Neurosci 2000; 20: RC102.
13. Schultz W. Reward signalling by dopamine neurons. Neuroscientists 2001; 7: 293–302. 14. Wilson LD, Shelat C. Electrophysiologic and hemodynamic effects of sodium bicarbonate in canine model of severe cocaine
intoxication. J Toxicol Clin Toxicol 2003; 41: 777–788.
15. Serper MR, Chou JC, Allen MH et al.
Symptomatic overlap of cocaine intoxication
16. Preuss UW, Bahlmann M, Koller G et al. Treatment of cocaine dependence.
Intoxication, withdrawal and prevention of relapse. Fortsch Neurol Psychiatr 2000; 68: 224–338.
17. Oesterheld JR, Armstrong SC, Cozza KL. Ecstasy: pharmacodynamis and
pharmacokinetic interactions. Psychosomatics 2004; 45: 84–89. 18. Lyles J, Cadet JL. Methylenedioxy-
methamphetamine (MDMA, ecstasy) neurotoxicity: cellular and molecular mechanisms. Brain Res Brain Res Rev 2003; 42: 155–168.
19. Ramamoorthy Y, Yu AM, Suh N et al. Reduced (l )-3,4-methylenedioxy-
methamphetamine (‘ecstasy’) metabolism with cytochrome P450 2D6 inhibitors and pharmacogenetic variants in vitro. Biochem Pharmacol 2002; 3: 2111–2119.
20. Shin JG, Kane K, Flockhart DA. Potent inhibition of CYP2D6 by haloperidol metabolites: stereoselective inhibition by reduced haloperidol. Br J Clin Pharmacol 2001; 51: 45–52.
21. Kaskey GB. Possible interaction between an MAOI and ‘ecstasy’. Am J Psychiatry 1992; 149: 411–412.
22. Smilkstein MJ, Smolinske SC, Rumack BH. A case of MAO inhibitor/MDMA interaction: agony after ecstasy. J Toxicol Clin Toxicol 1987; 25: 149–159.
23. Vuori E, Henry JA, Ojanpera I et al. Death following ingestion of MDMA (ecstasy) and moclobemide. Addiction 2003; 98: 365–368. 24. Stalker D, Jungbluth G. Clinical
pharmacokinetics of linezolid, a novel oxazolidinone antibacterial. Clin Pharmacokinet 2003; 42: 1129–1140. 25. Leichti ME, Vollenweider FX. The serotonin
uptake inhibitor citalopram reduces acute cardiovascular and vegetative effects of 3,4-methylenedioxymethamphetamine (‘ecstasy’) in healthy volunteers. J Psychopharmacol 2000; 14: 269–274. 26. Hernandez-Lopez C, Farre M, Roset PN et al.
3,4-Methylenedioxymethamphetamine (‘ecstasy’) and alcohol interaction in humans: psychomotor performance, subjective effects, and pharmacokinetics. J Pharmacol Exp Ther 2002; 300: 236–244. 27. Gahlinger PM. Club drugs: MDMA, c-
hydroxybutyrate (GHB), Rohypnol and ketamine. Am Fam Physician 2004; 69: 2619–2626.
28. Murray JB. Phencyclidine (PCP): a dangerous drug, but useful in schizophrenia research. J Psychol 2002; 136: 319–328.
dopamine hypothesis of schizophrenia. Neuropsychopharmacology 1999; 20: 201–225.
30. Milhorn HT Jr. Diagnosis and management of phencyclidine intoxication. Am Fam Physician 1991; 43: 1293–1302.
31. Faingold CL, N’gouemo P, Riaz A. Ethanol and neurotransmitter interactions: from molecular to integrative effects. Prog Neurobiol 1998; 55: 509–535.
32. Koob GF, Roberts AJ, Schultheis G et al. Neurocircuitry targets in ethanol reward and dependence. Alcohol Clin Exp Res 1998; 22: 3–9.
33. Spanagel Z, Zieglgansberger W. Anticraving compounds for ethanol: new
pharmacological tools to study addictive processes. Trends Pharmacol Sci 1997; 18: 37–65.
34. Mann K. Pharmacotherapy of alcohol dependence. A review of the clinical data. CNS Drugs 2004; 18: 485–504.
35. Benjamin D, Grant E, Pohorecky LA. Naltrexone reverses ethanol-induced
dopamine release in the nucleus accumbens in awake, freely moving rats. Brain Res 1993; 621: 137–140.
36. Cardoso Ra, Brozowski SJ, Chaves-Noriega LE et al. Effects of ethanol on recombinant human neuronal nicotinic acetylcholine receptors expressed in Xenopus oocytes. J Pharmacol Exp Ther 1999; 289: 774–780. 37. Soderpalm B, Ericson M, Olausson P et al.
Nicotinic mechanisms involved in the dopamine activating and reinforcing
properties of ethanol. Behav Brain Res 2000; 113: 85–96.
38. Garbutt JC, West SL, Carey TS et al. Pharmacological treatment of alcohol dependence: a review of the evidence. JAMA 1999; 281: 1318–1325.
39. Krystal JH, Cramer JA, Krol WF et al. Naltrexone in the treatment of alcohol dependence. N Engl J Med 2001; 345: 1734–1739.
40. Dahchour A, De Witte P. Ethanol and amino acids in the central nervous system:
assessment of the pharmacological actions of acamprosate. Prog Neurobiol 2000; 60: 343–362.
41. Johnson BA, Ait-Daoud N, Bowden CL et al. Oral topiramate for treatment of alcohol dependence; a randomized controlled trial. Lancet 2003; 17: 1677–1685.
42. Malec TS, Malec EA, Dongier M. Efficacy of buspirone in alcoholic dependence: a review. Alcohol Clin Exp Res 1996; 20: 853–858.
dependence. Alcohol Clin Exp Res 1994; 18: 879–885.
44. Johnson BA, Roace JD, Javors MA et al. Ondansetron for reduction of drinking among biologically predisposed alcoholic patients: a randomized clinical trial. JAMA 2000; 284: 1016–1017.
45. Baya M, McIntyre J, Hill K et al. Alcohol withdrawal syndrome. Am Fam Physician 2004; 69: 1443–1450.
46. Schwartz RH. Marijuana: A decade and a half later, still a crude drug with
underappreciated toxicity. Pediatrics 2002; 109: 284–289.
47. Iversen L. Cannabis and the brain. Brain 2003; 126: 1252–1270.
48. Rodriguez De Fonseca F, Gorriti MA et al. Role of the endogenous cannabinoid system as a modulator of dopamine transmission: implication for Parkinson’s disease and schizophrenia. Neurotox Res 2001; 3: 23–35.
49. Nichols DE. Hallucinogens. Pharmacol Therap 2004; 101: 131.
50. Marona-Lewicka D, Nichols DE. Behavioral alterations in rats following long term treatment with low doses of LSD. 2002 5th IUPHAR Satellite Meeting on Serotonin: 114. 51. Longo LP, Johnson B. Addiction: Paper I.
Benzodiazepines side-effects, abuse risk and alternatives. Am Fam Physician 2000; 61: 212–218.
52. Roache JD, Meisch RA. Findings from self administration research on the addiction potential of benzodiazepines. Psychiatric Ann 1995; 25: 153–157.
53. Parram TV. Prescription drug abuse. A question of balance. Med Clin North Am 1997; 81: 967–78.
54. Dani JA. Role of dopamine signaling in nicotine addiction. Mol Psychiatry 2003; 8: 255–256.
55. Corrigall WA. Nicotine self administration in animals as a dependence model. Nicotine Tob Res 1999; 1: 11–20.
56. Balfour DJK. The psychopharmacology of tobacco dependence. J Clin Psychiatry Monogr 2003; 18: 12–21.
57. Fagerstrom K. Smoking cessation treatment with sustained released bupropion:
optimizing approaches to management. Drugs Suppl 2002; 62: 1–70.
58. Baldessarini RJ. Drugs and the treatment of psychiatric disorders: depression and mania. In: Goodman and Gilman’s The
Pharmacological Basis of Therapeutics, 10th edn. (Hardman JG, Limbird LE, Molinoff PB et al, eds.) New York: McGraw-Hill, 2001:
cigarette smoking with nicotine gum, clonidine and naltrexone. J Subst Abuse Treat 2003; 24: 252–255.
60. Passie T, Seifert J, Schneider U et al. The pharmacology of psilocybin. Addiction Biol 2002; 7: 357–364.
61. McKenna DJ, Repke DB, Peroutka SJ.
Differential interactions of indolealkylamines with 5-hydroxytryptamines receptor
subtypes. Neuropsychopharmacology 1990; 29: 193–198.
62. Creese I, Burt DR, Snyder SH. The dopamine receptors: differential binding of d-LSD and related agents to agonist and antagonists states. Life Sci 1975; 17: 15–20.
63. Hidalgo W. Estudio comparative
psicofisiologico de la mescaline, dietilamina del acido D-lysergico y psilocibina. Acta Med Venezolana 1960; 8: 56–62.
64. Delay J, Pichot P, Lemperiere T, Nicholas- Charles PJ. Etude psychophysiologique et clinique de la psilocybine. In: Les
champignons hallucinogens due mexique. (Hein R, Wasson RG, eds). Paris: Museum de Histoire Naturelle; 1958: 287–310.
65. Hollister LE. Clinical, biochemical and psychologic effects of psilocybin. Arch Int Pharmacodyn Ther 1961; 130: 42–52. 66. Nichols DE. Hallucinogens. Pharmacol
Therap 2004; 101: 131–181. 67. Vollenwider FX. Advances and
pathophysiological models of hallucinogenic drug actions in humans: a preamble to schizophrenia research. Pharmacopsychiatry 1998; 31(Suppl 2), 92–103.
68. Brouette T, Anton R. Clinical review of inhalants. Am J Addict 2001; 10: 79–94. 69. Watson JM. Solvents abuse: presentation
and clinical diagnosis. Hum Toxicol 1982; 1: 249–256.
70. Fornazzari L. Clinical recognition and management of solvent abusers. Intern Med Specialist 1988; 9: 2–7.
71. Shepherd RT. Mechanism of sudden death associated with volatile substance abuse. Hum Toxicol 1989; 8: 287–291.
72. Wiseman MN, Banim S. ‘Glue sniffer’s’ heart? BMJ 1987; 294: 739.
73. Taylor GJ, Harris WS. Glue sniffing causes heart block in mice. Science 1970; 170: 866–868.
74. Yamanouchi N, Okada S, Kodam K et al. White matter changes by chronic solvent abuse. AJNR Am J Neuroradiol 1995; 168: 1643–1649.
75. Ron MA. Volatile substance abuse: a review of possible long-term neurological,
intellectual, and psychiatric sequela. Br J Psychiatry 1986; 148: 235–246.
76. Daynes G, Gillman MA. Psychotropic analgesic nitrous oxide prevents craving after withdrawal for alcohol, cannabis and tobacco. Int J Neurosci 1994; 76: 13–16. 77. Gillman MA. Nitrous oxide abuse in
perspective. Clin Neuropharmacol 1992; 15: 297–306.
78. Atkinson RM, Green JD. Personality, prior drug use, and introspective experience during nitrous oxide intoxication. Int J Addict 1983; 18: 717–738.
79. Gyulai FE, Firestone LL, Mintun MA et al. In vivo imaging of human limbic responses to nitrous oxide inhalation. Int J Addict 1983; 18: 717–738.
80. Newell GR, Spitz MR, Wilson MB. Nitrites inhalants: historical perspectives. Natl Inst Drug Abuse Res Monogr Ser 1988; 83: 1–14.