Neurotransmitters and Addiction

Outline
• Definition of Addiction
• Causes
• The Three Culprits
• Dopamine and the Reward Center
• Dopamine’s role in addiction
• Treatment for dopamine-related addictions
• Serotonin
• Serotonin’s role in addiction
• Treatment for serotonin-related addictions
• Noradrenaline
• Noradrenaline’s role in addiction
• Treatment for noradrenaline-related addictions
• Recap of The Three Culprits.
• A note about genetics
• A note about the craving effect
• Summary
• Bibliography
 What is Addiction?
• Addiction is a compulsive seeking, and then obtaining, of a
substance while behavior increasingly becomes out of control
(Spiga, Lintas, and Diana 1).
• Three types of neurotransmitters play an important role in
addiction by indicating which drug a person is most likely to
become addicted to: dopamine, serotonin, and noradrenalin. *
*Some sources focused solely on dopamine or a dopamine varient,
while others credited the neurotransmitters gamma- aminobutyric
acid (GABA), glutamate, and opioids as playing roles in addiction as
well. Two sources mentioned dopamine, serotonin and
noradrenalin, so I will proceed with those while cautioning that it is
not entirely agreed upon. It is more likely that all the
neurotransmitters listed play some sort of role in addiction- their
roles are just not fixed in scientific knowledge yet.
 Causes of Addiction
• Addiction has now been recognized as a medical disease, but no specific
cause has been found. Instead, addiction is caused by a combination of
genetics, environment and stress (Kipper and Whitney 62).
• The three main neurotransmitters involved in addiction- serotonin,
noradrenalin, and dopamine- exist in a balance (Kipper and Whitney 22) .
We all are born with a genetic tendency towards a slight imbalance
between these three neurotransmitters, however the more off-balance
the relationship between these neurotransmitters are, the greater risk
that person carries for addiction (Kipper and Whitney 30).
• What the person is most likely to be addicted to is dependent on what
neurotransmitter is the most out of balance ( Kipper and Whitney 29).
• Stress is a key trigger for most addictions. Stress throws off the brains‘
homeostasis (natural balance) and significantly increases the risks that the
person will turn to addictive self-medicating behavior (Kipper and
Whitney 30).
 Dopamine and the Reward Center
• All addictive substances studied cause a change in dopamine levels (The
Hyjacked Brain).
• Dopamine is the neurotransmitter in charge of pleasure. When you
experience something pleasurable, dopamine is released to the reward
center (the nucleus accumbus) of your brain. The pleasure pathway is
called the dopaminergic pathway. Neurotransmitters are then sent to the
memory center (the temporal lobe). The memory center then triggers the
behavior center, also in the temporal lobe, to repeat the experience.
Reward highways are built from highly pleasurable one-time experiences
or less pleasurable experiences that are repeated. The more pleasure an
experience gives or the more an experience is repeated, the stronger the
reward highway becomes. The stronger the reward highway, the more the
brain wants to repeat the experience that created the reward highways.
This is how addiction begins.
• The most addictive drugs are plant based, and the chemicals the plant
produces so closely mimic dopamine that the brain thinks it is receiving
the equivalent of massive amounts of dopamine (The Hyjacked Brain).
 Dopamine and Addiction
• An excess of dopamine in children causes behaviors ADD and ADHD. In
adults and older adolescents, excess dopamine can cause mania and
bipolar disorders. If the person with excess dopamine chooses to
experiment with drugs, s/he is most likely to become addicted to
stimulants that mimic dopamine (Kipper and Whitney 36).
• Cocaine’s chemical formula mimics dopamine’s formula. Cocaine blocks
the reuptake of dopamine, which then accumulates in the synapse to
stimulate receptors further and cause the person to feel extremely good
(Tomkins and Sellers 818). Once the cocaine wears off, the brain is used to
having that quantity of dopamine and triggers the need for more,
resulting in the person using more cocaine. Over time, more and more
cocaine is needed to produce the same effect and the person begins to
use cocaine merely to function (The Hyjacked Brain).
• Other drugs that may mimic dopamine are methamphetamine,
Dexedrine, Ritalin and Adderol (Kipper and Whitney38).
• Less harmful stimulants such as caffeine and sugar are also accepted as
dopamine mimics (Kipper and Whitney 38).
 Treatment of Dopamine-related
addictions
• Patients addicted to drugs that mimic dopamine can be treated
with other less harmful drugs that mimic dopamine to ease
withdrawal symptoms and prevent cravings. These drugs will also
help prevent problematic behaviors that could have caused the
harmful addiction in the first place (Kipper and Whitney 53).
• Safer dopamine-mimicking drugs for short-term use during detox
include Neurontin, Klonopin, Xanax, Valium, Seroquel, Zyprexa, and
Depokota. Drugs suitable for long-term stabilization for ADHD are
Adderall, Ritalin, Wellbutrin, Dexedrine, Strattera, Concerta, and
Provigil. Drugs for long term stabilization of bipolar disorder are
Zyprexa, Seroquel, Abilify and Lamactil. Some of these drugs are
addictive themselves, but without the severe side effects of
cocaine, meth and other harmful drugs (Kipper and Whitney 54).
 Serotonin
• Serotonin is the neurotransmitter primarily
responsible for regulating moods and
emotions (Kipper and Whitney 33).
• A lack of serotonin can lead to depression
and/or obsessive, compulsive behaviors
(Kipper and Whitney 33).
 Serotonin and Addiction
• For people with low serotonin levels, the
drugs they are most likely to get addicted to
are alcohol and opiates (heroin, Oxycontin).
Both mimic serotonin and lead to a temporary
increase in serotonin levels, making the
person feel better (Kipper and Whitney 42).
 Treatment for serotonin-related
addictions
• Treatment for opiates is a bit more complex than treated for dopamine-
related drugs.
• For short-term opiate withdrawal, drugs such as Buprenorphine are
suitable. To calm anxiety short-term, Klonopin, Ativan, Xanax, Neurontin,
and Seroquel would help. For sleep, Ambian, Lunesta, Sonata, Vistaril and
Benadryl would all be suitable as short-term candidates (Kipper and
Whitney 54).
• To help with alcohol withdrawal, Neurontin, Lyrica, Xanax, Klonopin,
Ativan and Librium would help at first (Kipper and Whitney 54).
• However, for long term stabilizing medication, serotonin and noradrenalin
reuptake inhibitors (SNRIs) and selective serotonin reuptake inhibitors
(SSRIs) should be given. SNRIs include Prozac, Zoloft, Lexapro, Celexa and
Paxil. SSRI’s include Pristiq, Savella, Effexor and Cymbalta (Kipper and
Whitney 54). These drugs will block the reuptake of serotonin in the brain
and cause serotonin to remain in the syntax, where it can stimulate
receptors.
 Noradrenalin
• Noradrenalin is the neurotransmitter that is in
charge of keeping is informed of potential threats
and signals our flight, fight or freeze response
(Kipper 31-32).
• An overabundance of noradrenalin leads to
anxiety. A massive overabundance leads to
extreme anxiety about even the smallest
situations, and extreme anxiety can lead to panic
(Kipper 32).
• An overabundance of noradrenalin also plays a
role in sleep disorders (Kipper 32).
 Noradrenalin and Addiction
• Having constant or extreme anxiety can lead to
people making bad decisions about how to treat
it, often turning to drugs whose affects lessen
anxiety. These include Valium, Xanax, Ativan,
Klonopin, marijuana or nicotine (Kipper and
Whitney 32).
• Endorphins also quiet the need for soothing
anxiety (Kipper and Whitney 32). This can lead to
people becoming addicted to physical exercise
since during exercise the brain receives an
endorphin rush.
 Treatment for Noradrenalin-related
addiction
• For short term detox treatment off Valium,
Xanax, Ativan and Klonopin, Phenobarbitol
can be used or the amount of the addicted
substance can simple be decreased over time
(Kipper and Whitney 54).
• For long-term treatment, SNRIs, SSRIs, beta-
blockers such as Inderol, and Lyrica,
Neurotonin and Seroquil can be used (Kipper
and Whitney 54).
 Recap of the Three Culprits
• When the brain is imbalanced in one of the three neurotransmitter
amounts attributed to addiction, it signals a desire for that
imbalance to be corrected. An excess of dopamine translates to
ADD, ADHD, mania and bipolar disorder. In trying to reduce their
hyperactivity, some people may turn to drugs. Because of their
dopamine imbalance, the drugs they are most likely to become
addicted to are dopamine mimics such as cocaine.
• A lack of serotonin can lead to depression, and/or obsessive
compulsive behavior. Drugs that mimic serotonin and provide a
needed boost are alcohol and heroin, which in turn become the
drug the user is most likely to become addicted to.
• An excess of noradrenalin causes anxiety, and anti-anxiety
medications like marijuana, Xanax and Valium become the abused
substances.
 A Note About Genetics
• You are born with an imbalance in one of these three
neurotransmitters, but the choices you make
determine whether or not this will lead to addiction.
• However, genes have been linked to certain
addictions. If you know your family has a history of
abusing a certain drug, it is advisable to avoid it
because the risk of becoming addicted is much higher.
• Children of alcoholics have a four-fold increase in the
likelihood of becoming alcoholics themselves
compared to children born to non-alcoholics (The
Hijacked Brain).
 A Note About Craving
• The brain’s pleasure highways are formed from
well-repeated patterns of behavior. For an addict,
even the sight of a place or object they have used
to receive or do drugs can send release dopamine
down the pleasure highway (The Hijacked Brain).
Odors can trigger the same response. Once the
response is triggered, the brain wants the real
deal- this is craving (The Hijacked Brain).
• Almost all relapses begin with a craving.
 Summary
• You are born with a genetic tendency towards an
imbalance of either dopamine, serotonin and
noradrenalin which can determine which drug you are
more likely to become addicted to. Study your family
history and stay away from substances that your family
has a history of abuse with. In dealing with an addict or
a recovering addict, remember that craving can be
triggered by something as simple as seeing a street
corner they were dealt the drug on. Relapse is a
trademark of addiction, so be patient and supportive if
the addict is otherwise trying to recover.
 Bibliography
• Kipper, David and Steven Whitney. The Addiction
Solution. New York: Rodale, 2010. Print.
• Spiga, Saturnino, Alessandra Lintas and Marco
Diana. “Addiction and Cognitive Function.”
Annals of the New York Academy of Sciences
1139 (2008): 299-306. Ebsco. Web. 27 Feb. 2010.
• The Hijacked Brain. Dir. Bill Moyers. Public Affairs
Television, 2004. DVD.