El test de apormorfina como marcador biológico de recaída en dependientes de cocaina

Identificador:  TDX:1618

Handle: https://hdl.handle.net/20.500.11797/TDX1618

Autors:  Roncero, Carlos

Resum:
Having biological markers that may be associated with the prognosis of addiction would be a breakthrough in the treatment. Quantification of yawning induced after apomorphine administration evaluates indirectly raising the dopaminergic system, in what is known as Apomorphine Test (AT). A clinical double-blind clinical trial was performed in 39 cocaine-dependent patients according to DSM-IV-TR, they were recruited addictions unit of the Hospital Vall Hebron. The TA is done in the Hospital Detoxification Unit and consist of two parts: the subcutaneous administration of 0.005 mg / kg of apomorphine and observation for 45 minutes and a second subcutaneous administration of placebo and observation for 45 minutes or vice versa. Two AT on day 1 and day 11/12 are performed. A 21 weeks follow-up were performed 21 weeks and patients who relapse early (during the first 4 weeks after performing detoxification) or non early are compared. Patients with early relapse have as many yawns in the sum of TA performed on Day 1 and completed the detoxification 11/12, compared with late levied. Therefore the sum of the two TA is a predictor of relapse. Yawning more patients in complete AT (sum of apomorphine-induced yawning and placebo) from Day 1 fall precociously, being a predictor of relapse. We proposed a model with a cutoff of 7 yawns in the first full AT which has a 61'9% sensitivity and specificity of 70'6%. The TA is an easily applicable tool in daily clinical practice and may be a marker for risk of early relapse.