Symptoms of anhedonia, not depression, predict the outcome of treatment of cocaine dependence

Abstract

The purpose of this paper is to reanalyze data from two studies to determine if anhedonia specifically, rather than depression overall, predicts treatment outcome for patients with cocaine use disorders. Measures of baseline anhedonia symptoms were created using anhedonia items from the Beck Depression Inventory (BDI) to re-examine National Institute on Drug Abuse Cocaine Collaborative Treatment study data (Crits-Christoph et al., 1999) and the contingency management group from the McKay et al. (2010) trial. Baseline anhedonia was used to predict cocaine abstinence rates across the treatment period in both studies. Anhedonia was a significant predictor of cocaine abstinence, even when overall depression scores excluding anhedonia were included in the models. The development of treatments to target individuals with cocaine use disorder who have symptoms of anhedonia has the potential to improve overall outcomes for those with this disorder.

Impaired frontostriatal functional connectivity among chronic opioid using pain patients is associated with dysregulated affect

“…Negative emotionality is included as one of the core domains in the newly developed Addictions Neuroclinical Assessment and is considered as one of the primary drivers of relapse during withdrawal . Negative affect is traditionally considered to be mediated through frontolimbic pathways (ie, anterior cingulate cortex/vmPFC→amygdala) with frontostriatal circuitry involved in ventral‐striatal inhibition; yet previous fMRI investigations into associations between frontostriatal activation, connectivity, and affect in addiction have primarily focused on appetitive processing and revealed associations with positive affect (and the lack thereof, ie, anhedonia or hypo‐hedonia) . Here, the opioid user group reported elevated negative affect relative to the control group.…”

A systematic literature review of clinical trials and therapeutic applications of ibogaine

“…However, some individuals wish to stop OAT and attain opioid abstinence. Moreover, insufficient evidence still exists for routine pharmacological management of CUD or stimulant use disorders (Crits-Christoph et al, 2018;Lee et al, 2018; National Institute on Drug Abuse (NIDA), 2018). Although psychosocial treatments show efficacy in treating CUD and stimulant use disorders (Zastepa et al, 2020), the field needs effective pharmacotherapeutic interventions (Dürsteler et al, 2015).…”

Anhedonia as a Key Clinical Feature in the Maintenance and Treatment of Opioid Use Disorder

“…Important questions remain regarding patient phenotypes that predict treatment response as well as what enduring psychological/behavioral symptoms after initiation of treatment might heighten risk of nonresponse to MAT or relapse during or following MAT. Because anhedonia has been found to be a predictor of earlier relapse to tobacco smoking during the first month of a quit attempt (Cook, Spring, McChargue, & Doran, 2010), a predictor of outcome from behavioral treatments for cocaine use (Crits-Christoph et al, 2018), as well as poor response to antidepressant medications (McMakin et al, 2012; Uher et al, 2012), it may be a promising feature to investigate in OUD treatment. The purpose of this article is to provide an updated and critical review of anhedonia in OUD, including its measurement, relevant neurobiology, treatment implications, and recommendations for future research.…”