Highlights of Recently Published NIDA-Supported Studies

Selenium Shows Promise as an Adjunct Therapy for HIV

Daily selenium supplements could serve as a useful adjunct therapy for HIV infection by holding HIV-1 viral load in check and elevating levels of infection-fighting CD4 cells. A randomized controlled trial, led by Dr. Barry Hurwitz of the University of Miami, included 262 HIV-infected men and women. After 9 months of treatment, greater increases of serum selenium predicted lower HIV viral load and greater CD4 cell count. Notably, of the 141 selenium-treated participants, the 50 whose selenium levels increased by 26.1 mg/L or more displayed no increase in HIV viral load, and their concentrations of CD4 cells increased by 24.2 percent. In contrast, the 121 placebo-treated participants averaged an increase of 20.2 percent in HIV viral load, which researchers consider large enough to affect the course of the disease. The selenium-treatment advantage, which was gained only by participants who took the supplement as scheduled, held when the researchers accounted for factors that affect immune responses, including antiretroviral therapy. No side effects were observed.
Archives of Internal Medicine 167(2):148-154, 2007. [Full Text]

Brain Proteins Differ in Cocaine-Overdose Victims

Scientists have found differences in protein concentrations in the brain pleasure centers of 10 people who died from cocaine overdose as compared with 10 people who did not abuse the drug. Dr. Scott Hemby and colleagues at Wake Forest University and the University of Miami Schools of Medicine used mass spectrometry to measure more than 1,400 proteins in post-mortem tissue samples from the nucleus accumbens. Levels of roughly 50 proteins were found to be either higher or lower in the cocaine abusers. These proteins participate in basic neurobiological processes such as forming cellular structures, strengthening neuronal connections, sending chemical messages between cells, deriving energy from glucose, and protecting cells from injury. Such information may point scientists toward new insights into the molecular mechanisms and consequences of cocaine addiction.
Molecular Psychiatry 12(1):55-73, 2007. [Abstract]

Reducing Postpartum Drug Use

In a recent clinical trial, a 20- minute computerized intervention reduced new mothers' drug abuse in the first 4 months postpartum. The computer software program, which was developed by Dr. Steven J. Ondersma and colleagues at Wayne State University in Detroit and Virginia Commonwealth University in Richmond, was administered in an urban obstetric hospital soon after each woman gave birth. The program features an animated narrator who asks questions, addresses ambivalence, provides feedback, and offers options. The intervention also included vouchers for an initial session of drug treatment and an easy-to-read brochure, mailed to the women after they took their babies home, that discussed infant and maternal health and briefly addressed drug abuse. The researchers estimated that the intervention had a "small to moderate" beneficial effect in their study population—107 mostly poor women who abused drugs. At a 4-month followup, those who received the intervention reported using cocaine, amphetamine, and opiates less frequently than before the birth, while the comparison group reported slightly increased abuse of these drugs. No definitive differences were observed between the two groups regarding marijuana use.
American Journal of Preventive Medicine 32(3):231-238, 2007. [Abstract]

Lofexidine May Enhance Naltrexone Efficacy

The anti-hypertensive medication lofexidine is used commonly in the United Kingdom and less often in the United States to alleviate symptoms of opiate withdrawal. Now, a pilot study by Dr. Rajita Sinha and colleagues at Yale University School of Medicine suggests that lofexidine can enhance success rates among patients taking maintenance naltrexone to avoid relapse to opioids. The researchers stabilized 18 opioid-detoxified men and women on naltrexone (50 mg) and lofexidine (2.4 mg) daily for 1 month. They then retained all the patients on naltrexone for 4 more weeks, but kept 8 on lofexidine and gave 10 others identical-looking pills containing lofexidine doses that—unbeknownst to the patients—tapered to zero over several days. Of the 13 patients who completed the study, 80 percent of those who continued to receive combination therapy submitted opiate-free urine samples throughout the 4-week period, compared with 25 percent of those tapered to placebo. A followup laboratory session that exposed 10 of the patients to stressful and opiate-related stimuli showed that lofexidine—but not placebo—reduced the patients' reaction to stress, stress-induced opiate craving, and negative emotions (such as anger), all of which can trigger relapse.
Psychopharmacology 190(4):569-574, 2007. [Full Text]

Volume 22, Number 2 (December 2008)