Drugs For Relapse Prevention in Addiction: Review of Psychological and Neurological Factors, Genetics and Neurobiological Mechanisms

Behavioral and substance addictions share more similarities than differences in etiological, phenomenological, and clinical presentations. Interactions between the variables of predisposing (i.e., neurobiological and psychological constitutions) and moderating (i.e., coping style and cognitive and attentional biases), as well as variables of mediating (i.e., affective and cognitive reactions to situational triggers) in combination with reduced inhibitory control may accelerate or reduce the developing of specific versions of model for addictive behaviors. Around 50% individuals’ variability in becoming addicted to substance (nicotine, alcohol, or illicit drugs) is attributable to genetic factors. Genetic variations to addiction susceptibility and environmental factors such as stress or social defeat also alter brain-reward mechanisms impart vulnerability to addiction. The emergence and maintenance of addiction might be the consequences of chronic exposure to drugs remodeling the chromatin structure including FosB, Cdk5, G9a, and BDNF around genes. Only few drugs for substance use disorders (SUDs) are approved by the FDA, But QSP approaches provide valuable strategies for designing novel prevention or treatment towards drug addiction. Conjugate vaccines and monoclonal antibodies treatments generating high-affinity anti-drug IgG antibodies neutralizing drug doses in the serum might lead the immunotherapy for SUDs in the future.

Keywords: Addiction, Alcohol Use Disorder (AUD), Brain reward system (BRS), Conjugate vaccine, Genome-wide association study (GWAS), Monoclonal antibodies, Nicotine, Opioids Use Disorder (OUD), Quantitative systems pharmacology (QSP).