Zoran M Pavlovic
PRA International, Germany
Zoran M Pavlovic MD, got his medical degree at the age of 25, completed his residency and obtained board certification in Psychiatry, from School of Medicine in Belgrade, Serbia. He has published numerous articles in the US (Journal of Neuropsychiatry and Clinical Neurosciences, Primary Care Companion to the Journal of Clinical Psychatry, Journal of Clinical Psychopharmacology) and European neuropsychopharmacology journals (International Journal of Neuropsychopharmacology and European Psychiatry). He serves as National Advisor at the European College of Neuropsychopharmacology (ECNP) and is a Member of the International College of Neuropsychopharmacology (CINP). He is currently working as Medical Director Psychiatry with PRA International in Germany.
Basic and clinical research suggests that excitatory glutamate transmission in the NAc also plays an important role in the development and maintenance of drug dependence, particularly in reinstatement to drug-seeking behavior and craving. One mechanism via which the lutamatergic system aff ects drug dependence is direct or indirect modulation of dopaminergic system activity. As addiction could be seen as a rapid-cycling series of failed attempts to control one’s drug-using behavior, antiepileptic drugs might be useful in preventing these reoccurring episodes. With respect to craving, anti-craving properties have been suggested for several antidepressants, however longer-term antidepressant exposure may favor mood swings to the manic-side, to which substance abusers may have a greater disposition, while antiepileptics are devoided of these side effects and have mood stabilizing properties. Antiepileptic medications which affect glutamatergic neurotransmission are lamotrigine,gabapentin and topiramate. We would present two case reports regarding successful use of lamotrigine in the treatment of alcohol and benzodiazepine withdrawal and cocaine abuse.