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Prometa ... WTF?

Probably just another placebo effect subsidized, pseudoscientific attempt to make money off an incurable, chronic ailment such as drug abuse and dependance, not unlike patent medicine, cure all Snake Oil remedies of yesteryear.

Giving the patients a drug cocktail of something, anything that produces noticeable effects which might be interpreted as being the desired outcome or close to it reminds me of when, back in the old days, some fake ecstasy dealer would sell somebody some DXM pills (or whatnot) and then, when the customer would come back and demand their money back, simply ask, "Well, did you at least feel _something_?" Since they did feel something, even though not MDMA, they were more likely not to raise a ruckus. Remember Herbal Ecstacy [sic] way back in the mid-1990's? Some guy got rich by pressing ephedrine into butterfly stamped pills and marketing it as a legal alternative to Ecstasy.

But hey, if this program works for some people, then that's great.
 
what the hell will the extra flumazenil shots do for someone addicted to meth or crack?

For the benzo or ethanol addict, it makes sense to me. the hydroxyzine is just a calmative, but the flumazenil and gabapentin make good sense (in a long term treatment program- not a quick detox)
 
Ham-milton said:
what the hell will the extra flumazenil shots do for someone addicted to meth or crack?
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That is what I don't get. What is the use of inducing a siezure and preventing it at the same time for a dopaminergic stim addict?
 
fastandbulbous said:
It shouldn't as it's a benzo antagonist. What's needed to induce convulsions is a benzo inverse agonist
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I'm more concerned with its use in someone with an alcohol or benzo problem. They're not uncommon with stimulant abusers.

I've never looked much into benzo antagonists, but flumazenil is a convulsant for benzo addicts, no?
 
Flumazenil can cause convulsions even in people who aren't habituated to benzos, needs large doses to do it normally but it does seem a bit risky using it in recovering alcoholics :\

Can see why this treatment might work though. All of the brain pathways associated with addiction are linked together to some extent, so a small dose of an antagonist at any of them can have an anti-addictive effect regardless of what you were addicted to.

Really the best treatment would be to block all of them at the same time, use a small dose of say flumazenil + naltrexone + rimonabant + mecamylamine but it would make you feel pretty crappy I'd imagine and there would be a problem with retention in treatment as no-one would want to stick with it.

Be interested to see how well this program works, not the mix of drugs I would have chosen but I guess they must have done animal studies etc before it went on to humans so it should have some degree of efficacy.
 
Might as well through a D2 antagonist in there too!!

Really, though, I don't see why there'd be any benefit to blocking all the passageways. In the end, it seems, dopamine is the root cause of euphoria.

Not to get too far off track, but has there been much research into how exactly ethanol interacts with the mu-opioid receptors? Antagonists block euphoria from ethanol (actually, partial agonists work pretty well too).

It'd be interesting to know which non-opioid drugs have their euphoria blocked with naltrexone, and which don't. I would suspect benzos and barbs and quinazolinones would all have their euphoria blocked.

The same for antagonists of other receptors (tested with other drugs that aren't agonists at the same receptors)
 
I would have thought that any agonist activity at the mu-opiod receptors resulting from administration of ethanol was through some sort of feedback pathway; as a later result of its initial effects on glumate or GABA concentrations in turn causing the release of endorphins, rather than any direct agonism at the mu-opiod receptors by ethanol.
 
UnfortunateSquid said:
I would have thought that any agonist activity at the mu-opiod receptors resulting from administration of ethanol was through some sort of feedback pathway; as a later result of its initial effects on glumate or GABA concentrations in turn causing the release of endorphins, rather than any direct agonism at the mu-opiod receptors by ethanol.
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Yeah, I know. I should have been more clear, I didn't mean interacting with receptors by the drug itself, but with the whole mu-opioid/endorphin system- whether by release or potentiation or synergism with endorphins or some other mechanism.

It seems that ethanol doesn't effect DA directly, but rather through some stimulation of the opioid system. It would be interesting to know about other addictive drugs and if they stimulate DA directly or through another system like ethanol seems to.

I wonder how addictive opiates would be if they had no effect on DA levels.
 
One problem is that the current idea about what μ-agonism actually does seems to be shakey at best. The idea is that it inhibits the release of pre-synaptic GABA which in turn causes an increase in the release of post-synaptic DA. This makes little sense when we look at the fact that benzos potentiate opioids. I know this is a simplified version, but correct me if I'm wrong.
 
A combo of Baclofen and gabapentin would probably be similarly effective. "Prometa" is most likely very expensive, probably far more so than the off-label prescription of those three components....

Not to get too far off track, but has there been much research into how exactly ethanol interacts with the mu-opioid receptors? Antagonists block euphoria from ethanol (actually, partial agonists work pretty well too
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I had once read that a 5-ht3 induced stress response lead to enkephalins/b-endorphin release after ethanol consumption. However, ethanol seems to affect the delta receptor far more than it does the MOR, i have no real idea why this is...
 
A long acting, slow release, subcutaneous form of disulfram would probably work best in people wantint to stop drinking (even those who don't want to stop!). Negative reinforcement is a big thing when it comes as violent vomiting from half a pint of beer...
 
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