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Study
Suggests Cocaine Impairs "Pleasure Circuits"; May Explain
Users' Higher Depression Rates
January
2, 2003
NEW YORK (AP)
-- Chronic cocaine use harms brain circuits that help produce the
sense of pleasure, which may help explain why cocaine addicts have
a higher rate of depression, a study suggests.
It's not clear whether
cocaine kills brain cells or merely impairs them, or whether the
effect is reversible, said study author Dr. Karley Little. But it's
bad news for cocaine addicts in any case, he said.
"I personally wouldn't
want to lose 10 or 20 percent of my reward-pleasure center neurons,
or have them just deranged or not working right," said Little,
of the Ann Arbor, Michigan, Veterans Affairs Medical Center and
the University of Michigan.
He and colleagues studied
brain samples taken during autopsies from long-term, heavy cocaine
users. Their results were reported in the January issue of the American
Journal of Psychiatry.
Little said the research
did not reveal whether the brain impairment resulted from years
of use or just recent use before death.
Stephen Kish, head of
the human brain laboratory at the Center for Addiction and Mental
Health in Toronto, said researchers have "always considered
cocaine to be a dangerous drug" because of its potential for
addiction and harm to the heart.
"We now have to
add to the list (of risks) a damaging effect of cocaine on the brain,
which was something we never expected before," Kish said.
The research provides
"a piece of the puzzle" in explaining why cocaine users
run a higher risk of depression, said Dr. Deborah Mash, a neuroscientist
at the University of Miami School of Medicine.
It remains unclear whether
cocaine causes depression or whether people start using the drug
because they are depressed. But in either case, Mash said, the study
suggests brain changes could "light the fuse" for depression
in a cocaine user who is prone to it.
The study also suggests
that the brain changes could cause the depression commonly seen
during cocaine withdrawal, Mash said.
In the study, Little
and colleagues studied brain autopsy specimens from an area called
the striatum in 35 cocaine users and 35 non-users of similar age
and sex.
They measured levels
of a protein called VMAT2, which is found in brain cells that signal
each other with a chemical called dopamine. Dopamine neurons form
circuits that are critical for the brain to feel pleasure.
The study found that
cocaine users' VMAT2 levels were lower on average. That could mean
dopamine neurons had been damaged or killed - an effect not observed
in animal studies - or that they were making less VMAT2, which suggests
they also were making less dopamine, Little said.
A person with impaired
or missing dopamine neurons could have difficulty feeling pleasure
and might become depressed, said Little, who added that researchers
will now compare the number of dopamine neurons in the autopsy specimens.
The study found hints
that VMAT2 levels were lower in cocaine users with severe depression
than in other users, but statistical analysis suggested this could
be a coincidence. Little said the link is strengthened when other
data are taken into account.
Copyright
2003 Associated Press. All rights reserved.
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