Nonmedical Use of Antihistaminergic Anxiolytics and Other Prescription Drugs among Persons with Opioid Dependence

Background. Nonmedical prescription drug use (NMPDU) is an increasing problem, insufficiently studied among people in opioid maintenance treatment (OMT). This study investigates the prevalence of and factors associated with NMPDU for drug classes insufficiently described in opioid-dependent populations, including antihistaminergic anxiolytics and central stimulants.Methods. Study participants were recruited at two OMT clinics in Malmo, Sweden, between October 2014 and December 2015 (N=73) and interviewed about their use, motivations for use, and acquisition and administration of prescription drugs.Results. The majority of the sample reported lifetime NMPDU: 60% for benzodiazepine-like hypnotics (z-drugs), 21% for pregabalin, 19% for stimulants, and 12%–15% for antihistaminergic anxiolytics. Lower age was associated with nonmedical benzodiazepine use (Adjusted Odds Ratio = 0.89; 95% Confidence Interval = 0.82–0.97). Illicit acquisition was reported by 61% of people using z-drugs, 46% of people using pregabalin, and 38% of people using prescription stimulants, but only by 6–10% of people using antihistaminergic anxiolytics.Conclusions. The substantial nonmedical use of pregabalin, z-drugs, and prescription stimulants found in this study suggests that clinicians should prescribe these drugs with great caution. Nonmedical use of antihistaminergic anxiolytics does not seem to be a clinical issue among people in OMT in a Swedish setting, but we propose future studies to monitor their use.

Differences in Psychiatric Problems and Criminality Between Individuals Treated With Central Stimulants Before and After Adulthood

Objective: The evidence for central stimulant (CS) treatment in ADHD is strong in some respects but not with respect to unselected clinical material and long-term effects over the life course cycle. The objective of this study was to explore differences in vocational, psychiatric, and social impairment, including crime and substance abuse, among adults with ADHD, treated or not, with CS drugs before age 18. Method: A clinical population of men ( N = 343) and women ( N = 129) seeking CS treatment as adults was assessed within a specific program for such treatment. Clinical information and data collected by structured instruments were available. Results: Previously CS-treated persons had a lower frequency of problems (alcohol/substance abuse, criminality), and of certain psychiatric disorders (depressive, anxiety and personality ones). Most differences were substantial. Conclusion: The study supports the assumption that CS treatment during childhood/adolescence offers some protection against the development of a range of problems known to characterize adult ADHD patients.

Increased antidepressant-like effect of desipramine combined with central stimulants (caffeine and amphetamine) in mice

Desipramine is a widely used antidepressive agent that inhibits the reuptake of noradrenaline and serotonin, and central stimulants such as caffeine and amphetamine help to release noradrenaline and serotonin. This work aimed to evaluate whether the combination of these agents could produce a stronger antidepressant-like effect than either of the drugs alone. To this end, male mice were treated with different doses of desipramine, caffeine, amphetamine, desipramine-caffeine and desipramine-amphetamine. The results showed that all drugs produced decreased immobility time in the forced swimming model. The combined treatment of desipramine (0.31, 1.0 or 3.1 mg/kg i.p.) with caffeine or amphetamine (0.31 or 1 mg/kg i.p.) reduced immobility time greater than either of those drugs alone. The combined treatment of desipramine (0.31, 1 and 3.1 mg/kg i.p.) with amphetamine or caffeine (0.1 and 1 mg/kg i.p.) did not increase the motor activity significantly compared to the control. These results also suggested that drugs which promote the release of noradrenaline and serotonin could increase antidepressant-like effect of desipramine.