Activation instead of blocking mesolimbic dopaminergic reward circuitry is a preferred modality in the long term treatment of reward deficiency syndrome (RDS): a commentary

Blum, Kenneth; Chen, Amanda LihChuan; Chen, Thomas JH; Braverman, Eric R; Reinking, Jeffrey; Blum, Seth H; Cassel, Kimberly; Downs, Bernard W; Waite, Roger L; Williams, Lonna; Prihoda, Thomas J; Kerner, Mallory M; Palomo, Tomas; Comings, David E; Tung, Howard; Rhoades, Patrick; Oscar-Berman, Marlene

doi:10.1186/1742-4682-5-24

Theoretical Biology and Medical Modelling

Table 1 Summary of completed clinical studies with nutraceutical supplementation: a literature review

From: Activation instead of blocking mesolimbic dopaminergic reward circuitry is a preferred modality in the long term treatment of reward deficiency syndrome (RDS): a commentary

Drug Abused or Dysfunction	Supplement Used	No. of Patients	No. of Days	Study Type	Significant Results	Publication
Alcohol	SAAVE	22	28	TO IP	100% decrease in BUD scores. Detoxification measures: reduction in benzodiazepine requirement, reduction in withdrawal tremors after 72 hours, reduction in depression	Blum K, Trachtenberg MC, Ramsey J. Improvement of inpatient treatment of the alcoholic as a function of neuronutrient restoration: a pilot study. Int J Addiction. 1988; 23:991–98.
						Blum K, Trachtenberg MC. Neurogenic deficits caused by alcoholism: restoration by SAAVE. Journal of Psychoactive Drugs. 1988; 20:297.
Alcohol plus Polydrugs	SAAVE	62	21	DBPC IP	Reduction in psychosocial stress reduction as measured by SCL, reduced BESS score, improved physical score, six-fold decrease in likelihood of leaving AMA after five days.	Blum et al. Enkephalinase inhibition and precursor amino acid loading improves inpatient treatment of alcoholics and poly-drug abusers: a double-blind placebo-controlled study of the neuronutrient intervention adjunct SAAVE. Alcohol. 1989; 5:481.
Cocaine	Tropamine	54	30	TO IP	Drug hunger significantly reduced in patients taking SAAVE as compared to controls; 4.2 percent AMA rate for patients on Tropamine versus 28 percent for patients on SAAVE and 37 percent for controls. </SPAN>	Blum et al. Reduction of both drug hunger and withdrawal against advice rate of cocaine abusers in a 30 day inpatient treatment program with the neuronutrient tropamine. Curr Ther Res. 1988; 43:1204.
Alcohol and Cocaine	SAAVE and Tropamine	60	379	TO CP	At end of one year over 50 percent of the alcoholic DUI offenders not using SAAVE dropped out of the program while less than 15 percent of those using SAAVE dropped out. For the cocaine abusers over 90 percent of the Non-Tropamaine group dropped out, but less than 25 percent of the patients in the control group.	Brown et al. Neurodynamics of relapse prevention: a neuronutrient approach to outpatient DUI offenders. J. Psychiatric Drugs. 1990; 22:173.
Over-Eating	PCAL 103	27	90	TO OP	The PCAL 103 group lost an average of 27 pounds in 90 days compared with an average loss of 10 pounds for the control group. Only 18.2 percent of the PCAL 103 patient group relapsed compared to 82 percent of the patients in the control group.	Blum et al.20 Neuronutrient effects on weight loss on carbohydrate bingeing in a bariatric setting. Curr Ther Res. 1990; 48:2a17.
Over-Eating	PCAL 103	247	730	PCOT OP	After two years, craving and binge eating were reduced one-third in group of patients on PCAL 103, as compared to the control patients. PCAL 103 group regained 14.7 pounds of their lost weight compared with 41.7 percent weight regained in control patients.	Blum K, Cull JG, Chen JHT, Garcia-Swan S, Holder JM, Wood R, et al. Clinical relevance of PhenCal in maintaining weight loss in an open-label, controlled 2-year study. Curr Ther Res. 1997; 58:745–63.
Over-Eating	Chromium Picolinate (CP) and L-Camitine	40	112	RDBPC CP	21 percent increase (p < 0.001) in resting metabolic rate (RMR), no change in lean body mass (LBM), RMR:LBM increased 25 percent (p < 0.001). Body fat decreased approximately 1.5 lbs./week, and reduction in serum cholesterol while incre asing RMR with no loss of LBM	Kaats FE et al. The short-term therapeutic effect of treating obesity with a plan of improved nutrition and moderate caloric restriction. Curr Ther Res. 1992; 51:261.
Over-Eating	Chromium Picolinate	32	180	DBPC OP	After six months the CrP group had an increase in lean body mass and avoided non-fat related weight loss. Difference between groups was significant at p < 0.001.	Bahadori B, Habersack S, Schneider H, Wascher TC, Topiak H. Treatment with chromium picolinate improves lean body mass in patients following weight reduction. Federation Am Soc Exp Bio 1995.
Over-Eating	Chromium Picolinate	154	72	RDBPC OP	200 and 400 mcg of CrP brought about significant changes in Body Mass composition indicies when compared with placebo	Kaats FE, Blum K, Fisher JA, Aldeman JA. Effects of chromium picolinate supplementation on body mass composition: a randomized, double-blind, placebo-controlled study. Curr Ther Res. 1996; 57:747–56
Over-Eating	Chromium Picolinate	122	90	RDBPC OP	After controlling for differences in caloric expenditure and caloric intake as compared with the placebo group, 400 mcg CrP group lost significantly more weight (p < 0.001) and body fat (p < 0.004), had a greater reduction in body fat (p < 0.001), significantly improve body composition (p < 0.004).	Kaats FE, Blum K, Pullin D, Keith SC, Wood R. A randomized double-masked placebo-controlled study of the effects of chromium picolinate supplementation on body composition: a replication of previous study. Curr Ther Res. 1998; 59:379–88.
Over-Eating	Chromium Picolinate	122	90	RDBPC OP	Measures of changes in fat weight, change in body weight, percent change in weight, and body weight changes in kgms were all significant in A2/A2 group, and non-significant in A1/A2 and A1/A1 carriers.	Blum K, Kaats G, Eisenbery A, Sherman M, Davis K, Comings DE, Cull JG, Ch en THJ, Wood R, Bucci L, Wise JA, Braverman ER, and Pullin D. Chromium Picolinate Induces Changes in Body Composition as a Function of the Taq1 Dopamine D2 Receptor A1 Alleles. Submitted to International J. Eat. Dis.
Over-Eating	Chromium Picolinate and Chromium Picolinate comparison	43	63	ROTPC OP	CrP supplementation resulted in significant weight gain, while exercise training combined with CrP supplementation resulted in significant weight loss and lowered insulin response to an oral glucose load. Concluded high levels of CrP supplementation are contraindicated for weight loss, in young obese women. Moreover, results suggested that exercise combined with CrP supplementation may be more beneficial than exercise training alone for modification of certain CAD or NIDDM risk factors	Grant KE, Chandler RM, Castle AL, Ivy JL. Chromium and exercise training: effect on obese women.20J Am Sports Med 1997; 29(8):992–8.
Healthy Volunteers	Tropagen	15	30	DBPC OP	Non-drug subjects with Tropagen performed better on computer memory and performance tasks as measured with P300 wave evoked potential. Changes in P300 wave evoked potential result in better focusing ADHD patients	Defrance JJ, Hymel C, Trachtenberg MC et al. Enhancement of attention processing by Kantrol in healthy humans: A pilot study. Clin Electroencephalgr. 1997; 28:68–75.

Abbreviations used: BUD – building up to drink; AMA – withdrawal against medical advice; OP – outpatient; MMPI – Minnesota Multiphasic personality inventory; DB – double-blind; IP – inpatient; SCL – skin conductance level; BESS – behavioral, emotional, social, spiritual; DBPC – double-blind placebo-controlled; DUI – driving under the influence; R – randomized; TO – open trial
Source : Chen et al 2004[39]with permission Elsevier.

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