Welcome to the EPA 2021 Interactive Programme
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Fully Live with Live Q&A On Demand with Live Q&A ECP Session Section Session EPA Course (Pre-Registration Required) Product Theatre
Sessions with Voting Ask the Expert Live TV
S0085 - Reduction of Reward Anticipation as a Pharmacological Target in the Treatment of AUD
S0086 - Role of Oxytocin in Modulating Addictive Behaviour
ABSTRACT
Abstract Body
Background: The brain oxytocin system is involved in a wide range of addictive behaviors, inhibiting prime- and cue-induced relapse in preclinical models of substance use disorders. Animal studies linked oxytocin’s effects on drug ingestion to modulation of neurotransmission in the nucleus accumbens (NAc). We set out to investigate whether oxytocin can modulate alcohol cue-induced functional connectivity between the brain reward system and cortical regions.
Methods: Fifteen male heavy social drinkers were enrolled in a randomized double-blind placebo-controlled cross-over functional magnetic resonance imaging study (fMRI) investigating the effect of 24 IU oxytocin on alcohol cue-modulated functional connectivity.
Results: Results of the functional connectivity analyses show that oxytocin application significantly reduced connectivity between the NAc and cuneus and thalamo-occipital connectivity, while enhancing connectivity between the paracingulate gyrus and precentral gyrus (tow-sided seed-level false discovery rate pFDR < 0.05). These effects were specific to the alcohol presentation and were absent during processing of neutral pictures. In addition, the NAc-cuneus connectivity significantly correlated with subjective alcohol cue-induced craving during the scanning session (r = 0.538, p = 0.024).
Conclusion: Results provide initial evidence for condition-specific and significant attenuation of NAc connectivity by oxytocin in a sample of heavy social drinkers that was related to lower subjective alcohol craving during the fMRI task. Oxytocin-induced attenuation of NAc connectivity was specific to processing alcohol stimuli and might reflect an attenuation of alcohol-cue saliency by oxytocin that could lead to a reduction of the sensitivity towards the appetitive aspects of alcohol cues.
S0087 - Cognitive Function as a Pharmacological Treatment Target in AUD
S0088 - Baclofen Approval in France: A Balance Between Two Conceptions of Medicine
ABSTRACT
Abstract Body
In October 2018, France became the first country to officially approve baclofen for alcohol use disorder (AUD), even if the French Drug Agency (ANSM) officially stated that the efficacy of baclofen in AUD could be not established at this stage, in the light of the available evidence. The decision of the ANSM comprised obvious political aspects, as baclofen approval followed a decade-long practice of off-label prescription, where doses used could reach 300 mg per day or more. This situation led to a prolonged and ferocious debate between those who questioned such a widespread and unevidenced practice, and those who defended the place of an “common sense” empirical medicine. The French story of baclofen echoes other similar controversial off-label prescribing practices in the country, from the pioneer use buprenorphine for opioid use disorder in the 1990s, to the more recent off-label use of hydroxychloroquine during the COVID-19 outbreak. In each case, similar “pros” and “cons” arguments were opposed, highlighting the difficult interpenetration between evidence-based medicine on the one hand, and on-the-ground practice on the other hand.