Drugs, the Brain, and Behavior: The Pharmacology of Therapeutics and Drug Use Disorders

Cover
Endorsement
Half Title
Title Page
Copyright Page
Table of Contents
About the Author
List of Figures and Tables
Preface
Acknowledgements
Introduction
	How to Get the Most From Drugs, the Brain and Behavior
1 What Is a Drug?
	Terminology Used Throughout This Book
	The Dilemma of Prescription Drug Misuse, Overuse and Addiction
	Golden Age of Pharmacology
	Why Study a Brain – Behavior Relationship in the Next Chapter?
	BBB Model of Drug Action
	Selected Bibliography
2 The Brain–Behavior Relationship
	Mind–Body Dichotomy
	The Mind Is Physical
	Enter the Nervous System
	The Bioelectric Brain and Behavior
	Neurons and Synapses Discovered
	Evidence of a Brain–Behavior Relationship
	The Emotional Brain
	The Organization of Behavior
	Why Do People Take Drugs? The Neural Basis of Drug Use and Addiction
	Selected Bibliography
3 Pharmacokinetics
	How Do Drugs Get to the Brain and What Do They Do?
	Entering the Circulation: The First Step
		Oral Administration
		Advantages of Oral Administration
		Disadvantages of Oral Administration
		Pulmonary Administration
		Advantages of Pulmonary Administration
		Disadvantages of Pulmonary Administration
		Surface Absorption
		Advantages of Surface Absorption
		Disadvantages of Surface Absorption
		Injection
		Advantages of Injection
		Disadvantages of Injection
	Distribution: The Second Step
	What Happens After the Drug Enters the Circulation?
		Blood–Brain Barrier
	Elimination: The Third Step
		Drug Half-Life
	Applying Pharmacokinetics: The Relationship Between Dose and Effect
		How Much Drug Is Needed? The Dose–Response Curve
		Drug Efficacy
		Lethal Dose, Effective Dose and Therapeutic Index
		Drug Interactions
		Pharmacokinetic
		Pharmacodynamic
		Pharmacodynamic Interactions
		Additive
		Synergistic
		Potentiation
		Antagonism
	Selected Bibliography
4 Functional Neuroanatomy: Where Do Psychoactive Drugs Act?
	The Brain Is the Target of Psychoactive Drugs
		Cortex
		What Does the Cortex Do?
		Subcortical Structures
		Cerebellum
		Brainstem (Midbrain, Pons, Medulla)
		Medulla
		Thalamus
		Hypothalamus
		Limbic System
		Basal Ganglia
		Pituitary (“Master Gland”)
		Ventricles
		Cranial Nerves
	Selected Bibliography
5 Neurophysiology: How Do Psychoactive Drugs Act?
	The Bottom Line
	Neurons, Glia, and Neurotransmission
	What Are Lons?
	Resting and Action Potentials Explained
	Ion-gated Neurotransmission
	Non-ion-gated Neurotransmission
	What Are Neurotransmitters?
	Where Do Neurotransmitters Come From?
	Where Do Neurotransmitters Go?
	What Are Receptors?
	Neurotransmission, Drugs and Behavior
	There Are No Coincidences
	Selected Bibliography
6 Antidepressants: Drugs That Lift Us Up
	What Is Depression?
	What Are Antidepressants?
	History of Antidepressant Medications
	Categories of Antidepressants
		Monoamine Oxidase Inhibitors
		Tricyclic Antidepressants
		Lithium Salts
		Stimulants
		Serotonin and Norepinephrine Reuptake Inhibitors
		Neuropeptides
		Faster Acting Antidepressants
		Other Medications
	Medical Consequences
		Prenatal Effects
	Tolerance and Dependence On Antidepressants
	Forensic Considerations
	Selected Bibliography
7 Anxiolytics: Drugs That Calm Us Down at a Cost
	What Is Anxiety?
	What Are Anxiety Disorders?
	Where Does Anxiety Begin?
	Pharmacological Treatment of Anxiety
		Drug Treatment of Anxiety
	Development of Librium and Valium
	Absorption, Distribution and Elimination
		Two Half-Lives
	How Do Benzodiazepines Work?
		Normal GABA Functioning
		Benzodiazepines Interfere With the GABA System
	Where Are Benzodiazepine Receptors?
	Biobehavioral Effects of Benzodiazepines
		Anxiolytics
		Motor Disorders
		Seizures
		Insomnia
		Ataxia and Miscellaneous Effects
		Mood and Driving
	Other Anxiolytic Medications
	Guidelines for the Use of Medications to Treat Anxiety
	Medical Consequences of Benzodiazepines
		Addiction
		Toxicity
		Benzodiazepines and the Fetus
	Forensic Considerations
	Selected Bibliography
8 Antipsychotics: Drugs That Make Us Sane
	History of Antipsychotic Medications
	What Is Psychosis?
	Signs and Symptoms of Schizophrenia
		Thinking and Speech Disturbances
		Catatonic Motor Behavior
		Schizophrenic Hallucinations
		Disturbances of Affect and Emotion
		Disturbances of Social Behavior
	Pharmacology of Antipsychotics
		Absorption, Distribution and Metabolism of Antipsychotics
		Phenothiazines: The Typical Antipsychotics
	Schizophrenia, Excess Brain Dopamine and the Basis of Therapeutics
		Too Much Dopamine?
		Excess Dopamine Receptors?
	Role of Monoamine Oxidase
	Endogenous Psychogens (Naturally Present Schizophrenia-Producing Chemicals)
	Abnormal Norepinephrine Metabolism May Alter Brain Dopamine
	Where Do Dopamine Antagonists Work?
	Brain Dopamine Pathways
	Atypical Antipsychotics
	Schizophrenia and Serotonin
	Where Do Serotonin Antagonists Work?
	Medical Consequences
	Schizophrenia and Parkinson’s Disease
	Extrapyramidal Side Effects
	Neuroleptic Malignant Syndrome and Other Adverse Effects
	Prenatal Effects of Antipsychotics
	Forensic Considerations
	Selected Bibliography
9 Stimulants: Drugs That Make Us High
	History of Stimulant Use
	Cocaine and Amphetamine: Differences and Shared Similarities
	Other Stimulants of Interest
		Cathinone
		Caffeine
	Administration, Absorption, Distribution and Elimination of Stimulants
		Absorption (Oral)
		Insufflation (Nasal)
		Injection
		Pulmonary
	Elimination
	Neuropharmacology of Cocaine and Other Stimulants
		Cocaine
		Cocaethylene
		Amphetamines
		Xanthines
	Biobehavioral Effects of Stimulants
	Tolerance and Dependence
		Caffeine
	Medical Consequences of Stimulants
		Psychological Consequences
		Heart Attacks, Convulsions, and Death
		Neurological
		Pulmonary Effects
		Other Systems
		Stimulants and the Fetus
	Forensic Considerations
		Driving
	Selected Bibliography
10 Alcohol: The Socially Accepted Addictive Drug
	What Is Alcohol?
	History of Alcohol Use
		Social Drinking
		Alcohol Use Disorders
	Who Drinks?
	Administration, Absorption and Distribution
		How Alcohol Gets Into the Body
	Absorption
		Factors Affecting Absorption
			Beverage Characteristics
			Food
			Volume
		Alcohol Absorption After Drinking Stops
		Distribution
		Factors Affecting Distribution
		Gender Differences
	Metabolism and Elimination
		Less-Known Routes of Elimination
	What Is a BAC?
		Detection and Measurement of Alcohol
		Calculating the BAC
	Neuropharmacology of Intoxication
		No Magic Bullet for Sobriety
	Biobehavioral Effects of Alcohol Intoxication
		Driving and Other Complex Divided Attention Tasks
			Accidental Injuries
			Suicide
			Overdose
	Tolerance and Dependence
	Medical Consequences of Alcohol
		Organ and Tissue Damage
		Cancer
			Heart Disease
			Hypertension
			Stroke
			Liver Disease
			Withdrawal
	Alcohol and the Fetus
	Forensic Considerations
	Selected Bibliography
11 Opioids: Drugs That Calm Our Pain
	History of Opiate Use
	What Are Opioids?
	Natural Opiates
	Opium – The Natural Opioid
	Semi-Synthetic Opioids
	Synthetic Opioids
		Endogenous Opioid Peptides
	Administration, Absorption, Distribution, Metabolism/Elimination
		Administration and Absorption
		Distribution
		Metabolism and Elimination
	Pharmacology of Opioids
	Opioid Antagonists
	Biobehavioral Effect of Opioids
	Medical Uses
	Medical Consequences
	Opioids and the Fetus
	Tolerance and Dependence On Opioids
	Rapid and Ultra-Rapid Opioid Detoxification
	Treatment After Detoxification
	Forensic Considerations
	Selected Bibliography
12 Inhalants: A Matter of Life and Breath!
	What Are Inhalants?
	History of Inhalant Problem Use
	Administration, Absorption and Distribution
	Identifying Inhalant Abuse
	Biobehavioral Effects of Inhalant Use
	Tolerance and Dependence
	Medical Consequences of Inhalant Use
	Prenatal Effects
	Forensic Considerations
	Selected Bibliography
13 Marijuana: The Sometimes Illegal Recreational Plant
	What Is Marijuana?
	Different Types of Marijuana-Based Products
	History of Marijuana Use
	Who Uses Marijuana?
	What Is THC?
	What Is CBD?
	What Are Synthetic Cannabinoids?
	How Is Marijuana Administered?
	Distribution and Elimination
	Neuropharmacology of Cannabinoids
	Biobehavioral Effects of Marijuana
	General Effects
	Communication, Memory, Driving and Motivation
	Strength, Coordination and Judgment
		Medical Uses
	Medical Consequences of Cannabis Use
	Cardiovascular System
	Schizophrenia
	Panic Attacks
	Brain Damage and Cognitive Functioning
	Cancer
	Immune System
	Sex Hormones
	Toxicity
	Fetal Effects
	Tolerance and Dependence
	Forensic Considerations
	Marijuana and Criminal Activity: History, Lessons and Current State of Knowledge
	Motor Vehicle Operation
	Laboratory Detection of THC
	Selected Bibliography
14 Hallucinogens: Altering Reality Or Helping?
	What Are Hallucinogens?
	History of Hallucinogen Use
	Common Hallucinogens
	Absorption, Distribution, and Metabolism of Hallucinogens
	Pharmacology of Hallucinogens
	Biobehavioral Effects of Hallucinogens
	Medical Use of Hallucinogens
	Medical Consequences of Hallucinogen Use
	Psychological Effects
	General Toxic Effects
	Cardiovascular Toxicity
	Tolerance and Dependence
	Forensic Considerations
	Selected Bibliography
15 Nicotine: Of What Value?
	History of Tobacco Use
	Pharmacokinetics: How Nicotine Gets Into the Body
	Administration and Distribution
	Elimination: How Is Nicotine Metabolized and Removed From the Body?
	Pharmacology of Nicotine
	Pharmacodynamics
	Tolerance and Dependence
	Medical Consequences of Nicotine and Tobacco Use
	Forensic Considerations
	Selected Bibliography
16 Addiction: The Chronic Medical Illness
	Definitions
	Current Terminology
	Neurochemical Dysregulation as a Cause of Addictions
	Other Hypotheses About “Addiction”
	Treatment of Addictions
	Physiological But Non-Pharmacological Factors in Relapse
	Conclusions
	Looking Ahead
	Selected Bibliography
17 Biobehavioral Markers of Substance Use Disorders
	Basic Biobehavioral Markers
	Toxicology
	Qualitative Drug Testing
	Quantitative Drug Testing
	Blood Chemistry Biomarkers
	State Vs. Trait Markers
	Other Biomarkers of Alcohol Use
	Proteomics
	Epigenetics
		Other Potential Biomarkers Requiring More Research
	Trait Markers
		Adenylyl Cyclase (AC) Activity
		Gamma-Aminobutyric Acid (GABA)
		Dopamine
		Beta-Endorphin
		Serotonin
	Drugs Other Than Alcohol
	Summary
	Selected Bibliography
18 Forensic Issues in Psychopharmacology
	Forensic Considerations
	Scope of the Problem
	Detection and Measurement of Drugs
	Interpreting Toxicology Findings
	Applied Pharmacology
	How Long Before the Drug Concentration Is Zero?
	How Much Drug Was Ingested?
	Drug Interactions
		Why More Than One Drug at a Time?
		Pharmacological Basis of Alcohol-Drug Interactions
	Pharmacokinetic Interactions
		Absorption
		Distribution
		Metabolism
		Excretion
	Pharmacokinetic and Pharmacodynamic Interactions
	Toxicology Findings After Death
	Summary
	Selected Bibliography
Index