Clinically Combating Reward Deficiency Syndrome (RDS) with Dopamine Agonist Therapy as a Paradigm Shift: Dopamine for Dinner?
Everyday, there are several millions of people that are increasingly unable to combat their frustrating and even fatal romance with getting high and/or experiencing "normal" feelings of well-being. In the USA, the FDA has approved pharmaceuticals for drug and alcohol abuse: tobacco and nicotine replacement therapy. The National Institute on Drug Abuse (NIDA) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA) remarkably continue to provide an increasing understanding of the intricate functions of brain reward circuitry through sophisticated neuroimaging and molecular genetic applied technology. Similar work is intensely investigated on a worldwide basis with enhanced clarity and increased interaction between not only individual scientists but across many disciplines. However, while it is universally agreed that dopamine is a major neurotransmitter in terms of reward dependence, there remains controversy regarding how to modulate its role clinically to treat and prevent relapse for both substance and non-substance-related addictive behaviors. While the existing FDA-approved medications promote blocking dopamine, we argue that a more prudent paradigm shift should be biphasic-short-term blockade and long-term upregulation, enhancing functional connectivity of brain reward circuits.
Department of Psychiatry and McKnight Brain Institute, College of Medicine, University of Florida, P. O. Box 100256, Gainesville, FL, 32610-0256, USA. drd2gene@gmail.com.|Human Integrated Services Unit, Center for Clinical and Translational Science, Department of Psychiatry, College of Medicine, University of Vermont, Burlington, VT, USA. drd2gene@gmail.com.|Division of Applied Clinical Research, Dominion Diagnostics, LLC, North Kingstown, RI, USA. drd2gene@gmail.com.|Department of Addiction Research and Therapy, Malibu Beach Recovery Center, Malibu, CA, USA. drd2gene@gmail.com.
Kenneth
K
Blum
Department of Psychiatry and McKnight Brain Institute, College of Medicine, University of Florida, P. O. Box 100256, Gainesville, FL, 32610-0256, USA.
Marcelo
M
Febo
Behavior Neuropharmacology and Neuroimaging Laboratory, Department of Psychology, SUNY at Stony Brook, Stony Brook, NY, USA.
Panayotis K
PK
Thanos
Department of Psychiatry, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.|Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
David
D
Baron
Division of Applied Clinical Research, Dominion Diagnostics, LLC, North Kingstown, RI, USA.
James
J
Fratantonio
Department of Psychiatry and McKnight Brain Institute, College of Medicine, University of Florida, P. O. Box 100256, Gainesville, FL, 32610-0256, USA.|Department of Research, Rivermernd Health, Atlanta, GA, USA.
Mark
M
Gold
D000818:Animals; D016739:Behavior, Addictive / Q000235:genetics / Q000523:psychology*; D001921:Brain / Q000187:drug effects*; D004298:Dopamine / Q000378:metabolism*; D018491:Dopamine Agonists / Q000627:therapeutic use*; D006801:Humans; D017448:Receptors, Dopamine D2 / Q000187:drug effects / Q000378:metabolism*; D012201:Reward
D018491:Dopamine Agonists; D017448:Receptors, Dopamine D2; D004298:Dopamine
Agonistic therapy; Dopamine; Dopamine societies; Genetics and epigenetics; Reward deficiency syndrome (RDS)