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F J Lichtigfeld

Publications and source records attributed to F J Lichtigfeld.

At least 19 recordsLinked to original sources
PubMed1998

Antidepressants are not drugs of abuse or dependence.

There is a view among both the lay and medical audience that antidepressants are addictive. Non-compliance may arise as a result, with fatal consequences in some cases. In spite of the fact that anti-depressants have not proved to be drugs of abuse or dependence, confusion exists in the literature, particularly regarding the definition of the terms misuse and abuse in opioid addicts. Here, antidepressants are used to treat the depressive component of the addictive syndrome and have proved effective. In some instances, however, misuse of antidepressants has been found in methadone-treated addicts, which may be due to an enhancement of the effects of methadone. These effects have led some people to believe, wrongly, that antidepressants are substances of abuse. Our findings, from a review of the literature, show that such use of antidepressants by methadone patients is by definition misuse and not abuse. Further, the known withdrawal symptoms which occasionally follow cessation of anti-depressant therapy are not, on their own, an indication of addictive potential. We therefore conclude that antidepressant drugs are not substances of abuse and dependence.

Antidepressive Agents↗
PubMed1998

Clinical role and mechanisms of action of analgesic nitrous oxide.

We give a brief history and development of the use of analgesic nitrous oxide in various clinical situations, emphasizing the very important difference between analgesic and anesthetic concentrations of the gas. We give evidence for the opioid nature of analgesic nitrous oxide and the probable role that these opioid properties play in its clinical effects. Its uniqueness among the opioids arises from its ability to safely stimulate both mu and kappa opioid receptors thereby modulating these systems, which are at times antagonistic to each other. These opposing systems appear to be particularly important during addictive withdrawal. We also discuss the possible relationship existing between nitric and nitrous oxide.

Analgesics, Non-Narcotic↗
PubMed1996

Role of dopamine mesolimbic system in opioid action of psychotropic analgesic nitrous oxide in alcohol and drug withdrawal.

Psychotropic analgesic nitrous oxide (PAN) has been used successfully in the treatment of alcohol and drug withdrawal in > 15,000 cases. It is an opioid and thus the first gaseous member of the opioid family. We propose the existence of two mutually antagonistic opioid systems as underlying addictive withdrawal states; mu and kappa. PAN as a multipotent opioid activates these systems. Dopamine (DA) activity in the nucleus accumbens appears to be controlled by kappa- and mu-receptors, with mu enhancing and kappa inhibiting release. In morphine and alcohol withdrawal, there is severe inhibition of dopamine release from nucleus accumbens. We thus infer that a probable major therapeutic effect of PAN is in modulating this dopamine system, thereby correcting the severe deficit in dopamine release found in withdrawal states. This has been achieved without any transfer of addiction to PAN in any of the treated patients because of modulation of DA in the nucleus accumbens by PAN. This effect may also explain its anticraving action.

Analgesics, Non-Narcotic↗
PubMed1994

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Ions↗
PubMed1994

Pharmacology of psychotropic analgesic nitrous oxide as a multipotent opioid agonist.

We show that psychotropic analgesic nitrous oxide is a partial opioid agonist since it fulfills all the following criteria to be classified as an opioid: 1) its effects are antagonised by various opioid antagonists including stereospecific naloxone antagonism; 2) it is cross tolerant with morphine; 3) its effects are potentiated by enkephalinase inhibition; 4) it provokes the release of endogenous opioids; 5) it interferes at low concentrations with specific opioid ligand binding at radio-receptor assay. Like the prototype opioid morphine it acts directly and indirectly at opioid receptors. PAN, although considered an exogenous inorganic molecule was also the first gas to be shown to have a direct role in influencing neurotransmission. We also describe some of the relationships that exist between nitrous oxide and its close relative, the endogenous gas nitric oxide. We describe the use of PAN as a safe, effective tool for investigating and treating the endogenous opioid system in man.

Animals↗
PubMed1994

Psychotropic analgesic nitrous oxide and neurotransmitter mechanisms involved in the alcohol withdrawal state.

We relate the extremely rapid and lasting beneficial effects of psychotropic analgesic nitrous oxide (PAN) on the alcohol withdrawal state (AWS) to the underlying neurotransmitter system disturbances and clinical findings. PAN is an opioid and its main therapeutic effects are produced by stimulating the underactive endogenous opioid system (EOS) found in the AWS. In common with other opioids, PAN also acts on other neurotransmitter systems. While controlling the cholinergic and adrenergic overactivity and the concomitant stress state, through its opioid agonism, it simultaneously stimulates the underactive serotonergic and GABA-ergic systems found in the AWS. PAN also ameliorates disturbances in corticotropin-releasing factor (CRF) dopaminergic, glutaminergic and second messenger function. This unique combination of stimulation and inhibition enables a single 20 minute administration of PAN to rapidly restore the patients' homeostatic balance with lasting effect, and almost no other medication requirements during the entire detoxification period. Unlike other currently available therapies this is achieved without sedation.

Acetylcholine↗