DRUG ABUSE TREATMENT COMORBIDITY AND CLINICAL TRIALS

药物滥用治疗合并症和临床试验

• 批准号: 3088813
• 负责人: Edward V. Nunes
• 金额: $ 12.86万
• 依托单位: COLUMBIA UNIV NEW YORK MORNINGSIDE
• 依托单位国家: 美国
• 财政年份: 1991
• 资助国家: 美国
• 起止时间: 1991-01-01 至 1995-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3088813
• 关键词: alcoholism /alcohol abuse; antidepressants; antisocial personality; anxiety disorders; behavior prediction; biomarker; buprenorphine; case history; clinical trials; cocaine; diagnosis design /evaluation; disease /disorder proneness /risk; drug abuse chemotherapy; family genetics; female; fluphenazine; human subject; imipramine; interview; intravenous drug abuse; male; mental disorder diagnosis; methadone; mood disorders; panic disorder; prognosis; psychopharmacology; questionnaires

Requested is a Scientist Development Award for Clinicians to study comorbid mood disorders in drug abuse and their implications for clinical treatment trials. Affective and anxiety syndromes are common among drug abusers. The majority of such syndromes probably result from drug toxicity or withdrawal, but a subgroup may represent true mood disorders, providing an opportunity for treatment with antidepressant medication. The problem is to accurately identify this subgroup. Training is proposed in structured diagnostic interview methodology, family-genetic methodology, clinical trials methodology and statistics, and psychopharmacology. It is hypothesized that treatable affective disorder is more likely to be chronologically primary, or to have persisted during periods of drug abstinence, or to be chronic. A version of the Structured Clinical Interview for DSM-III-R will be designed to isolate these historical dimensions. It is also hypothesized that treatable affective disorder will be associated with increased risk of affective disorder in biological relatives. Structured diagnosis and study of family pedigrees will be integrated into an ongoing trial of imipramine for cocaine and intravenous drug abusers in methadone treatment. Training in advanced experimental design and statistics will be undertaken. Psychopharmacology training will include study of the preclinical literature to target theoretically promising treatments. Pilot treatment trials will focus on cocaine and intravenous drug abuse. Studies initiated in later years will include a high risk study of offspring of drug abusers, exploration of the utility of biological markers, such as CO2 inhalation induced panic, to distinguish comorbid disorders, and formal clinical trials for promising treatment agents. The training and experience will foster a broad expertise in clinical trials in drug abuse, emphasizing the matching of treatment to patient based on diagnostic, familial, and biological predictors of response.

要求是临床医生研究合并的科学家发展奖 药物滥用的情绪障碍及其对临床治疗的影响 试验。 情感和焦虑综合征在滥用药物中很常见。 大多数这种综合征可能是由药物毒性或 提取，但是子组可能代表真实的情绪障碍，提供了 抗抑郁药治疗的机会。 问题是 准确识别此子组。 在结构化诊断访谈方法中提出了培训， 家庭遗传学方法论，临床试验方法和统计以及 心理药理学。 假设可治疗的情感障碍 更可能是按时间顺序排列的，或者在 戒毒时期或慢性。 结构化的版本 DSM-III-R的临床访谈旨在隔离这些 历史维度。 还假设可以治疗的情感 疾病将与情感障碍的风险增加有关 生物亲戚。 家族血统的结构化诊断和研究 将纳入可卡因的咪帕明的持续试验和 美沙酮治疗中的静脉滥用药物。 高级培训 将进行实验设计和统计。 心理药理学 培训将包括研究临床前文献的目标 理论上有希望的治疗。 试验治疗试验将重点放在 可卡因和静脉吸毒。 后来开始的研究将 包括对虐待者后代的高风险研究，探索 生物标记物的效用，例如二氧化碳吸入引起的恐慌， 区分合并症和正式临床试验 治疗剂。 培训和经验将促进广泛的 药物滥用方面的临床试验专业知识，强调匹配 根据诊断，家族和生物学治疗患者 反应的预测指标。