Both psychotherapy and pharmacotherapy approaches are needed to a successful treatment of tobacco addiction. Until now, bupropion and nicotine substitutes where the more important pharmacological agents, but things are becoming to change.

The authors make a review about the new drugs available.

Varenicline tartrate has been approved by FDA in May of 2006, and preliminary studies of efficacy reveal percentages of tobacco cessation even higher than bupropion. Rimonabant is another new drug with potential utility in tobacco addiction. It is the first selective blocker of canabinoid receptors CB1. Selegiline and Topiramate can be useful in cases of comorbidity or resistance to other drugs, but they need more studies to establish their utility in treatment of tobacco addiction. Antinicotine vaccines are also been discussed, because they could reduce the cerebral distribution of nicotine, and then act in the positive reinforcement of tobacco addiction.

Varenicline and rimonabant are two promising drugs in farmacological treatment of tobacco addiction

In our study, the magnitude of EEG power spectra of delta, theta, alpha and beta power was examined to address the relationship between EEG spectral changes after activation methods and alcohol dependence. Electroencephalography has shown that the brain activity of alcoholics and nonalcoholics differs in some characteristic ways. These differences are consistent with an imbalance between excitation and inhibition processes in the brains of alcoholics.

We examined eyes-closed resting EEG and EEG after activation procedures (eyes-open, hyperventilation). A group of 54 male chronic alcoholics were selected according to inclusion and exclusion criteria. We compared this group with 54 age- and gender-matched control subjects from the group of healthy volunteers. All subjects in both groups were Caucasians.

Our results in power spectra of activated EEG /after eyes-open period, hyperventilation) showed statistically significant differences in reactivity to activation methods between alcohol dependent patients and healthy volunteers. Our data manifested significant contrast in modulation of alpha activity after EEG activation using eyes-open test.

In previous studies researchers compared eyes-closed resting EEG spectra in alcohol dependent study participants and age- and gender-matched control subjects. The present study reported statistically significant differences in reactivity to activation methods in both groups. Hence, the EEG spectra after activation methods in children of alcoholic, especially before alcohol exposure, need to be examined to consider these differences in reactivity to activation methods as an endophenotype marker of chronic alcoholism.

we evaluate the effects of a diverse set of visual cues on subjective craving for intravenous heroin users (IHUs) then; we designed and assessed reliability and validity of a Visual Cue – Induced Craving Assessment Task (VCICT) for induction of subjective craving among IHUs.

first, five sessions were held with IHUs groups to provide a list of visual signs that might evoke heroin craving. According to this list, needed photographs provided from real situations. Intravenous Heroin Users were asked to score the severity of their craving induced by each photo on a self report. Second, for designing of VCICT, we used ten most provocative cues. We used the Opiate Withdrawal Symptoms Checklist (OWSC) before and after exposure to cues, Barret Impulsivity Scale (BIS) and the Addiction Severity Index (ASI). 30 male IHUs entered this study before treatment.

packed and open powder of heroin, injecting syringe and act of injection had the largest effect on induction of craving. VCICT score was significantly correlated with drug component of ASI and the post exposure score in OWSC that shows the validity of task. Test–retest of cue exposure with one day interval showed higher level of reliability (82%). Responder group to VCICT (17 out of 30) showed higher level of cognitive impulsivity.

These findings let researchers assess cue induced craving as the main predictor of treatment failure. Personality characteristics and addiction severity differences between responder and non-responders to cue induced craving demonstrate underlying structures of substance abuse.

Heroin injection is the most prevalent registered cause of HIV transmission in Iran. Regarding the high prevalence of Intravenous heroin use among homelesses in Tehran; Iran Police force and Ministry of Health collaborated in a national project of capture and reference of these high risk group for opium detoxification using methadone maintenance therapy.we examined impulsive personality characteristics among captured homeless HIV positive or negative IHUs and compared them to their matched none captured, none homeless casually referred cases of intravenous heroi users (IHUs).

Two groups of HIV positive (25 cases) and HIV negative (25 cases) of Homeless IHUs had been compared to 50 cases of nonhomeless IHUs.we used Eysenk Impulsiveness Questionnaire-7 (EIQ), Barret Impulsiveness Scale-11 (BIS), and Delayed Discounting Task.Results:More prison history, criminal behaviors and longer history of needle sharing and drug abuse have been observed in homeless IHUs. More Impulsiveness indexes according to BIS, EIS and more delayed discounting had been observed in this group. And less venturesomeness measured by EIQ incentive. In the homeless IHUs who were HIV positive, more cognitive impulsivity detected according to EIQ and BIS tools.

Significant increase in impulsivity among homeless IHUs and lower life expectancy in addition to more needle sharing behavior in this group can be a clue for HIV transmission spread among this group. High degree of impulsivity alteration and longer history of addiction period, dose and frequency of needle sharing are among the other factors which may predict the risk of HIV spread amoung homeless IHUs.

Antinociceptive activity of Olanzapine was demonstrated in animals and is a useful drug in controlling of aggression. This study evaluated the efficacy of this drug in treatment of patients that were dependant to Opioids (Opium and Heroin) and had Antisocial Personality Disorder.

During 6 month (2004) study 36 cases with Opioids substances dependency evaluated and 24 of them introduced as main study group with Antisocial Personality Disorder. Clinical interview and MMPI-2 test has been used in this process. All patients received clonidine and analgesics and 12 of them received Olanzapine10-30 mg/day. Patients evaluated after one month of treatment.

Compliance for treatment during One month was better (10 of 12 cases = 83.3%) in cases that have been received Olanzapine than versus group (4 of 12 cases = 33.3% P < 0.05). Frequently reported symptoms in second group were irritability (100%), verbal and physical hostility (100%, 84%) and restlessness (100%).

In patients with Opioids dependency and concomitant Antisocial Personality Disorder usefulness of Olanzapine may be in focus of attention in new researches. This drug improves the compliance of treatment especially in acute withdrawal phase.

Frequency of drug misuse has increased in the society and also in psychiatric patients. It´s known that drugs have a negative influence in psychiatric pathology, so its identification is very important for a better prognosis.

We aim to demonstrate that drug misuse draws out the stay in hospital of psychiatric patients and increases the number of readmissions needed, basing the hypothesis on our laboratory information of drug screening in a psychiatric hospital.

It is analyzed, retrospectively, all admission to a short stay unit in a psychiatric hospital in 2000 and 2005, and compared all patient with a positive result in a urine sample obtained by a drug screening protocol with the rest of admissions to that unit, measuring in both groups the number of readmissions, and the extension of hospitalization.

Our hypothesis is confirmed, being the number of readmissions more frequent and the extension of hospitalization longer when patients are drug-users.

Prevalence of drug misuse has met increased in the last decade and more frequently among mental patients. Drug misuse difficults psychiatric treatments and increases sanitary expenses, being important stablishing diagnostic and treatment measures to face this problem So it`s important to take under consideration that this behaviour affects negatively in the progress of hospitalization, as proved in our investigation.

Purpose of this study was to examined resilient of adolescents from alcoholic families which parents were treated at the Institute of mental health in Belgrade and compared with their peers.

Study was made in period 2000-2004 at Department of alcoholism. Total sample was N=296 (155 male, 141 female), age 10 – 19 years. Into account were taken: demographic data (age, educational, place were live and members of family), family history of alcoholism and resilien of adolescents. The following instruments were used: Socio-psychiatrically Checklist, Children of alcoholics Screening Test (Jones 1981)- CAST 6 and Adolescents Resilience Assessment Scale (Biscol, Harris 1994)-ARAS.

Obtained results confirmed our hypotheses that some elements of resilience of adolescents from alcoholics families were better statistical significant compared to adolescents without family alcoholism.

In order to estimate more exact data we need study about children from alcoholics families in their earlier age; it is necessary to follow further functioning of these children in their families.

Comorbidity between drug consumption and several psychiatric disorders is a topic of increasing interest. It´s known that between 30% and 80% of psychiatric inpatients use drugs, and these patients often show worse prognosis, for what their identification turns out to be one of the biggest challenges for the clinician.

Based on clinical practice in a psychiatric hospital, we investigate the possible existence of underdiagnosis for misuse of drugs in psychiatric inpatients.

It is analyzed, retrospectively, all admission to a psychiatric hospital in 2000 and 2005, in which diagnosis to the discharge involves drug misuse (dependence, abuse, toxic psychosis). Likewise it´s analyzed laboratory information of drug screening in urine (obtained of every patient suspicion of consumption). Both results are then compared.

Our hypothesis is confirmed, being very scanty the number of diagnosis to the discharge associated with drug misuse, compared to the high prevalence of drug use demonstrated in the laboratory screening.

Although it´s known that drugs are often used by psychiatric patients, clinicians often elude to diagnose it (probably another diagnosis, such as schizophrenia, are so important for us that we don´t pay enough attention to drugs).

This investigation should remind clinicians that drug use is frequent, adds worse prognosis, and must be specifically treated.

Alcoholism is one of the most common chronic disorders in the western world that causes and aggravates a whole range of diseases and disorders. The purpose of this study was to determine the prevalence of cases of erectile dysfunction (ED) among the alcoholics attending a detoxification unit.

100 male alcoholic patients were selected from all consecutive visits to an alcohol outpatient unit. The diagnosis of ED was determined using the SQUED questionnaire for ED (score <= 12). All the patients were questioned about their use of alcohol and other drugs, the organic diseases they were suffering from and the pharmacological treatment they were receiving.

One hundred patients recruited had a mean age of 47.2 ± 9.8 years. The mean daily amount of alcohol consumed was 14.4 ± 7.6 standard drink units, the mean frequency being 6.5 +- 1.4 days a week. The abstinence time over the last six months was 14.2 ± 9.8 weeks. 83% of patients were smokers and 29% consumed hypnotics-sedatives. 73% of patients were on pharmacological treatment (57% for alcoholic detoxification, 33% with antidepressants). According to the SQUED questionnaire, 26% of patients presented ED and 20% had had no sexual relationship during the last 6 months.

The prevalence of ED in alcoholic patients was high (26-46%). The diagnosis and treatment of ED should be an aspect to be taken into account in this type of patients to reduce their anxiety and so aid in preventing possible relapses of their alcoholism.

Measurable traits of human personality may mark the predisposition to psychopathology. Increased novelty seeking plays an important role in the pathogenesis of substance abuse. Novelty seeking, one of the fundamental traits of the human temperament, is related to dopamine. Catechol-O-methyltransferase (COMT) is essential for dopamine inactivation. The aim of our study was to assess whether the COMT gene Val158Met functional polymorphism in patients dependent on methamphetamine is related to their novelty seeking score.

Patients dependent on methamphetamine who had been treated at the Addiction Treatment Unit in Nechanice in 2004 and 2005 agreed to participate in the investigation. We administered the Temperament and Character Inventory (TCI) questionnaire, assessed their novelty seeking score and analysed their DNA samples for COMT Val158Met genotype.

The subjects were thirty-seven Czech Caucasians (women N = 10) dependent on methamphetamine with an average age of 23.6 ± 3.8 years. We found a significantly higher mean novelty seeking score among the patients with the Met allele (Met/Met homozygotes + Val/Met heterozygotes; N = 28) than in nine Val/Val homozygotes (27.4 vs 24.1; p = 0.042, Two-Sample T-Test).

The Met allele of the COMT gene Val158Met polymorphism is associated with low COMT enzyme activity and high endogenous dopamine synaptic levels in the prefrontal cortex. This leads to a decrease in dopaminergic neurotransmission in nucleus accumbens and a need for an increased activity to stimulate it. Novelty seeking behavior corresponds with this need.

The presence of anxiety in addicted patients, although it is expected, has been connected to poorer outcome of addiction treatment, decreased percentages of completion in patients admitted to substance abuse detoxification programmes and shorter period of abstinence. The Addictions Department at the Psychiatric Hospital of Thessaloniki in Greece has an integrated Therapeutic Program which delivers a therapeutic continuum and attempts to cover the needs of various populations through a flexible, interconnected network of multi-dimensional services.

Sixty (60) subjects -equally regarded in a randomized way from three different domains of a Therapeutic Program in Addictions (Detoxification Unit, Residential Therapeutic Community, Reintegration Programme)- were examined. They were screened with the Stait-Trait Anxiety Inventory (STAI) and with the General Health Questionnaire (GHQ-30).

Most of the subjects were young single men, with a secondary educational level. Anxiety level at the Detoxification Unit was quite high (median Stait Score: 56.35±10.37, median Trait Score: 50.70±10.58) as well as at the Therapeutic Community (median Stait Score: 52.90±9.10, median Trait Score: 45.20±7.48). Although there is a gradual decrease of anxiety level, it is not statistically significant. Anxiety level is decreased statistically significant at the Reintegration Programme (median Stait Score: 45.95±6.67, median Trait Score: 41.25±5.35) (p<0.05).

Addicted patients express high anxiety levels at the first stages of a therapeutic detoxification programme. As the therapeutic procedure goes on and abstinence is established, anxiety is decreased –although they are treated as outpatients at the final stage.