Could a history of hypomanic experiences potentially affect the chances of developing a substance use disorder?

This summary is based on a paper published from our lab and available on our website: “Subjective responses to amphetamine in young adults with previous mood elevation experiences”.

We studied young adults with a history of hypomanic episodes or mood elevations— a history of having repeated, exaggerated highs and lows in mood.

We studied young adults with a history of hypomanic episodes or mood elevations— a history of having repeated, exaggerated highs and lows in mood.

This study aimed to further understand the relationship between hypomanic experiences—or periods of mood elevation—and responses to drugs as a predictor for the likelihood of developing substance use disorders in young people. Previous research suggested that young adults who previously had hypomanic experiences reported less subjective effects when given a low dose of alcohol, and this may foreshadow future risk of addiction. The previous finding of a lower subjective response may be seen in other drugs beyond alcohol, such as amphetamine, and this was the topic of this research.

Dextroamphetamine, known as d-amphetamine, is commonly used to treat ADHD and narcolepsy. It is also a commonly abused substance.

Dextroamphetamine, known as d-amphetamine, is commonly used to treat ADHD and narcolepsy. It is also a commonly abused substance.

For this study, d-amphetamine was administered to healthy, young 18 and 19-year old participants recruited from the University of Chicago and its surrounding area. The participants had experienced various amounts of hypomanic experiences which had been measured using the Mood Disorders Questionnaire (MDQ) used to infer the possibility of an individual being diagnosed with BP.

Medical and psychiatric screening including an electrocardiogram, drug use and medical history, a physical exam, and a modified structural clinical interview (SCID) were also conducted by a clinical psychologist. The participants all participated in three 4-hour laboratory sessions where they received a placebo, 10mg, or 20mg d-amphetamine under double blind conditions; that is, both the participant and the researcher were blind as to which was administered at each session.

The results were similar as they previously were for alcohol: participants with higher MDQ scores experienced less stimulation after 10mg (the lower dose), but not 20mg (the higher dose), d-amphetamine, than individuals who had scored lower on the MDQ. This suggests that a previous history of hypomanic states is related to a dampened response to lower doses of psychostimulant drugs, as previously seen in alcohol. It is possible that the lower subjective effect on these participants contributes to a greater risk of subsequent drug use and/or misuse.

PODCAST: Effects of MDMA on attention to positive social cues and pleasantness of affective touch

The recreational drug MDMA, also known as Ecstasy or Molly, is particularly popular in social settings and raves, in large part because of how socially connected it makes the users feel. It's being studied for use in psychotherapy — there's a phase III clinical trial for the use of MDMA to treat PTSD. What's clear is that the drug affects how users experience social interactions. But there are questions: Does the drug make positive social interactions feel better, or reduce the negative feelings associated with negative social interactions?

Listen to Anya Bershad, MD, PhD discussing our recent research on the Neuropsychopharmacology BRAINPOD.

Could microdosing LSD make you happier?

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Over the past few years the popularity and public familiarity with the concept of “microdosing” has rapidly increased. Microdosing consists of taking a low, sub-perceptual dose of a psychedelic drug, most often psilocybin or lysergic acid diethylamide (commonly known as mushrooms and LSD, respectively), typically twice a week. What used to be a fringe practice in the tech offices of Silicon Valley has become a popular topic of interest and practice in the general population. People who microdose claim it has numerous beneficial effects on their mental health--particularly in regard to their mood, creativity, and cognitive capabilities. Yet, until now, there has been no placebo-controlled, double-blind studies to empirically test whether or not microdosing, specifically with LSD, actually has these positive effects that users report. The Human Behavioral Pharmacology Lab enrolled 20 healthy young adults in an experimental study to do just that. Participants attended 4 laboratory sessions during which they received 0 (placebo), 6.5, 13, or 26 μg of LSD in a randomized order at ≥1-week intervals. 

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We found that LSD produce mild, dose-related subjective effects across the three doses. On the 5-Dimensional Altered States of Consciousness Rating Scale (5D-ASC), participants reported increased feelings of unity and blissfulness on the 13 μg and 26 μg dose relative to placebo, without the sensory disturbances typical of higher doses (aka hallucinations or “trips”). On the Profile of Mood States Questionnaire (POMS), they reported greater feeling of vigor, and a slight increase in anxiety after the 26 μg dose relative to placebo. There were no effects on tasks measuring cognitive and motor functioning, suggesting that these doses could be appropriate for use without impairing daily functioning. Unexpectedly, at the 13 and 26 μg doses, LSD slightly decreased positivity ratings of images with positive emotional content. LSD significantly increased systolic blood pressure from 105.35 mmHg on the placebo session to a peak of 111.5 mmHg at 13 μg and 115.3 mmHg at 26 μg. The 6.5 μg dose did not produce any significant effects as compared to placebo. The study provides a basis for future testing of low repeated doses in individuals with mild depression--a big step!

Read the whole article here. And another short article on the subject here.

Phone app that tells you how high you are?

With legalization of recreational cannabis use spreading across the nation, one question remains on many minds--how can we measure cannabis-induced impairment?

Biochemical measures, like Breath Alcohol Content (BAC), do not exist for detecting cannabis use. Tools currently on the market, such as the standardized field sobriety test or cannabis/THC breathalyzers, are ineffective as roadside measurements of driving under the influence. We wish it was that easy!

Biochemical measures, like Breath Alcohol Content (BAC), do not exist for detecting cannabis use. Tools currently on the market, such as the standardized field sobriety test or cannabis/THC breathalyzers, are ineffective as roadside measurements of driving under the influence. We wish it was that easy!

This question does not have a simple answer. Prior research indicates variables such as gender, age, body mass index (BMI), age of onset of cannabis use, and frequency of use all factor into how intoxicated someone may become after using cannabis. People who use cannabis more often are less likely to feel as strong effects as an occasional user. Unfortunately, accurate and effective biochemical measures (like Breath Alcohol Content (BAC) for alcohol) do not exist for detecting cannabis use.

Tools currently on the market, such as the standardized field sobriety test or cannabis/THC breathalyzers, are ineffective as roadside measurements of driving under the influence. Elisa Pabon, a fourth-year doctoral candidate studying behavioral neuroscience in our lab, decided to take a different approach: a behavioral measurement of intoxication symptoms using a phone-based application. She took the first step in validating this novel measure by conducting two double-blind, placebo controlled clinical studies (the first of their kind).

Why not let people just smoke weed?  Scientists need to maintain the same conditions across all participants in studies. Using smoked cannabis requires careful consideration of strain and standardizing how much is smoked. This would have led to far too many inaccuracies, plus our results would be restrained to that specific strain!

Why not let people just smoke weed? Scientists need to maintain the same conditions across all participants in studies. Using smoked cannabis requires careful consideration of strain and standardizing how much is smoked. This would have led to far too many inaccuracies, plus our results would be restrained to that specific strain!

In the first study, participants identifying as occasional to more frequent cannabis users ingested capsules containing delta-9-tetrahydrocannabinol (THC) (0, 7.5, 15 mg doses; which produce plasma levels similar to those attained with recreational cannabis use) and completed the phone-based app measure. Neither they nor the experimenter running the study knew what drug was administered on each session, to reduce expectancies.  Three sessions were conducted, one for each dose. Drug-induced impairments in cognitive performance, reaction time, and working memory were detected on standard computer-based tasks, and fine motor coordination impairment was detected on the phone-based app at the 15 mg dose of THC. These results confirmed that at least fine motor impairment due to THC intoxication could be detected via our brief phone-based app under controlled conditions!

A follow-up study was done, adapted with new knowledge from Study 1 results. The phone-based app measure was lengthened and its difficulty increased, and two new tasks were added to measure time perception and time estimation (time estimation and production are impaired under the influence of smoked cannabis and oral THC and is likely to affect driving performance. Unfortunately, the new phone-based app did not detect any consistent THC intoxication impairment. The sensitivity of the phone-based app was too low to detect impairment, most likely due to the briefness of the measure. It would require additional research to develop a sensitive tool that could accurately and effectively detect cannabis impairment, but also be brief and convenient enough to use roadside.

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Furthermore, these two studies were conducted under highly controlled conditions, and each person’s intoxicated performance was compared to their own respective placebo control performance. If an app like this were to be used as a roadside sobriety test,  law enforcement officers would have to compare each person’s personal baseline/sober performance to their possibly intoxicated performance to accurately determine whether driving ability was impaired. Ultimately, with additional research and field work a cannabis or THC roadside field sobriety test may one day be established and validated. For now, we have a long way to go.