title: Experimentally induced aggressiveness in heroin-dependent patients treated with buprenorphine: comparison of patients receiving methadone and healthy subjects.
abstract: Objective measures of experimentally induced aggressiveness were evaluated in heroin-dependent patients (HDP), 15 receiving buprenorphine (BUP) and 15 receiving methadone (METH) treatment. HDP were randomly assigned to BUP and METH groups. Fifteen healthy subjects (CONT) were included in the study as controls. During a laboratory task, the Point Subtraction Aggression Paradigm, subjects earned monetary reinforcement and could respond by ostensibly subtracting money from a fictitious subject (the aggressive response). Money-earning (points maintained) responses did not differ in BUP patients and in controls. In contrast, point-maintained responses were significantly lower in the group of HDP treated with METH than in both the BUP and CONT groups. Aggressive responses were significantly higher in the HDP group than in the CONT group. No significant differences in aggressive responses were found between the BUP and METH groups. Baseline concentrations of plasma adrenocorticotropic hormone (ACTH) and cortisol (CORT) were higher in HDP than in CONT. During the experimental task, ACTH and CORT increased significantly less in METH patients than in BUP patients and CONT. Norepinephrine (NE) and epinephrine (EPI) levels increased significantly more in HDP than in CONT, without any difference between the METH and BUP patients. PSAP aggressive responses positively correlated with NE and EPI changes, as well as with Buss-Durkee Hostility Inventory (BDHI) scores in both METH and BUP patients and also in CONT subjects. No correlation was found between the extent of heroin exposure, drug doses and aggressiveness levels. BUP, similarly to METH, does not seem to affect outward-directed aggressiveness, as aggressive responses related more to monoamine levels and personality traits than to the action of opioid agonists. Money-earning responses seemed to be unimpaired in BUP patients.
authors.affiliation: Centro Studi Farmacotossicodipendenze, Ser.T., Az. U.S.L., Parma, Italy. g.gerra@palazzochigi.it
authors.forename: Gilberto
authors.initials: G
authors.lastname: Gerra
authors.forename: Amir
authors.initials: A
authors.lastname: Zaimovic
authors.forename: Maria Augusta
authors.initials: MA
authors.lastname: Raggi
authors.forename: Gabriele
authors.initials: G
authors.lastname: Moi
authors.forename: Barbara
authors.initials: B
authors.lastname: Branchi
authors.forename: Mirko
authors.initials: M
authors.lastname: Moroni
authors.forename: Francesca
authors.initials: F
authors.lastname: Brambilla
mesh_terms: D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D000374:Aggression / Q000187:drug effects*; D001794:Blood Pressure / Q000502:physiology; D002047:Buprenorphine / Q000627:therapeutic use*; D004837:Epinephrine / Q000097:blood; D006339:Heart Rate / Q000502:physiology; D006556:Heroin Dependence / Q000534:rehabilitation*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D008995:Monoamine Oxidase / Q000097:blood; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D009638:Norepinephrine / Q000097:blood; D011594:Psychometrics; D011795:Surveys and Questionnaires
chemical_list: D009292:Narcotic Antagonists; D002047:Buprenorphine; D000324:Adrenocorticotropic Hormone; D008995:Monoamine Oxidase; D008691:Methadone; D006854:Hydrocortisone; D009638:Norepinephrine; D004837:Epinephrine