Abstract
BackgroundImpulsivity refers to a wide spectrum of actions characterized by quick and nonplanned reactions to external and internal stimuli, without taking into account the possible negative consequences for the individual or others, and decision-making is one of the biologically dissociated impulsive behaviors. Changes in impulsivity may be associated with norepinephrine. Various populations of drug addicts all performed impulsive decision making, which is a key risk factor in drug dependence and relapse. The present study investigated the effects of clonidine, which decreased norepinephrine release through presynaptic alpha-2 receptor activation, on the impaired decision-making performance in abstinent heroin addicts.Methodology/Principal FindingsDecision-making performance was assessed using the original version of Iowa Gambling Task (IGT). Both heroin addicts and normal controls were randomly assigned to three groups receiving clonidine, 0, 75 µg or 150 µg orally under double blind conditions. Psychiatric symptoms, including anxiety, depression and impulsivity, were rated on standardized scales. Heroin addicts reported higher scores on the Barratt Impulsiveness Scale and exhibited impaired decision-making on the IGT. A single high-dose of clonidine improved the decision-making performance in heroin addicts.Conclusions/SignificanceOur results suggest clonidine may have a potential therapeutic role in heroin addicts by improving the impaired impulsive decision-making. The current findings have important implications for behavioral and pharmacological interventions targeting decision-making in heroin addiction.
Highlights
The high propensity to relapse is a hallmark feature of drug addiction and a main challenge for treatment strategies
No significant differences in age, education and anxiety score were found in the three subgroups of heroin addicts and normal controls
The present placebo-controlled, double-blind study demonstrated that 150 mg clonidine improved the impaired decision-making performance in abstinent heroin addicts, which was assessed with the original card version of the Iowa Gambling Task (IGT)
Summary
The high propensity to relapse is a hallmark feature of drug addiction and a main challenge for treatment strategies. Impulsivity, which refers to behavior performed with little or inadequate forethought, is a key vulnerability factor in drug addiction and risk factor in relapse [1]. Chronic drug abusers showed elevated scores on questionnaires measures of impulsivity [2] and impaired performance on laboratory tasks of impulsivity [3,4]. Research in normal subjects found that laboratory-measured impulsivity was increased by acute administration of yohimbine, which augments norepinephrine release by blocking alpha-2 noradrenergic receptors [18]. There has been no research about the effects of clonidine on decision-making performance in abstinent heroin addicts. Our hypothesis was that, at doses that decreased behavioral arousal or activation, clonidine would improve decision-making performance in abstinent heroin addicts. No significant differences were found for heroin abuse characteristics (duration, dose, and abstinence time). No significant differences were found for heroin abuse characteristics (duration, dose, and abstinence time). aDifference between heroin addicts and normal controls
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