title: Hypothesizing That Neuropharmacological and Neuroimaging Studies of Glutaminergic-Dopaminergic Optimization Complex (KB220Z) Are Associated With "Dopamine Homeostasis" in Reward Deficiency Syndrome (RDS).
abstract: There is need for better treatments of addictive behaviors, both substance and non-substance related, termed Reward Deficiency Syndrome (RDS). While the FDA has approved pharmaceuticals under the umbrella term Medication Assisted Treatment (MAT), these drugs are not optimal.
  
  
  
  It is our contention that these drugs work well in the short-term by blocking dopamine function leading to psychological extinction. However, use of buprenorphine/Naloxone over a long period of time results in unwanted addiction liability, reduced emotional affect, and mood changes including suicidal ideation.
  
  
  
  We are thus proposing a paradigm shift in addiction treatment, with the long-term goal of achieving "Dopamine Homeostasis." While this may be a laudable goal, it is very difficult to achieve. Nevertheless, this commentary briefly reviews past history of developing and subsequently, utilizing a glutaminergic-dopaminergic optimization complex [Kb220Z] shown to be beneficial in at least 20 human clinical trials and in a number of published and unpublished studies.
  
  
  
  It is our opinion that, while additional required studies could confirm these findings to date, the cited studies are indicative of achieving enhanced resting state functional connectivity, connectivity volume, and possibly, neuroplasticity. Conclusions/Importance: We are proposing a Reward Deficiency Solution System (RDSS) that includes: Genetic Addiction Risk Score (GARS); Comprehensive Analysis of Reported Drugs (CARD); and a glutaminergic-dopaminergic optimization complex (Kb220Z). Continued investigation of this novel strategy may lead to a better-targeted approach in the long-term, causing dopamine regulation by balancing the glutaminergic-dopaminergic pathways. This may potentially change the landscape of treating all addictions leading us to the promised land.
authors.affiliation: a Department of Psychiatry & McKnight Brain Institute , University of Florida College of Medicine , Gainesville , Florida , USA.|b Departments of Psychiatry & Behavioral Sciences , Keck School of Medicine of USC , Los Angeles , California , USA.|c Department of Clinical Neurology , PATH Foundation NY , New York , New York , USA.|d Human Integrated Services Unit , University of Vermont Centre for Clinical & Translational Science , Burlington , Vermont , USA.|e Division of Addiction Services , Dominion Diagnostics, LLC , North Kingstown , Rhode Island , USA.|f Division of Neuroscience-Based Therapy , Summit Estate Recovery Center , Los Gatos , California , USA.|g Division of Neuroscience Research and Addiction Therapy , The Shores Treatment and Recovery Center , Port Saint Lucie , Florida , USA.|h Institute of Psychology , Eötvös Loránd University , Budapest , Hungary.|i Department of Psychiatry , Wright State University Boonshoft School of Medicine , Dayton , Ohio, USA.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Blum
authors.affiliation: a Department of Psychiatry & McKnight Brain Institute , University of Florida College of Medicine , Gainesville , Florida , USA.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Febo
authors.affiliation: g Division of Neuroscience Research and Addiction Therapy , The Shores Treatment and Recovery Center , Port Saint Lucie , Florida , USA.
authors.forename: Lyle
authors.initials: L
authors.lastname: Fried
authors.affiliation: b Departments of Psychiatry & Behavioral Sciences , Keck School of Medicine of USC , Los Angeles , California , USA.
authors.forename: Mona
authors.initials: M
authors.lastname: Li
authors.affiliation: b Departments of Psychiatry & Behavioral Sciences , Keck School of Medicine of USC , Los Angeles , California , USA.
authors.forename: Kristina
authors.initials: K
authors.lastname: Dushaj
authors.affiliation: b Departments of Psychiatry & Behavioral Sciences , Keck School of Medicine of USC , Los Angeles , California , USA.
authors.forename: Eric R
authors.initials: ER
authors.lastname: Braverman
authors.affiliation: j Center for Psychiatric Medicine , North Andover , Massachusetts , USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: McLaughlin
authors.affiliation: k Department of Psychology , Curry College , Milton , Massachusetts , USA.
authors.forename: Bruce
authors.initials: B
authors.lastname: Steinberg
authors.affiliation: i Department of Psychiatry , Wright State University Boonshoft School of Medicine , Dayton , Ohio, USA.
authors.forename: Rajendra D
authors.initials: RD
authors.lastname: Badgaiyan
mesh_terms: D016739:Behavior, Addictive / Q000378:metabolism / Q000503:physiopathology*; D001921:Brain / Q000000981:diagnostic imaging / Q000378:metabolism / Q000503:physiopathology; D002395:Catecholamines / Q000502:physiology*; D004298:Dopamine / Q000378:metabolism*; D006706:Homeostasis / Q000502:physiology; D006801:Humans; D008995:Monoamine Oxidase / Q000502:physiology*; D015260:Neprilysin / Q000502:physiology*; D059906:Neuroimaging / Q000379:methods; D009480:Neuropharmacology / Q000379:methods; D012201:Reward; D019966:Substance-Related Disorders / Q000378:metabolism / Q000503:physiopathology; D013577:Syndrome
chemical_list: D002395:Catecholamines; C000601005:KB220Z; D008995:Monoamine Oxidase; D015260:Neprilysin; D004298:Dopamine
keywords: Dopamine homeostasis; KB220Z; Reward Deficiency Syndrome (RDS); neuroimaging; neuropharmaco-logical