The relationship between postpartum depression and change in perinatal alcohol use: An analysis of prams data

Abstract

s / Drug and Alcohol Dependence 140 (2014) e169–e251 e193 Post-retrieval propranolol may alter reconsolidation of trauma memory in individuals with PTSD and comorbid alcohol dependence Michael E. Saladin1, K. Gray1, T. Abbott1, S. LaRowe1,2, Aimee McRae-Clark1, S. DeSantis1, N. Baker1, S. Back1, Karen Hartwell1,2, Kathleen T. Brady1,2 1 Medical University of South Carolina, Charleston, SC, United States 2 Ralph H. Johnson VAMC, Charleston, SC, United States Aims:We recently completed a laboratory studyof anovelmedication intervention that targeted attenuation of trauma related distress by altering trauma memory reconsolidation in individuals with PTSD and comorbid alcohol dependence (AD). The medication intervention consisted of the administration of the -blocking agent, propranolol, immediately following thepresentation trauma cues (the cues initiate the reconsolidation). A placebo control group was also employed. In a test session performed the next day, we examined subjective distress and alcohol craving to both trauma and alcohol cues. It was hypothesized that propranolol-treated PTSD+AD individuals would evidence lower distress and craving during the test session than placebo-treated individuals. Methods: PTSD+AD participants received either 40mg propranolol (n=21) or placebo (n=23) immediately after trauma cue exposure (description of participant’s worst trauma presented via headphones). After remaining overnight in an alcohol-free environment, participants received a ‘test’ session of cue exposure that was identical to the first session except (a) trauma cue exposure was followed by alcohol cue exposure, and (b) no medication was administered. Subjective distress and craving were measured (100 point scale) prior to, during, and following cue exposure in both sessions. Results: Compared to placebo-treated participants (M=56.0, se =3.7), propranolol-treated (M=42.8, se =4.0) participants evidenced significantly lower distress to the combined traumaalcohol cues presented during the test session (p= .03). The groups did not evidence any difference in craving. Conclusions: This study provides the first evidence that propranolol administration following trauma cue exposuremaymodulate traumamemories in PTSD+ADhumans. Implications for basic neuroscience and drug addiction treatment will be noted. Financial support: NIAAA grant 5RC1AA019019 (M. E. Saladin, PI), USPHS grant M01 RR01070 and NIH Grant Numbers UL1 RR029882 and UL1 T62. http://dx.doi.org/10.1016/j.drugalcdep.2014.02.538 The relationship between postpartum depression and change in perinatal alcohol use: An analysis of prams data S. Salimi1, M. Chisolm2, D. Cheng3, M. Terplan4 1 Department of Medicine, University of Maryland, Baltimore, MD, United States 2 Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States 3 Bureau for Maternal and Child Health, Maryland Department of Health and Mental Hygiene, Baltimore, MD, United States 4 Obstetrics, Gynecology and Reproductive Sciences and Epidemiology and Public Health, University of Maryland, Baltimore, MD, United States Aims: Postpartum depression (PPD) is common andmore likely to affect women with drug and alcohol problems. Although most womenquit drinkingduringpregnancy, approximately 10%continues. This study investigated the relationship between postpartum depression and change in perinatal alcohol use. Methods: The study population was from the Pregnancy Risk Assessment Monitoring System, 2004–2008 births which is a population-based surveillance and collects data from postpartum women on health behaviors before, during, and shortly after pregnancy. Women who self-reported any alcohol use during the 3 months before pregnancywere included in analysis. Overall change in alcohol use (difference between self-reported use in 3 months before and last 3 months of pregnancy) was compared between those with and without PPD. Also, change in heavy (7 or more drinks/week) and binge drinking (5 or more drinks/sitting) by PPD status were examined. Bivariate analysis and logistic regression were performed using the weight functions. Results: The study sample consisted of 64,595women of whom 10% reported PPD. Most women (87%) quit drinking during pregnancy, although 1.4% and 0.4% reported binge and heavy drinking, respectively, in the last 3months of pregnancy. PPDwasmore common among women who continued drinking compared to who quit or reduced use (AOR 1.30 [95% CI: 1.07, 1.55]). Moreover, any binge drinking during pregnancy was associated with PPD (AOR 1.53 [95%CI: 1.06, 2.20]), whereas heavy drinking was not (AOR 0.90 [95% CI: 0.43, 1.88]). Conclusions: These findings suggest several associations between postpartum depression and change in perinatal alcohol use, highlighting the need for vigorous screening and treatment for both PPD and alcohol use in this population. Financial support: None. http://dx.doi.org/10.1016/j.drugalcdep.2014.02.539 Preclinical investigation of the abused synthetic cannabinoid CP47,497 Kimberly L. Samano1, A. Poklis2, A.H. Lichtman1 1 Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, VA, United States 2 Pathology, Virginia Commonwealth University, Richmond, VA, United States Aims: CP47,497 and other synthetic cannabinoid compounds were incipiently synthesized as research tools to investigate mechanismsbywhichmarijuanaaffects thebrainand for thedevelopment of potential therapeutic drugs. Over the past few years, these compoundshave resurfacedon thedesigner drugmarket. The