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Bezzy communities provide meaningful connections with others living with chronic conditions. Join Bezzy on the web or mobile app. In the short term, cocaine can increase your alertness and energy, as well as cause a feeling of euphoria. But frequent cocaine use can cause changes in the way your brain functions that may contribute to — or worsen — depression. Research suggests that about half of all people who live with substance use disorders have a co-occurring mental health condition. This includes people with cocaine use disorder previously called cocaine addiction. The most common co-occurring conditions include depression and anxiety. So, does cocaine use cause depression? Or does depression make someone more likely to use cocaine? The answers to both questions are complicated and vary from person to person based on things like medical history, level of cocaine use, and other factors. Certain pleasurable activities — like eating good food or having sex — trigger the release of dopamine. When dopamine is released in your brain, it nestles into spaces between neurons. Usually, nearby cells will absorb some of this dopamine for later reuse. This process is known as reuptake. It helps to regulate the amount of available dopamine in your brain. Cocaine blocks this reuptake process from happening. As a result, excess dopamine builds up, causing intense feelings of euphoria and alertness. As the effects of cocaine wear off, so does all that extra dopamine. These symptoms typically resolve within a few days as your brain replenishes its supply of dopamine and other neurotransmitters. This decrease in dopamine can lead to long-term complications, including depression and other mental health concerns. This can lead to the development of cocaine use disorder. Learn more about dopamine and its role in substance use disorders. Anhedonia refers to a decreased ability to feel pleasure or a loss of pleasure in non-drug rewards. Researchers are still trying to learn why some people who use cocaine develop anhedonia but others do not. In a study , researchers found that anhedonia in people living with cocaine use disorder was associated with certain genes that play a role in developing inflammation. But with ongoing use, these effects can have more of a lasting impact. If you stop using cocaine, you may continue having sleep disturbances throughout the withdrawal period, which can last anywhere from a week to several months. Historically, many experts considered depression to be a risk factor for both substance use and the development of a substance use disorder. One reason the authors note is that there are many factors that can contribute to developing depression. For some people, depression may have a strong genetic component. For others, depression might be rooted in a stressful childhood or other environmental factors — or a combination of genetic and environmental factors. These underlying causes may provide more specific insight into the link between depression and cocaine. For example, the authors noted that rodents displaying depression-like symptoms actually appeared less likely to self-administer cocaine. Those who did typically consumed less cocaine than the control group. But rodents who experienced early-life stress, a potential contributor to depression, were more likely to self-administer cocaine. These results suggest the links between depression and cocaine might be more closely related to the underlying causes of depression, rather than the depression itself. In addition to contributing to depression or depression-like symptoms, using cocaine can cause a range of other potentially harmful health effects. In the short-term, cocaine can increase your heart rate, blood pressure, and body temperature. These effects can increase your risk of having a heart attack or stroke, especially if you have a preexisting heart condition. Make sure you and those around you know to call or your local emergency number right away if someone experiences any of the following signs of an opioid-induced overdose:. If you plan on using cocaine, you may also want to consider carrying naloxone, a medication that can reverse an opioid overdose if someone ingests contaminated cocaine. Learn more about how to handle a potential overdose. If you feel comfortable doing so, consider bringing up the issue with your primary healthcare professional. They can refer you to a mental health professional or care team trained to address both depression and cocaine use disorder. Alternatively, you can search for a mental health professional on your own. Many therapist databases allow you to search for professionals who specialize in addressing co-occurring mental health concerns and substance use. Treatment can take many forms depending on your symptoms and needs, but it could include a combination of therapy and medication. Cocaine use, especially when done long-term, may increase your chances of developing depression or depression-like symptoms. Depression may raise your risk for substance use disorders — but substance use can also play a part in depression. We explain the link here. Depression can be debilitating for those who experience it. But there are many effective treatments available that can help you manage your symptoms. Many people see dopamine as one of the main driving factors in addiction. But it's not that simple. We'll bust some common myths about dopamine and…. Deep brain stimulation is a treatment that involves implanting a small device into the brain. It offers hope for those living with treatment-resistant…. Depression and burnout are two different experiences. Here's what they have in common and what sets them apart. A new study compared psilocybin — the active compound in magic mushrooms, with a common antidepressant medication. During 6 months of follow up, both…. Here's what experts say about the possibility of symptoms of depression after a concussion and how to manage. Here's all about late-onset or delayed postpartum depression. Original Series All. Fresh Food Fast Food hacks to make eating healthier, easier. Diagnosis Diaries Real diagnosis stories from people who get it. Present Tense Real-world mindfulness for busy people. Video Series All. Youth in Focus Mental health challenges facing our youth. Healthy Harvest Meet your food, from farm to table. Through An Artist's Eye A breast cancer story told through art. Future of Health Innovations shaping the future of health. How Well Do You Sleep? Find Your Bezzy Community Bezzy communities provide meaningful connections with others living with chronic conditions. Follow us on social media Can't get enough? Connect with us for all things health. Mental Well-Being. How cocaine affects your brain. Does cocaine cause depression? During this acute withdrawal phase, you might experience depression-like symptoms, including:. Other links between cocaine and depression. If you only use cocaine occasionally, these effects will typically resolve within a few days. Still, while this research gives us insights, further research will need to be done in humans. Other health impacts. Make sure you and those around you know to call or your local emergency number right away if someone experiences any of the following signs of an opioid-induced overdose: trouble breathing noisy breathing loss of consciousness pinned pupils pale, clammy skin, or skin that looks ashen or washed out If you plan on using cocaine, you may also want to consider carrying naloxone, a medication that can reverse an opioid overdose if someone ingests contaminated cocaine. Treating depression and cocaine use disorder. The bottom line. How we reviewed this article: Sources. Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy. Share this article. Read this next. Dopamine and Addiction: Separating Myths and Facts. Medically reviewed by Timothy J. Legg, PhD, PsyD. Deep Brain Stimulation for Depression. Medically reviewed by Tiffany Taft, PsyD. Burnout or Depression? Here Is How to Know. Can Concussions Cause Depression? Medically reviewed by Nancy Hammond, M. What Is Delayed Postpartum Depression?
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Official websites use. Share sensitive information only on official, secure websites. The effects of cocaine on microbiota have been scarcely explored. CUD patients reported a significant decrease in alpha diversity and modification of the abundances of several taxa in both GM and OM. In conclusion, CUD patients showed a profound dysbiotic fecal and oral microbiota composition and function and rTMS-induced cocaine abstinence determined the restoration of eubiotic microbiota. The CUD patients showed a marked microbial fecal and oral dysbiosis. We documented lower fecal levels of butyric acid on CUD patients. CUD patients significantly showed different microbial metabolic functions than controls. Microbiota dysfunction has been associated with several diseases and a significant body of evidence has identified microbial dysbiosis as a contributor to cognitive and neuropsychiatric disorders. The relationship between GM dysbiosis and SUD has been widely reported in rodents 6 , 7 , 8 and humans. Many drugs of abuse have also been reported to have a detrimental effect on the composition and function of GM. Volpe et al. In detail, several genera resulted decreased in saliva samples of cocaine-addicted patients whereas Streptococcus spp. Therefore, the present study aims to evaluate the fecal and oral microbiota composition and function in patients with CUD and to examine whether the positive effects of rTMS treatment on cocaine consumption can also favor the restoration of eubiotic microbiota and pave the way to the future development of supplemental strategies for the management of complications correlated with cocaine abuse. For the present study, 58 patients with CUD and 20 volunteer healthy controls HC 17 males, 3 females; with a mean age of We first evaluated whether CUD patients showed a different intestinal and oral microbiota structure in comparison with HC. Statistically significant beta diversity, namely the variability in microbial community composition the identity of the observed taxa among samples, between fecal or saliva samples of HC and CUD patients was also found at all taxonomic ranks Table S2. Taxonomic analysis of fecal and saliva samples is detailed in Table S3 and the stacked bar-plot representation displayed a marked different relative abundance of both the top five phyla and genera in either fecal respectively reported in Figures 2 A and 2B and saliva respectively reported in Figures 2 C and 2D samples collected from CUD patients and HC. In detail, the top five phyla in stool samples were Actinobacteriota, Bacteroidota, Firmicutes, Proteobacteria, and Verrucomicrobiota whereas saliva samples showed high abundances of Actinobacteriota, Bacteroidota, Firmicutes, Fusobacteria, and Proteobacteria. Besides, the top five genera in stool samples were Bacteroides , Bifidobacterium , Blautia , Collinsella , and Faecalibacterium whereas saliva samples showed high abundances of Actinomyces , Prevotella, Rothia , Streptococcus and Veillonella. Stacked bar graphs showing relative bacterial abundances at phylum and genus level among HC and CUD patients. Subsequently, differential abundance analyses were performed at all taxonomic ranks and notably several taxa resulted differentially abundant in fecal Figure 3 A, Table S4 and saliva Figure 3 B, Table S5 samples of HC and CUD patients. On the other hand, CUD patients showed higher saliva levels of Rothia spp. Analyses were assessed using the Mann-Whitney test and p-values less than 0. Instead, a significant increase of F spp. All the presented results have an adj. Analyses were assessed using the paired Wilcoxon signed-rank test and p-values less than 0. To date, much of the research on cocaine addiction has been focused on the neurological and genetic aspects of consumer behavior. However, recent preclinical studies of intestinal dysbiosis in animal models and people with cocaine addiction have strengthened the presence of bidirectional communication between the enteric and the central nervous system. In addition, we examined whether the positive effects of rTMS treatment on cocaine consumption can also support the restoration of eubiotic microbiota. Our results showed that both oral and intestinal microbiota structures present a significant reduction of the alpha diversity between CUD patients and HC with a significant parting between CUD patients and HC fecal and saliva samples. These data are in line with Scorza et al. Our findings are supported by preclinical studies in mice, where Erysipelotrichaceae members and Turicibacter spp. Barnesiella spp. In support of our findings, cocaine addiction has been associated with reduced abundances of H aemopilus. In general, these microbial compositional alterations in both OM and GM of CUD patients reflect the presence of a remarkably dysbiotic condition. In fact, although a eubiotic intestinal or buccal environment is constituted by a high richness of species, 61 the reduction of the fecal or saliva microbial diversity and the increase in pro-inflammatory species have been widely reported as a reflection of intestinal or oral dysbiosis. We observed that various metabolic functions of either salivary or intestinal microbiota resulted differentially expressed between CUD patients and HC. The several enhanced inflammatory pathways found in CUD patients confirmed that the inflammatory tone in chronic cocaine consumers has been regarded as consequential to behaviors that occur in conjunction with cocaine-related changes in brain function. Parallel to the ascertained gut-brain interplay, in the last years has been documented that also oral resident microbes in the mouth can communicate with the brain through specific mechanisms such as 1 microbial and metabolite escape, 2 modulation of neuroinflammation, 3 modulation of brain signaling and 4 response to neurohormones. About this, our results show that pathways involved in isoleucine and valine biosynthesis were highly expressed by the salivary microbiota of CUD patients compared to HC. Both isoleucine and valine are included in the group of branched-chain amino acids BCAAs that serve as substrates for protein synthesis or energy production and perform several metabolic and signaling functions. Notably, they are transported into the brain via the same carrier that transports phenylalanine, tyrosine and tryptophan, making competition that may influence the synthesis of some neurotransmitters, especially dopamine, norepinephrine, and serotonin. Indeed, high concentrations of BCAAs were found to be neurotoxic because of increased excitotoxicity and oxidative stress. The evaluation of fecal SCFAs and MCFAs also confirmed a functional GM alteration, in fact, CUD patients showed lower levels of butyric and hexanoic acids but higher abundances of isohexanoic, heptanoic, nonanoic, decanoic and dodecanoic acids. The SCFAs, especially acetic, propionic and butyric acids, are the main end-products of the bacterial fermentation of dietary fibers that exert crucial immunomodulatory and physiological effects on several organs including the brain. In particular, butyric acid is an attractive therapeutic molecule because of its wide array of biological functions, such as its ability to serve as a histone deacetylase HDAC inhibitor, an energy metabolite to produce ATP and a G protein-coupled receptor GPCR activator and, pharmacologically, butyrate has a profoundly beneficial effect on neurodegenerative and psychological disorders. Instead, although MCFAs can be metabolized to ketones by astrocytes to be used as an energy source for the brain 84 they display remarkable pro-inflammatory effects by enhancing the production of pro-inflammatory cytokines and reducing the anti-inflammatory IL levels through TLR2 activation. Finally, considering our previously reported beneficial effect of rTMS treatment in lowering cocaine craving and consumption 45 and taking into account the aforementioned interplay between the brain and both oral and intestinal microbiota, we have also evaluated the compositional and functional modifications in both GM and OM of CUD patients after 8 weeks rTMS treatment. Although no significant differences have been found in GM composition, rTMS-subjects reported a significant increase in fecal butyric acid abundance, an SCFA with potent anti-inflammatory effects in the gut and an important neuroprotective role in the brain. Although increased levels of Peptoanaerobacter stomatis and Scardovia wiggsiae have been associated with periodontal disease, 89 , 90 rTMs treatment has also determined the beneficial reduction of Lactobacillales because drug users reported an increase in Lactobacillus spp. However, the effects of rTMS in inducing changes in neurotransmitter systems have been largely demonstrated, specifically in the alterations of striatal dopamine release and metabolite levels, as well as to glutamate transporter and receptor expression, which may be relevant to improving the aberrant plasticity observed in individuals with SUD. Moreover, it is well known that CUD is strictly associated with depression and the efficacy of rTMS in the treatment of depression has been demonstrated by many studies. Through the modulation of the hypothalamic-pituitary-adrenocortical HPA axis, rTMS can directly or indirectly prevent hippocampal neuron atrophy and apoptosis and alleviate the symptoms of depression. Thus, we can speculate that rTMS-induced cocaine abstinence could play a role in the gut-brain axis and exert effects on microbial communities leading to GM and OM beneficial properties. Furthermore, the remarkable alteration of both oral and intestinal microbiota structure and function in CUD patients confirmed the evidence suggesting the important role of microbes in the pathogenesis of neuropsychiatric pathologies, including reward processes and substance-related disorders. To conclude, our study demonstrates the profound oral and intestinal compositional and functional dysbiosis of CUD patients and that rTMS treatment inducing reduced cocaine consumption and craving may represent a promising avenue for future therapeutic development. Although we have analyzed for the first time both GM and OM composition and function in CUD patients and the effects of rTMS, we are aware that this study has some limitations such as the enrollment of CUD patients that also consumes other drugs including alcohol e. Despite this, we have documented various and consistent differences in the gut and oral microbial communities of CUD patients that are often sustained by several animal studies and the only two human studies present in the literature. Importantly, our work suggests the OM relevance as a future investigative tool for several diseases, including SUD, and indicates that a diet rich in butyrate could be used as a therapy to treat CUD preventing some of the frequent relapses by improving their cognitive abilities. Further information and any related requests should be directed to and will be fulfilled by the lead contact, Prof. Amedeo Amedei amedeo. Inclusion and exclusion criteria and rTMS treatment protocol were reported in our previously published randomized controlled trials Scarpino, Lanzo et al. Before their processing, saliva samples were centrifuged in a 1. Briefly, 0. Afterwards, DNA was captured on a silica membrane in a spin column format, washed and eluted. This quality trimming has been evaluated separately for saliva and stool samples according to their specific average sequencing quality. Hence, ASVs amplicon sequence variants were generated, and the taxonomic assignments have been performed through a scikit-learn multinomial naive Bayes classifier trained on the SILVA database release The qualitative and quantitative evaluation of fecal short chain fatty acids SCFAs and medium chain fatty acids MCFAs was performed by Agilent gas chromatography-mass spectrometry GC-MS system composed with single quadrupole mass spectrometer, gas-chromatograph and autosampler, through our previously described method. Then, the obtained suspensions were sonicated for 5 min, centrifuged at rpm for 10 min and then the supernatants were collected. Subsequently, each tube was shaken in a vortex apparatus for 2 min and centrifuged at 10, rpm for 5 min. Lastly, the solvent layer was transferred to an autosampler vial and processed three times. The quantitative determination of both SCFAs and MCFAs in each sample was carried out by the ratio between the area abundance of the analytes and the area abundance of the respective labeled internal standard isotopic dilution method. The value of this ratio was named Peak Area Ratio PAR and it was used as the abundance of each analyte in the quantitative evaluation. The target point of rTMS was the dorsolateral prefrontal cortex and the 5 cm method was employed. The methods for determining the position of the primary motor cortex M1 area and the motor threshold will be repeated before each rTMS session. During the 15 rTMS treatment sessions, the rMT was measured daily for each participant to ensure safety and efficacy. Statistical analyses on the bacterial communities were performed in R 4. PCoAs were performed on proportional count data of each sample, adjusted with square root transformation while at the different taxonomic ranks, the differential analysis of abundance was performed with DESeq2 on raw count data. Differential abundances of predicted pathways among healthy controls and cocaine consuming users were determined and displayed using LefSe linear discriminant analysis effect size tool on the Galaxy platform. Moreover, the software GraphPad Prism v. Mann-Whitney test was used to assess differences between unpaired samples while Wilcoxon signed-rank test was used for paired statistical analysis. Conceptualization, E. Any additional information required to reanalyze the data reported in this paper is available from the lead contact upon request. This section collects any data citations, data availability statements, or supplementary materials included in this article. As a library, NLM provides access to scientific literature. Oral and fecal microbiota perturbance in cocaine users: Can rTMS-induced cocaine abstinence support eubiosis restoration? Find articles by Elisabetta Gerace. Find articles by Simone Baldi. Find articles by Maya Salimova. Find articles by Leandro Di Gloria. Find articles by Lavinia Curini. Find articles by Virginia Cimino. Find articles by Giulia Nannini. Find articles by Edda Russo. Find articles by Marco Pallecchi. Find articles by Matteo Ramazzotti. Find articles by Gianluca Bartolucci. Find articles by Brunella Occupati. Find articles by Cecilia Lanzi. Find articles by Maenia Scarpino. Find articles by Giovanni Lanzo. Find articles by Antonello Grippo. Find articles by Francesco Lolli. Find articles by Guido Mannaioni. Find articles by Amedeo Amedei. Open in a new tab. Similar articles. Add to Collections. Create a new collection. Add to an existing collection. Choose a collection Unable to load your collection due to an error Please try again. Add Cancel. Saliva and stool samples from patient with cocaine use disorder, pre- and post- rTMS intervention. Bolyen et al. Martin et al. Callahan et al. Douglas et al. McMurdie and Holmes Love et al. Dixon Wickham Galili Segata et al. Cat Q Gas chromatography-mass spectrometry system composed with single quadrupole mass spectrometer, gas-chromatograph and autosampler.
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